what regular activity is the most important and recommended in the patient with diabetes mellitus☆daily foot inspection
→clinicians are advised to complete comprehensive foot examinations annually on all diabetic patients, who should in turn be instructed on prophylactic foot care for trauma or infection (eg. wash and closely examined daily, change fitting socks daily, trim nails to the shape of the toe) endocrinologyUWorld SIM1 HirotoShishido
patiromer
mechanism, clinical use, adverse effecta nonabsorbable cation exchange resin that binds colonic potassium in exchange for calcium, trapping potassium within the resin where it is then excreted in the feces.
often used for treatment of ★chronic hyperkalemia. (however, onset of action takes several hours, so it is not recommended as monotherapy in acute hyperkalemia)
GI disturbance, hypercalcemia, hypokalemia, hypomagnesemia
hypothyroidism and T3synthetic T3 (liothyronine) is not recommended for the routine treatment of hypothyroidism, as it has a short half-life and patients can experience wide fluctuations in plasma T3 levels
three types of chronic gout drugsxanthine oxidase inhibitors
-allopurinol
(oxypurinol)
-feboxostat
uricosuric medication
-probenecid
-sulfinpyrazone(not used in Japan)
→☆dosage adjustment for penicillin
(because organic anion transporter(OAT) is inhibited in the proximal convoluted tubule, and inhibits secretion of penicillin)
hormones associated with intracellular receptorsteroids hormones(aldosterone, cortisol,gonadotropin),
vitamin D (cholecalciferol,ergocalciferol,calcitriol)
thyroid hormone endocrinology HirotoShishido
two diseases the risk of which is increased by Hashimoto diseaseceliac disease
type Ⅰ diabetes mellitus endocrinology HirotoShishido
small cell carcinoma
hormone productionACTH→Cushing syndrome
ADH→SIADH
Antibodies against presynaptic Ca2+ channel→Ach release is affected→weakness on the lower extremities(Lambert-Eaton myasthenic syndrome) endocrinologyrespiratoryneurology HirotoShishido
metformin
mechanism,adverse effects(biguanides)
inhibit hepatic gluconeogenesis (especially from lactate to glucose)+↓insulin resistance=☆↑peripheral glucose uptake,↓intestinal glucose uptake
lactate accumulation→lactic acidosis
B12 deficiency
use with caution in renal insufficiency
weight loss(desired)
function of human placental lactogen(hPL)Stimulates insulin production; ☆increased overall insulin resistance.
Gestational diabetes can occur if maternal pancreatic function cannot overcome the insulin resistance.
