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Endocrine - DVR > 159b Endo Pharm > Flashcards

159b Endo Pharm Flashcards

1
Q

Desmopressin - Rx?

A

ADH analog (much stronger antidiuretic than pressor)

longer half life

Rx -central DI, vWF disease

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2
Q

ADH receptors?

A

GPCR

V1 –> PLC –> Ca –> vasoconstriction, CNS side effects

primary V2 –> adenylate cyclase –> increase cAMP –> aquaporin + clotting factors (VIII and vWF)

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3
Q

ADH uses?

A

central diabetes insipidus (along with desmopressin)

stop bleeding from esophageal varices

hemophilia A and VW disease

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4
Q

ADH side effects

A

vasoconstriction via V1 –> careful in those with CAD

nausea, cramps, headaches, allergies

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5
Q

treatment of lithium induced/nephrogenic DI?

A

Thiazide diuretics (also increase Ca reabsorption)

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6
Q

SIADH treatment - mechanism and drug names?

A

ADH receptor antagonists

conivaptan
tolvaptan (V2>V1)

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7
Q

oxytocin - mechanism

A

G-prtn –> PLC –> increases Ca –> contraction
of uterus and myoepithleial

increases prostaglandins and leukotriences

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8
Q

GH - replacement drugs?

A

somatropin –> identical to GH

somatrem –> longer half life

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9
Q

GH: + and - regulators

A

+ GHRH

  • somatostatin, dopamine, GH, IGF-1
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10
Q

GH mechanism?

A

tyrosine-kinase linked receptors –> dimerize –> JAK activation –> STAT proteins

increases IGF-1 release from liver which causes most effects

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11
Q

oxytocin use

A

induce labor

pospartum to control uterine hemorrhage

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12
Q

oxytocin adeverse effects?

A

uterine rupture, fetal distress

high doses –> activates ADH receptors

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13
Q

GH action

A

stimulates long bones
increases muscle mass
decreases central fat
reduces sensitivity to insulin

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14
Q

IGF-1 agonists, use

A

Mecasermin (meca - sir - min)

mecasermin rinfabate - longer half life

GH resistance deficiencies

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15
Q

GH uses?

A 
kids with deficiency
short stature (turner, prader-willi, etc.)
AIDS wasting
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16
Q

effects of octreotide

A

inhibits GH
inhibits TSH, ACTC, glucagon, gastrin, insulin

Rx for acromegaly, hormone-secrteting tumors, secratory diarrhea

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17
Q

Pegvisomant

A

modified GH

causes receptor dimerization but blocks activation of JAK-STAT pathway

Rx for acromegaly

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18
Q

dopamine agonists to treat GH excess?

A

bromocriptine
cabergoline

also inhibit prolactin

RX for acromegaly and prolactinoma

19
Q

GH side effects

A 
athralgias, myalgias
peripheral edema
carpal tunnel
increacranial htn
instulin resistance
20
Q

generic names for TH

A

t4= levothroxine

t3=liothyronine

21
Q

TH mechanism

A

nuclear receptor –> heterodimers –> regulate genes

unligated receptors acts a repressor at gene

22
Q

IGF-1 agonists adverse effects

A

hypoglycemia, lipohypertrophy
scoloiosis
dont give to patients with cancer

23
Q

adrenal steroids mechanisms

A

receptors in cytoplasm

release hsp90 –> exposes dna binding domain and translocation to nucleus

24
Q

liver glucocorticoids affects

A

conservation of glucose –> promote glycogen synthesis (anabolic) and gluconeogenesis to protect brain

25
Q

glucocorticoid connect tissue affect and fat

A

decreases fibroblasts

decreases protein synthesis and increases breakdown –> need fuel for gluconeogenesis in liver

increases truncal obesity and fat redistribution

26
Q

kidney affect of steroids

A

increases Ca excretion, mineral corticoid activity –> K and H excretion, H retention

27
Q

immune sytem - steroids

A

decreases Ab production

decrease lymphocytes, cytokines, prostaglandings

28
Q

TH structure

A

idoinated peptides - from tyrosine residues on TG

29
Q

CNS - steroids

A

euphoria, depression, psychoses, sleep issues

30
Q

adrenal hyperfunction - rx drugs

A

somatostatin analogs (octreotide) –I ACTH

glucocorticoid synthesis inhibitors
metyrapone –I 11 hydroxylase
ketoconazole –I multiple steps

glucocorticoid receptor antagonist
mifepristone

31
Q

non-endocrine glucocorticoid use

A

antiinflammaroty
immunisuppressive
anticancer actions

32
Q

hyperthroidism Rx (drugs), radiation

A

thionamide durgs

propylthiouracil (PTU) –I TPO and 5’-deidonase
methimazole –I TPO

I131–> beta particles cause necrosis of cells; dont use in pregnant or nursing women

B-blockers (stops tachycardia, htn, a fib) propranolol also weakly –I t4–>t3

KI –> inhibits hormone release, TPO, prevents radioactive uptake of I to prevent throid cancer

33
Q

methimazole and PTU side effects

A

PTU - hepatotoxicity so use methimazole

both - agranulocytotis (look for fever –> get blood count)

34
Q

GI - steroids

A

thinning of mucus, increase pepsin and acid secretion, decrease Ca absoprtion

35
Q

stress response - steroids

A

increases CO, GFR

36
Q

mineralocorticoid action

A

DCT and collecting duct

37
Q

addison’s disease

A

adrenal doesn’t produce steroids–> weakness and hypotension

38
Q

CAH causes

A

deficient hydroxylases –> low glucocoritcoids –> no feedback –> high ACTH

39
Q

metyrapone

A

–I 11 hydroxylase

40
Q

mifepristone

A

glucocorticoid receptor antagonist

41
Q

ketoconazole

A

blocks glucocorticoid synthesis

42
Q

somatostain

A

suppresses ACTH

43
Q

glucocorticoid replacement

A

cortisol/hydrocortisone (100:1)
prednisone (400:0.8)
dexamethasone (2500:0)

(gluco:mineralo activity)

Endocrine - DVR (22 decks)

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