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Chlorpropamide and Tolbutamide (Orinase) (1st Generation Sulfonylureas)
Mechanisms
1st Generation Sulfonylureas
Stimulate Release of Insulin
Indications
Type 2 Diabetes
Side Effects
Hypoglycemia
Possible Cardiovascular Toxicity
Weight Gain
Considerations
Exacerbated Hypoglycemia with Beta-blockers
Avoid During Pregnancy and Breast Feeding
Avoid Alcohol
2 mins
Glyburide and Glipizide (2nd Generation Sulfonylureas)
Mechanisms
2nd Generation Sulfonylureas
Blocks Potassium Channels in Beta Cells
Stimulate Release of Insulin
Indications
Type 2 Diabetes
Side Effects
Hypoglycemia
Considerations
More Potent
Beta Blockers Reduce Effects
Avoid Alcohol
Avoid Breastfeeding
2 mins
Sitagliptin (Januvia) and Saxagliptin (Onglyza) (DPP-4 Inhibitors)
-gliptin Suffix
Mechanisms
DPP-4 Inhibitor
Increases Insulin Release
Indications
Type 2 Diabetes
Side Effects
Pancreatitis
Upper Respiratory Infection and Inflammation
Stevens-Johnson Syndrome
Considerations
Used as Add-on Agents
2 mins
SGLT2 Inhibitors
"-gliflozin" Suffix
Mechanism of Action
Blocks Glucose Reabsorption in Proximal Tubule
Indications
Type 2 Diabetes Mellitus
Side Effects
Weight Loss
Lower Blood Pressure
Hyperkalemia
Urinary Tract Infections (UTIs)
Considerations
Contraindicated in Chronic Kidney Disease
1 min
Levothyroxine
Indications
Hypothyroidism
Myxedema Coma
Mechanism of Action
Isomer of Thyroid Hormone (T4)
T3 has Higher Potency
Side Effects
Hyperthyroid Symptoms
57 secs
Propylthiouracil (PTU) and Methimazole (MMI)
Indications
Hyperthyroidism
Mechanism
Inhibits Thyroid Peroxidase
PTU Blocks Peripheral Conversion of T4 to T3
Side Effects
Agranulocytosis
Skin Rash
Hepatotoxicity (PTU)
Teratogen (MMI)
1 min
Hyperthyroidism Interventions
Drug Therapy
Propylthiouracil (PTU)
Methimazole (Tapazole)
Iodine
Beta Blockers
Other Therapies
Radioiodine Ablation
Thyroidectomy
Complications
Thyrotoxicosis
Post-Surgery Hypocalcemia
2 mins
Hypothyroidism Intervention
Medications
Levothyroxine (Synthroid)
Liothyronine (Cytomel)
Complication
Myxedema Coma
Nursing Considerations
Lifelong Replacement Hormone
Monitor Vital Signs
Fluids and Fiber
Low Calorie, Low Fat Diet
Medication Education
No Switching Brands
2 mins
Benzodiazepines Overview
Indications
First Line for Status Epilepticus
Anesthesia Induction
Anxiety
Eclampsia
Detoxification
Mechanism of Action
'-zepam' and '-zolam' Suffix
Increase Frequency of Cl- Channel Opening
Side Effects
Decrease REM Sleep
CNS Depression
Dependence
Antidote
Flumazenil for Overdose
2 mins
Raloxifene
Mechanism of Action
Selective Estrogen Receptor Modulator (SERM)
Agonist in Bone
Antagonist in Breast and Uterus
Indications
Osteoporosis
Breast Cancer Prophylaxis
Uterine Fibroids
Side Effects
Hot Flashes
Thromboembolism
2 mins
Buspirone
Indications
Generalized Anxiety
Mechanism of Action
Releases Dopamine and NE
Stimulates 5-HT1A receptors
Side Effects
Low Side Effect Profile
Safer with Alcohol than Other Anxiolytics
1 min
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