12 - Endocrine Flashcards

1
Q
  • Recombinant GH

- increases release of IGF-1 in liver and cartilage

A

Somatropin

- given SC

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2
Q

Recombinant IGF-1 agonist

- for children unresponsive to GH therapy

A

Mecasermin

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3
Q

GH receptor antagonist

- for acromegaly

A

Pegvisomant

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4
Q

Somastostatin analogue

- suppresses the release of GH, glucagon, insulin, gastrin, IGF-1, serotonin and GI peptides

A
  • octreotide

- lanreotide

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5
Q

FSH analog

A
  • Follitropin Alfa
  • Follitropin Beta: recombinant FSH forms
  • Menotropin (hMG)
  • Urofollitropin: purified preparation from urine of postmenopausal women
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6
Q

LH analog

A
  • Choriogonadotropin Alfa: recombinant hCG
  • hCG: given IM
  • hMG: mixtures of FSH and LH from postmenopausal womeb
  • Lutropin Alfa: recombinant LH
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7
Q

GnRH analog

A

Leuprolide
- long agonist activity

Other names:

  • leuprorelin
  • leuprolin
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8
Q

Time of administration of Leuprolide to increase LH and FSH secretion

A

Intermittent

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9
Q

Time of administration of Leuprolide that reduce LH and FSH secretion

A

Prolonged and continuous

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10
Q

Remedy for apoplexy and blindness during forst few weeks of therapy (Leuprolide) and temporary exacerbation of precocious puberty or prostate CA

A

Flutamide

  • co-administer
  • androgen receptor antagonist
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11
Q

Synthetic human GnRH

A

Gonadorelin

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12
Q

GnRH antagonist

A

Ganirelix

- prevent LH surge in controlled ovulation

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13
Q

GnRH antagonist for prostate CA

A

Degarelix

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14
Q

Dopamine agonist

- inhibits prolactin release

A

Bromocriptine

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15
Q

SE of bromocriptine

- burning pain and warmth and redness of the extremities

A

Erythromelalgia

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16
Q

Activates oxytocin receptors

  • for labor induction,
  • control of postpartum hemorrhage
A

Oxytocin

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17
Q

Oxytocin receptor blocker

A

Atosiban

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18
Q

Agonist of peripheral oxytocin receptors

A

Carbetocin

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19
Q

ADH agonist relatively selective to V2

A

Desmopressin

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20
Q

ADH Antagonist at V1A and V2 receptors

A

Conivaptan

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21
Q

This may occur with rapid correction of hyponatremia

A

Central pontine myelinolysis

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22
Q

ADH antagonist that is more selective for V2

A
  • Tolvaptan

- Lixivaptan

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23
Q

Thyroid drug that has 4:1 ratio of T4:T3

A

Liotrix

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24
Q

Recombinant human TSH

A

Thyrotropin

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25
Q

Thyroid drug that has faster onset but shorter half- life

A

Liothyronine (T3)

Compared to
Levothyroxine (T4)

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26
Q
  • inhibits thyroid peroxidase reactions
  • blocks iodine organification
  • inhibits peripheral conversion of T4 to T3
A

PTU

  • DOC for pregnant
  • short FOA
  • slow onset of action
  • more strongly protein bound
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27
Q
  • inhibits thyroid peroxidase

- blocks organification

A

Methimazole

  • DOC for non-pregnant
  • prenatal exposure: Aplasia Cutis Congenita
  • 10x more potent
  • slower excretion
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28
Q

Mainstay of treatment of postpartum hyperthyroidism, in particular during lactation

A

Methimazole

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29
Q

Related to choanal and esophageal atresia

A

Methimazole

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30
Q

Emits beta rays causing destruction of thyroid parenchyma

A

RAI 131I

  • preferred for nost patients
  • C/I: pregnant or nursing mothers

Patients shoulf be euthyroid or on BB before RAI

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31
Q

Onset of action of RAI

A

6-12 weeks

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32
Q

Max effect seen of RAI

A

3-6 months

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33
Q

Thyroid CA associated with radiation exposure

A

Papillary thyroid CA

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34
Q
  • Inhibits iodine organification and hormone release

- reduce size and vascularity of thyroid gland

A

Potassium iodide

- Lugol’s solution/KISS

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35
Q

Acts through inhibition of thyroglobulin proteolysis

A

Potassium Iodide

  • should not be used alone
  • prevents radiation-infuced thyroid damage
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36
Q

Ingestion of iodine causes HYPOTHYROIDISM

A

Wolf-Chaikpff effect

37
Q

Ingestion of iodine cause HYPERTHYROIDISM

A

Jod-Basedow

- seen in thyroid-deficient

38
Q
  • inhibits peripheral conversion of T4 to T3
  • control HR and other cardiac abnormalities
  • slows pacemaker activity
A

Propanolol

39
Q

May be used to treat thyrotoxicosis-related arrhythmias

A

Emsolol

40
Q

Drugs inhibit peripheral conversion of T4 to T3

A
  • PTU
  • Propanolol
  • Htdrocortisone
41
Q

Controls severe cardiovascular manifestations of Thyroid storm

A

Propanolol

42
Q

Protects against shock and also blocks peripheral conversion of T4 to T3

A

Hydrocortisone

43
Q

Drug-induced hyperthyroidism

A

CAM

  • Clofibrate
  • Amiodarone
  • Methadone
44
Q

Block uptake of iodide by the gland through competitive inhibition of iodide transport mechanism

A
  • perchlorate
  • pertechnetate
  • thiocyanate
45
Q

Prototype glucocorticoid

A

Hydrocortisone (cortisol)

46
Q

Glucocorticoid with highest anti-inflammatory potency

A

Betamethasone

47
Q

Mineralocorticoid with highest salt-retaining potency

A

Fludrocortisone

48
Q

Active metabolite of prednisone

A

Prednisolone

49
Q

Term used for behavioral changes secondary to steroid use

A

Steroid rage

50
Q

Postcoital contraceptive used for emergency contraception (within 72°)

A

Levonorgestrel

  • activates estrogen and/or progesterone receptors
  • thickens cervical mucus
  • inhibits ovulation
51
Q

Estrogen ANTAGONIST in breast and CNS

Estrogen AGONIST in urerus, liver and bone

A

Tamoxifen

52
Q

Used for hormone-responsive breast CA, prophylaxis of breast CA

A

Tamoxifen

53
Q

Full estrogen receptor ANTAGONIST

No agonist effect

A

Fulvestrant

54
Q

Given for breast CA patients who are ER/PR (+)

A

Tamoxifen/toremifene

55
Q

Estrogen ANTAGONIST in breast, CNS, uterus

AGONIST in liver and bone

A

Raloxifene

56
Q

Used for osteoporosis and breast cancer prevention

A

Raloxifene

- preferred in patient with history of breast CA in the management of hot flushes

57
Q

Partial agonist of estrogen receptors in pituitary.
Reduces negative feedback by estradiol
Increase FSH and LH output

A

Clomiphene

58
Q

Used for induction of ovulation for those who want to get pregnant

A

Clomiphene

59
Q

Estrogen synthesis inhibitor by inhibiting aromatase

A

Anastrazole

- for breast CA and precocious puberty

60
Q

Irreversible inhibitor of aromatase (testosterone to estradiol)

A

Exemestane

61
Q

Ovarian inhibitor (antiandrogen)

  • weak cytochrome P450 inhibitor
  • partial agonist of progestin and androgen receptors
A

Danazol

For:

  • endometriosis
  • fibrocystic disease
  • hemophilis
  • angioneurotic edema

C/I: pregnancy and breastfeeding

May also act on glucocorticoid receptors

62
Q

Glucocorticoid synthesis inhibitor

- inhibits desmolase

A

Aminoglutethimide

For:

  • breast CA
  • Cushing syndrome
63
Q

Selective inhibitor of 11 hydroxylation interfering with cortisol anf corticosterone synthesis

A

Metyrapone

64
Q

DOC for pregnant wit Cushing syndrome

A

Metyrapone

65
Q

Glucocorticoid receptor antagonist

Progesterone receptor antagonist

A

Mifepristone

66
Q

Anabolic steroid androgen

- illegal performance enhancement drug in athletes

A

Oxandrolone

67
Q

Competitive antagonist at androgen receptor

- for prostate CA

A

Flutamide

68
Q
  • Antagonist at androgen receptor

- marked progestational effect that suppresses the feedback enhancement of LH and FSH

A

Cyproterone

For

  • hirsutism
  • decreases sexual drive in men
69
Q

Androgen synthesis inhibitor that inhibits 5 alpha-reductase (testosterone to dihydrotestosterone)

A

Finasteride/Dutasteride

For

  • BPH
  • male pattern baldness
  • hirsutism
70
Q

Rapid acting Insulin

A

LAG

  • lispro
  • aspart
  • glulisine
71
Q

Long acting insulin

A
  • Glargine
  • Lantus
  • Detemir
72
Q

Early morning hyperglycemia

3AM: hypoglycemia

7AM: hyperglycemia

A

Somogyi effect

73
Q

Treatment for Somogyi effect

A

Decrease evening insulin

SOMOGYI = SUMOBRA

74
Q

Early morning hyperglycemia

3AM: normal

7AM: hyperglycemia

A

Dawn phenomenon

75
Q

Treatment for Dawn phenomenon

A

Increase evening insulin

76
Q

Early morning hyperglycemia

3AM: hyperglycemia

7AM: hyperglycemia

A

Waning of Insulin Dose

77
Q

Treatment for waning of insulin dose

A

Increase evening insulin

78
Q

Early morning hyperglycemia

3AM: hyperglycemia

7AM: more hyperglycemia

A

Dawn + Waning

Increase insulin dose

79
Q

Perior in T1 DM when exogenous insulin requirements decrease due to an increase in endogenous production of insulin

A

Honeymoon period

80
Q

Antidiabetic drugs which causes weight gain

A

GITS

  • glinides (non-sulfonylurea insulin secretagogues)
  • insulin
  • TZD
  • SUR
81
Q

Antidiabetic agents which accelerates gastric emptying time

A
  • GLP 1 agonist
  • DPP4 inhibitor
  • pramlintide
82
Q

SUR that has the longest duration of action and disulfiram reaction

A

Chlorpropramide - 1st gen SUR

Disulfiram drugs
Clara took the Pre-Medical Test in the PM

  • chlorpropramide
  • cefoperazone
  • cefomandole
  • cefotetan
  • procarbazine
  • metronidazole
83
Q

MOA of SUR

A

Increase insulin secretion by closing ATP-sensitive K channels

84
Q

2nd gen SUR which has SE of cholestatic jaundice

A

Glibenclamide

- most notorious among 2nd gen SUR

85
Q

1st gen SUR which are highly protein bound

- compete wfor protein binding and may enhance hypoglycemic effects

A

Tolbutamide

Chlorpropamide

86
Q

Antidiabetic agents which mag cause hypoglycemia

A
  • insulin
  • SUR
  • glinides (less)
87
Q

MOA of glinides

  • repaglinide
  • nateglinide
  • mitiglinide
A
  • Increase insulin secretion by closing ATP-sensitive K channels
  • reduces circulating glucose
  • increases glycogen, fat and protein formation and gene regulation
88
Q

Glinide that has the least incidence of hypoglycemia and may be used in CKD patients

A

Nateglinide

89
Q

Has the lowest risk of developing hypoglycemia since they have a short duration of action

A

GLINIDES

Other drugs that cause hypoglycemia

  • insulin
  • SUR