1st class

Question 0

Sodium alendronate (?)

Answer 0

A= second generation bisphosphate, nitrogen-containing agent 
B= inhibits FPP (farnesyl pyrophosphate synthase) synthase enzyme in osteoclasts which prevents the biosynthesis of isoprenoid lipids (FPP) which further prevents osteoclastic activity and reduces bone resorption and turnover. In postmenopausal women it reduces he elevated rate of bone turnover leading to a net gain in bone mass
C= osteoporosis, Paget's disease,

Question 1

Calcium gluconas

Answer 1

A= calcium salt preparation (replacement therapy) B= calcium supplement, increase calcium levels in the body
C= hypocalemic tetany, acute hypocalcemia secondary to renal failure, hypoparathyroidism, premature delivery, poisoning with magnesium, oxalic acid, phosphates. Myasthenia gravis treatment, muscle cramps, rachitis, osteoporosis, allergic diseases, inflammation, increased permeability of bv

Question 2

Teriparatidum

Answer 2

A=recombinant form of PTH1-34
B= stimulates new bone formation and bone turnover by acting via its G protein- coupled receptors–> leading to increased bone mineral density
[calcitonin suppresses bone resorption]
C= osteoporosis in persons at risk for having a fracture, men with primary or hypogonadal osteoporosis

Question 3

Thiamine hydrochloride

Answer 3

A= vitamin B1, 
B= increases vit b1 conc levels
C= thiamine and niacin deficiencies, delirium, peripheral neuritis, korsakovs alcoholic psychosis, wernickes-korsakovs syndrome

Question 4

Isotretinoin

Answer 4

A= synthetic retinoid (vitA)
B= inhibits sebaceous gland size and function, It also reduces inflammation in moderate-severe inflammatory acne. Thought to act through RAR receptors--> synthesis of certain proteins that reduces sebaceous gland production and inhibits keratinization
C= severe nodular acne vulgaris

Question 5

Acitretin

Answer 5

A= synthetic retinoid (vit A)
B=The mechanism of action of acitretin is unknown, however it is believed to work by targeting specific nuclear receptors (retinoid receptors such as RXR and RAR) in the skin which help normalize the growth cycle of skin cells.
C= psoriasis, acne

Question 6

Calcitriol

Answer 6

A= active form of Vit D
B= regulates the gene transcription via the vit D receptor: stimulates intestinal calcium absorption, bone resorption, renal calcium and phosphate reabsorption, decreases PTH, promotes innate immunity and inhibits adaptive immunity
C= chronic kidney diseases, vit D deficiency, bone development disorders, osteoporosis, osteomalacia, renal failure, malabsorption, psoriasis

Question 7

Ethinylestradiol

Answer 7

A= steroid hormone, replacement therapy of estrogens active form estradiol
B= replacement therapy: Estrogens diffuse into their target cells and interact with a protein receptor. Target cells include the female reproductive tract, the mammary gland, the hypothalamus, and the pituitary. Estrogens increase the hepatic synthesis of sex hormone binding globulin (SHBG), thyroid-binding globulin (TBG), and other serum proteins and suppress follicle-stimulating hormone (FSH) from the anterior pituitary. This cascade is initiated by initially binding to the estrogen receptors. The combination of an estrogen with a progestin suppresses the hypothalamic-pituitary system, decreasing the secretion of gonadotropin-releasing hormone (GnRH).
C= hypogonadism, osteoporosis, regulation of menstrual cycle, breast cancer, as an oral contraceptive,

Question 8

Clomiphen

Answer 8

A= anti-estrogen, 
B= stimulates ovulation by affecting the negative feedback and therefore cause FSH and LH release. Clomiphen is a partial agonist at estrogen receptors --> increases the secretion of the gonadotropins and estrogens by inhibiting estradiols negative feedback on the gonadotropins
C= infertility, induction of ovulation (anovulation), POS, oligomenorrhoea/amenorrhoea

Question 9

Medroxyprogesteron

Answer 9

A= steroid hormone, synthetic progestin
B= acts through nuclear receptors causing selective inhibition of pituitary functions that results in inhibition of ovulation. 
C= oral contraceptive, hormone replacement therapy

Question 10

Dydrogesterone

Answer 10

A= steroid hormone, orally active progestogen
B=Dydrogesterone is a progestogen that works by regulating the healthy growth and normal shedding of the womb lining by acting on progesterone receptors in the uterus.
C=Used to treat irregular duration of cycles and irregular occurrence and duration of periods caused by progesterone deficiency. absent, irregular or painful menstrual periods, infertility, premenstrual syndrome and endometriosis. Also used to prevent natural abortion in patients who have a history of habitual abortions.

Question 11

Levonorgestrel

Answer 11

A=emergency contraceptive, steroid hormone, synthetic progestin
B=prevents ovulation and may inhibit fertilization or implantation: Binds to the progesterone and estrogen receptors. Target cells include the female reproductive tract, the mammary gland, the hypothalamus, and the pituitary. Once bound to the receptor, progestins like levonorgestrel will slow the frequency of release of gonadotropin releasing hormone (GnRH) from the hypothalamus
C= emergcency contraceptive(high dose) irregular cycle disorders (dose dependent), or in combination with other hormones as an oral contraceptive.

Question 12

Levonorgestrel/ Medroxyprogesteron

Answer 12

A= combined oral contraceptive, steroid hormones
B= acts through nuclear receptors causing selective inhibition of pituitary functions that results in inhibition of ovulation. Also produces a change in the cervical mucus, in the endometrium and in the motility and secretion in uterine tubes all of which decrease the likelihood of conception and implantation
C= oral contraceptive

Question 13

Testosterone

Answer 13

A= androgen,steroid hormone
B= acts on intracellular androgen receptors in target cells. In skin, prostate, seminal vesicles and epididymis its converted to its active form 5alphadihydrotestosterone. 
C= replacement therapy, erectile dysfunction due to hormonal disturbances (androgen replacement therapy in men), protein anabolic agent e.g. to promote growth after trauma

Question 14

Nandrolon

Answer 14

A= anabolic drug, steroid hormone with androgenic properties
B=Nandrolone is an androgen receptor agonist. The drug bound to the receptor complexes which allows it to enter the nucleus and bind directly to specific nucleotide sequences of the chromosomal DNA. The areas of binding are called hormone response elements (HREs), and influence transcriptional activity of certain genes, producing the androgen and anabolic effects.
C= stimulation of muscle growth after severe traumas, dystrophy and bone calcification disorders; osteoporosis, anemia treatment

Question 15

Cyproteron

Answer 15

A= anti-androgen, gestagen
B= blocks androgen receptors + combined contraceptive. In addition, cyproterone exerts a negative feed-back on the hypothalamo-pituitary axis, by inhibiting the secretion of luteinizing hormone resulting in diminished production of testicular testosterone
C= reduces testosterone levels in males with prostate cancer, hypersexuality in males, in women with hirsutism and severe acne

Question 16

Fludrocortison

Answer 16

A= mineralocorticoid with anti-inflammatory activity, synthetic corticosteroid
B= binds the mineralocorticoid receptor (aldosterone receptor). This binding (or activation of the mineralocorticoid receptor by fludrocortisone) in turn causes an increase in ion and water transport and thus raises extracellular fluid volume and blood pressure and lowers potassium levels. (Mineralocorticoids act on the distal tubules of the kidney to enhance the reabsorption of sodium ions from the tubular fluid into the plasma; they increase the urinary excretion of both potassium and hydrogen ions)
C= adrenal insufficiency, primary and secondary adrenocortical insufficiency in Addison's disease and for the treatment of salt-losing adrenogenital syndrome.