DOC/ indications Flashcards
mag sulfate
delay labor- relax uterus
preeclampsia
eclampsia
clomiphene
(anti-estrogen)
DOC for infertility in women
(stimulates LH and FSH)
ergonovine maleate
methylergonovine maleate
(ergots)
prevent hemorrhage after delivery or suction abortion
(by causing contractions)
not first line (OT)
leuprolide
goserelin
(long acting GnRH agonists)
precocious puberty
prostate CA
endometriosis
(can also be used in ART to suppress LH and FSH
but GnRH antagonists preferred)
“gliptins”
(DPP-4 inhibitors)
medium A1C decrease
raloxifene
(anti-estrogen)
post menopausal osteoporosis
PTH effects
increases serum calcium
by getting osteoblasts to release RANK-L (osteoclastic)
increases renal reabsorption
increases GI absorption
acarbose
miglitol
T1DM and T2DM
moderate A1C decrease
colesevelam
small decrease in A1C
decreases LDL
HMG (FSH analog)
HCG (LH analog)
infertility
tamoxifen
(anti-estrogen)
DOC for estrogen dependent breast CA
pre and post menopause
indomethacin
(NSAID)
delay labor- relax uterus
by reducing prostaglandins
nitroglycerin
in emergency to delay labor- relax uterus
calcitonin effects
decreases serum calcium
stimulated by estrogen
“dronates”
(bisphosphonates)
DOC for osteoporosis
in men and postmenopausal women
pagets disease
metformin benefits
1st line- big decrease in A1C
reduces glucose to euglycemic state
good for heart- decreases MIs
does not increase weight
decreases mortality
pramlintide
(amylin like peptide)
used in T1DM and T2DM
small decrease in A1C
weight loss
testosterone
methyltestosterone
M- testicular deficiency
F- female hypopituitaryism (treated w/ both estrogens and androgens)
everyone- debilitated people (burns, preemies, post op pts)
vit D effects
increases blood calcium
by getting osteoblasts to release RANK-L (osteoclastic)
increases renal reabsorption
increases GI absorption
- works in conjunction w/ PTH*
- stimulates collagen synthesis in osteoblasts*
tolbutamide, chlorpropamide, tolazamide
glyburide, glimepride, glipizide
(sulfonylurea)
big A1C decrease
drospirenone/ethinyl estradiol
combo oral contraceptive that
reduces water retention
reduces PMDD sxs
nifedipine
(CCB)
delay labor- relax uterus
starting to be 1st line
calcium
alone will not prevent or tx osteoporosis
needed for other tx to work though
cetrorelix
ganirelix
(GnRH antagonists)
ART (suppresses LH and FSH)
endometriosis
prostate CA
carboprost tromethamine
(prostaglandin)
abortion- 2nd trimester
calcitonin
prevents vertebral compression fractures
propylthiouracil
(thioamide derivative)
for pregnant women with hyperthyroidism, Graves, toxic nodular goiter
(tachycardia, wide pulse pressure, sensitivity to heat, tremor, fatigue, weight loss, diarrhea, increased sensitivity to adrenergic stimulation)
radioactive iodine 131
DOC for toxic nodular goiter
LD for hyperthyroid diagnosis
HD for thryoid destruction (ablation)
hyperthyroid pts with heart dz that cannot tolerate sx
danazol
(weak progestin + androgen)
endometriosis
repaglinide
nateglinide
(meglitinide)
if you want to give a sulfonylurea but can’t because of sulfa allergy
liothyronine sodium
(T3)
myxedema coma or severe hypotension
(poorly responsive pt w/ thyroidectomy scar)
iodide
used prior to thyroidectomy (it decreases gland vascularity)
to prevent uptake of radioactive iodine
hyperthyroidism- short term effect
(tachycardia, wide pulse pressure, sensitivity to heat, tremor, fatigue, weight loss, diarrhea, increased sensitivity to adrenergic stimulation)
exemestane
anastrozole
letrozole
(aromatase inhibitor)
DOC- POST menopausal refractory breast CA
mifepristone
(anti-progestin, also antagonizes glucocorticoid receptors)
abortion
often used in combo w/ PG (RU-486)
what do you give to girls who don’t go through puberty
HRT
estrogens + progesterone
(combo to reduce ovarian hyperplasia)
use LD
“gliflozins”
(SGLT-2 inhibitors)
medium A1C effect
good for heart- decreases MI
weight loss
what do you give for:
vasomotor problems: HA, hot flashes
GU: dryness, painful sex
osteoporosis
heart disease
HRT
estrogens + progesterone
(combo to reduce ovarian hyperplasia)
use LD
ONLY BENEFICIAL FOR 1ST 5-10 YEARS OF MENOPAUSE
raloxifene
male infertility issues due to pituitary prob or hypothalamic hypogonadism
(ART)
1st HCG- LH- given for up to a year
(stimulates testosterone)
2nd HMG- FSH- added for months
(stimulates spermatogenesis)
teriparatide
abaloparatide
rhPTH
(recombinant PTH)
osteoporosis
not DOC but the
only anabolic menopausal tx
what do you give to a pt who wants a “bioidentical birth control”
natazia
pioglitazone
rosiglitazone
(thiazolidinones)
big decrease in A1C
SPECIFICALLY TARGETS INSULIN RESISTANCE
levothyroxine sodium
(T4)
hypothyroidism
(slow metabolic rate, hypothermia, sensitive to cold, fatigue, bradycardia, thick skin, low BP)
vit D
prophylaxis of osteomalacia
estrogen dependent breast CA
tamoxifen
bromocriptine mesylate
(dopamine agonist)
small decrease in A1C
reduces FA and TG levels
good for the heart
propanolol
decrease hyperthyroidism sxs
(tachycardia, wide pulse pressure, sensitivity to heat, tremor, fatigue, weight loss, diarrhea, increased sensitivity to adrenergic stimulation)
“glutides” and exenatide
benefits
(GLP-1 agonists)
big decrease in A1C
good for heart- decreases MI
weight loss
finasteride
dutasteride
(5 alpha reductase inhibitors)
benign prostatic hyperplasia
male pattern baldness
female infertility issues
(ART)
in sequence:
1st- HMG- for 9-12 days
(develops ovarian follicles)
2nd- HCG- 1 dose
(helps to synthesize progesterone in corpus luteum)
tranexamic acid
(anti-fibrinolytic)
reduced postpartum hemorrhage death
flutamide
bicalutamide
nilutamide
(androgen receptor antagonist)
prostate CA
also when you initiate long acting GnRH agonists to suppress the initial surge of androgens
estradiol
estrogens
oral contracetives
hormone replacement therapy
primary hypogonadism (to stimulate puberty)
prostate CA
19-nortesterone
progesterone, medroxyprogesterone, megestrol acetate
contraception +/- estrogen
decrease endometrial hyperplasia in HRT
prophylactically to maintain pregnancy (and delay early contractions in at risk pregnancy)
methimazole
(thioamide derivatives)
DOC for hyperthyroidism and Graves
also for toxic nodular goiter
(tachycardia, wide pulse pressure, sensitivity to heat, tremor, fatigue, weight loss, diarrhea, increased sensitivity to adrenergic stimulation)
denosumab
osteoporosis in postmenopausal women and men at high risk of fractures
in review she said it was also good for osteoporosis prevention in CA pts
dinoprostone
(prostaglandin)
abortion
cervical ripening (gel form)
spironolactactone
hirsutism
precocious puberty
VERY HIGH DOSE
oxytocin
DOC to induce labor (after massage has been tried)
prevent hemorrhage after delivery
stimulate milk let down
breast CA:
1st, 2nd, 3rd line
DOC- tamoxifen
2- exemastane, anastrozole, letrozole (but not in premenopause)
3- fulvestrant
DM agents’ A1C… high to low effect
high
metformin, GLP-1, sulfonylureas, thiazolidinones
med
DPP-4, SGLT-2
low
acarbose, miglitol, bromocriptine, repaglinide, nateglinide, pramlintide
order of drugs for postpartum hemorrhage
1- massage
2- OT
3- ergots
4- tranexamic acid (anti-fibrinolytic)
drugs for abortion
dinoprostone
carboprost tromethamine
mifepristone
drug for placenta delivery
ergots
