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pharmacology final ( 1st sem) > A: 12-15 > Flashcards

A: 12-15 Flashcards

1
Q

Thyroid preparations (2)

A

Levothyroxine

Iodine

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2
Q

Levothyroxine:
How to give?
When is the maximum effect?

A

Oral/IV

After 6-8 weeks

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3
Q

Daily requirement of Iodine

A

150 micro g

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4
Q

Iodine indications

A

Deficiency

Thyrotoxicosis crisis

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5
Q

Iodine side effects

A

Cutaneous and mucus membrane irritation
Allergic
Hypo/Hyper -thyroiditis

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6
Q

Antithyroid drugs MOA

A

Inhibit thyroid Peroxidase activity

Inhibit Deionidase

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7
Q

Antithyroid drugs (2)

A

Propylthiouracil (PTU)

Thi.amazole

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8
Q

Propylthiouracil (PTU)
Hoe to give
Duration of action

A

Oral

6-8 h

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9
Q

Propylthiouracil (PTU)
Methimazole

How long until they work? Why?

A

3-4 weeks

Since the realease of preformed hormones is not affected

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10
Q

Propylthiouracil (PTU) side effects

A 
Skin rash
GI
Vasculitis
Liver
Hypothyroidism
Lupus
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11
Q

Methimazole
Hoe to give
Duration of action

A

Oral

24 h

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12
Q

Which of them doesnt effect Deionidase?

Propylthiouracil (PTU)
Methimazole

A

Methimazole

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13
Q

Which of them is safe during pregnancy?

Propylthiouracil (PTU)
Methimazole

A

Propylthiouracil (PTU)

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14
Q

Methimazole side effects

A 
Skin rash
Nausea
Vasculitis
Agranulocytosis
Liver
Hypothyroidism
Lupus
Teratogenic
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15
Q

Somatostatin analoge

A

Octreotide

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16
Q

Dopamine D2-R agonist

A

Bromocriptine

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17
Q

Hypothalamic and Pituitary hormones- which drugs should I know?

A

Desmopresin (ADH)
Octreotide (GH antagonist)
Bromocriptine (D2-R agonis)
Oxytocin

DOB-O

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18
Q

Octreotide MOA

A

GH antaginist (Somatostatin anloge)

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19
Q

Octreotide indications

A

Control of bleeding in esophageal varices
Acromegaly
Gigantism
Endocrine tumors

CAGE

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20
Q

Octreotide side effects

A 
bradycardia
Cardiac conduction abnormalities
GI
Gall stones
Steatorrhea
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21
Q

Why will we see Gall stones when taking Octreotide?

A

Impaired pancreatic secretions

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22
Q

Which drug can suppress pituitary excretion of prolactin?

A

Bromocriptine

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23
Q

Bromocriptine indications

A

Prolactin secreting adenoma

Acromegaly

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24
Q

Bromocriptine side effects

A 
GI
Orthostatic hypotension
Headache
Psychiatric disturbance
Vasospasm
Pulmonary infiltrates in high dosage
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25
Q

How to give Oxytocin?

A

IV

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26
Q

Oxytocin indications

A

Induction of labor

Control of uterine hemorrhage after delivery

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27
Q

Oxytocin side effects

A 
Fetal distress
Placental abruption
Uterine rupture
Fluid retention
Hypotension
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28
Q

Oxytocin MOA

A

Mediates uterine contraction via activation of Oxytocin-R that are Gq coupled

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29
Q

Desmopressin MOA

A

Selective V2-R agonist

Synthetic analoge of ADH

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30
Q

Desmopressin indications

A

Central DI
Hemophilia A
Von-Willebrand disease

(increases insertion of water channels in CD in kidney; antiduiretic)
(extra-renal V2 receptors regulate release of cogulation factor 8 & von willebrand factor)

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31
Q

Desmopressin side effects

A

GI
Headache
Hypo-Natremia
Allergy

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32
Q

Rapid acting Insulin

A

Lispro
Aspart
glulisine

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33
Q

Lispro, aspart, glulisine Insulin
Onset of action
Peak
Duration

A

Onset of action: 10 min
Peak: 1 h
Duration: 3-4 h

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34
Q

Short acting Insulin

A

Regular Insulin

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35
Q

Regular Insulin
Onset of action
Peak
Duration

A

Onset of action: 30 min
Peak: 1-3 h
Duration: 4-8 h

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36
Q

Intermidiate acting Insulin

A

NPH (Isophan)

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37
Q

NPH (Isophan)
Onset of action
Peak
Duration

A

Onset of action: 1-2 h
Peak: 4-6 h
Duration: 8-12 h

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38
Q

Long Acting Insulin

A

gLArgine
detemir
degludec

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39
Q

Glargine
Onset of action
Peak
Duration

A

Onset of action: 2 h
Peak: Flat
Duration: 12-24 h

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40
Q

Rapid acting Insulin indications

A

Pre-parandial injection
contineous SC infusion devices
Emergency diabetic keto acidosis

41
Q

Short acting Insulin indications

A

Pre-parandial injection (S.C)
Emergancy keto acidosis (iv)
hyperkalemia (iv)

42
Q

Intermediate acting Insulin indications

A

Combined with short/rapid

43
Q

Long acting Insulin indications

A

For Basal Insulin levels

44
Q

What does human Inslin means?

A

Original AA sequence is not altered

45
Q

What does analogue Inslin means?

A

AA sequence has been modified to generate more long/short acting Insulin

46
Q

Insulin side effects

A

Hypoglycemia –> CNS
Injection site reaction
Edema

47
Q

Total daily Insulin needs in T1DM

A

~ 0.55 Unit/Kg

48
Q

Total daily Insulin needs in T2DM

A

> 1 Unit/Kg

49
Q

GLP-1 analogue

A

Liraglutide

50
Q

GLP-1 job?

A

Has the ability to decrease blood sugar levels in a glucose-dependent manner by enhancing the secretion of insulin

  • its released from bowel in response to food.
  • glucose-stimulated insulin release
  • retard gastric emptying
  • inhibit glucagon secretion
  • feeling of satiety
51
Q

GLP-1 and GIP are also called togather-

A

Incretins

52
Q

Which GLP-1 drug can cause weight loss?

A

Liraglutide

53
Q

Which DM patient will get Liraglutide

A

T2DM

54
Q

What effect will a contineous Sulfonylurea use have?

A

Enhances tissue response to Insulin

55
Q

Sulfonylurea 2nd generation

A

Glim.epi.rid

Glipi.zid

56
Q

Which drug group is like Sulfonylurea MOA but is not a Sulfa drug?

A

Meglitinide

57
Q

Meglitinides:

A

Rapeglinide

58
Q

Sulfonylurea administration

A

Oral

59
Q

Sulfonylurea side effects

A

Weight gain
Hypoglycemia
Skin Rash
Cardiovascular risk

60
Q

Meglitinides side effects

A

Hypoglycemia

61
Q

Meglitinides onset of action:

A

Meglitinides are more rapid than sulfonylurea

62
Q

Biguanides MOA

A
  • Activates AMPK –> Reduce hepatic & renal glucoNEO –> Post-parandial & fasting glucose level decrease
  • Decrease intestinal glucose absorption
  • Increase Insulin sensitivity
63
Q

Metformin elimination

A

Renal

64
Q

When does Metformin requires caution?

A

GFR < 45 mL/min/1.73 m2

Lower than 30 is contraindication

65
Q

Metformin indications

A

it is a BIGuanide

  • T2DM
  • Restore fertility in anovulatory women with PCOS
  • Weight reduction in obesity
  • Hyperinsulinemia
66
Q

Metformin side effects

A

GI

Lactic acidosis

67
Q

Incertins actions

A

Increase Insulin release
Decrease Glucagon release
Delayed gastric emptying
Satiety

68
Q

DDP-4 inhibitors

A

Vildagliptin

sitagliptin

69
Q

DDP-4 inhibitors side effects

A 
Headache
Rhinitis
nasopharyngitis (sitagliptin)
Upper respiratory tract infections
rare allergic rxn
70
Q

SGLT2 location

A

Proximal convoluted tubule

71
Q

When are SGLT2 inhibitors contraindicated?

A

Impaired renal function

72
Q

SGLT2 inhibitors side effects

A

Genitourinary infections

Osmotic diuresis

73
Q

a-glucosidase inhibitors

A

Acarbose

74
Q

Acarbose side effects

A

Hypoglycemia
Diarrhea
Abdomianl pain

75
Q

PTH effects in the kidneys

A

Decrease Ca2+ excretion
Increase Phosphate excretion
Vit. D synthesis

76
Q

PTH effects in the bones

A

Osteoclast and blast activation
Net bone resorption in high conc.
Net bone formation in low conc.

77
Q

PTH effects in the intestines

A

Ca2+ and Phosphate absorption mediated by Vit. D

78
Q

PTH analogue

A

Teriparatide

79
Q

How to give Teriparatide?

A

SC injection

80
Q

Teriparatide indications

A

Osteoporosis

81
Q

Teriparatide side effects

A

Hypercalcemia

Hypercalciuria

82
Q

Vit. D3 is also called

A

Cholecalciferol

83
Q

Cholecalciferol is given ____

Why?

A

Oral

Requires metabolism in liver (Calcifediol ) and kidney (calcitriol)to become the active form

84
Q

Cholecalciferol indications

A

Vit. D def.
osteoporosis
osteomalacia
psoriasis

85
Q

Cholecalciferol side effects

A

Hypercalcemia
Hyperphosphatemia
Hypercalciuria

86
Q

What is the effect of Vit. D on PTH?

A

Vit. D inhibits PTH release

87
Q

Calcitonin effects

A
  • decreases serum calcium and phosphate by:
  • inhibit bone resorption (Osteoclast activity)
  • Kidney: Ca2+ and Phos. excretion
88
Q

SERM used in Osteoporosis

A

Raloxifene

89
Q

What is the effect of Estrogen on bones?

A

Inhibition of PTH-stimulated bone resorption

90
Q

Raloxifene side effects

A

Hot flushes

Increased risk of thromboembolism

91
Q

Bisphosphonates MOA

A

-Direct suppression of osteoclasts
(Inhibition of farnesyl
pyrophosphate synthase enzyme)

-inhibits bone resorption

  • Rapid increase in bone mineral density in the first year
  • Later equilibrium
92
Q

Bisphosphonates:

A

Alendronate

Zoledronate

93
Q

Alendronate
Zoledronate

Indications

A

Osteoporosis

Paget’s disease

94
Q

Alendronate
Zoledronate

Side effects

A
  • Hypocalcemia
  • Adynamic bone
  • gastric + esophageal irritation (patients should drink a lot of water)
  • Osteonecrosis of the jaw (rare)
95
Q

RANKL inhibitors

A

Denosumab

96
Q

Denosumab

How to give and what is it?

A

SC injection every 6 months

IgG

97
Q

Denosumab indications

A

Post menopausal osteoporosis

98
Q

Denosumab side effects

A

Increase risk of infections

osteonecrosis of jaw (rare)

pharmacology final ( 1st sem) (15 decks)

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