DOC/ indications (review lecture) Flashcards by Jeri Sheldon (AZ PA Mast 20)

PTH effects

increases serum calcium

by getting osteoblasts to release RANK-L (osteoclastic)

increases renal/GI (re)absorption of calcium

How well did you know this?

Not at all

Perfectly

repaglinide/nateglinide would mostly be used if

you want to give a sulfonylurea but can’t because of sulfa allergy

(meglitinide)

How well did you know this?

Not at all

Perfectly

Can also be used in ART to suppress LH and FSH

but GnRH antagonists preferred

leuprolide

goserelin

(long acting GnRH agonists)

How well did you know this?

Not at all

Perfectly

Treat Infertility (generally)

HMG (FSH analog)

HCG (LH analog)

How well did you know this?

Not at all

Perfectly

19-nortesterone

progesterone, medroxyprogesterone, megestrol acetate

contraception +/- estrogen

prophylactically to maintain pregnancy (and delay early contractions in at risk pregnancy)

How well did you know this?

Not at all

Perfectly

tolbutamide, chlorpropamide, tolazamide

glyburide, glimepride, glipizide

(sulfonylurea)

big A1C decrease

How well did you know this?

Not at all

Perfectly

calcium

alone will not prevent or tx osteoporosis

needed for other tx to work though

How well did you know this?

Not at all

Perfectly

estradiol/estrogens

oral contracetives

hormone replacement therapy

prostate CA

How well did you know this?

Not at all

Perfectly

reduced postpartum hemorrhage death

only used in combination

tranexamic acid

(anti-fibrinolytic)

How well did you know this?

Not at all

Perfectly

denosumab is used for

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

How well did you know this?

Not at all

Perfectly

vit D effects

increases serum calcium

by getting osteoblasts to release RANK-L (osteoclastic)

increases renal/GI (re)reabsorption of calcium

How well did you know this?

Not at all

Perfectly

Treat prostate cancer

leuprolide

goserelin

(long acting GnRH agonists)

Antiandrogen at beginning to prevent problems with initial surge of LH and FSH

How well did you know this?

Not at all

Perfectly

primary hypogonadism (to stimulate puberty) in girls

Conjugated estrogens

How well did you know this?

Not at all

Perfectly

delay labor- relax uterus

starting to be 1st line

nifedipine

(CCB)

How well did you know this?

Not at all

Perfectly

male infertility issues due to pituitary problem or hypothalamic hypogonadism

1st HCG- LH- given for up to a year

(stimulates testosterone)

2nd HMG- FSH- added for months

(stimulates spermatogenesis)

How well did you know this?

Not at all

Perfectly

decrease endometrial hyperplasia in HRT

19-nortesterone

progesterone, medroxyprogesterone, megestrol acetate

How well did you know this?

Not at all

Perfectly

Prevention of postmenopausal osteoporosis

Raloxifine

How well did you know this?

Not at all

Perfectly

Treat precocious puberty

leuprolide

goserelin

(long acting GnRH agonists)

cetrorelix

ganirelix

(GnRH antagonists)

How well did you know this?

Not at all

Perfectly

radioactive iodine 131

DOC for toxic nodular goiter

Low dose=hyperthyroid diagnosis

High dose=thryoid destruction (ablation)

hyperthyroid pts with heart dz that cannot tolerate sx

How well did you know this?

Not at all

Perfectly

delay labor- relax uterus

by reducing prostaglandins

indomethacin

(NSAID)

How well did you know this?

Not at all

Perfectly

in emergency in case of uterine rupture- relax uterus

nitroglycerin

How well did you know this?

Not at all

Perfectly

Preferred for suppression of LH and FSH in ART

cetrorelix

ganirelix

(GnRH antagonists)

How well did you know this?

Not at all

Perfectly

Hypoproteinemia of nephrosis

Negative nitrogen balance: debilitated post-op patients, Burns, Prematurity

Testosterone/methyltestosterone

How well did you know this?

Not at all

Perfectly

delay labor- relax uterus

preeclampsia

eclampsia

mag sulfate

How well did you know this?

Not at all

Perfectly

Off label \*T1DM\* oral drugs

acarbose miglitol alphaglucosidase inhibitors

"gliptins"

(DPP-4 inhibitors) medium A1C decrease

weak progestin + androgen for \*endometriosis\*

danazol

what do you give to a pt who wants a "bioidentical birth control"

natazia

**DOC for osteoporosis** in men and postmenopausal women Pagets disease

"dronates" | (bisphosphonates)

Treat endometriosis

## Footnote Long acting GnRH agonists: Leuprolide Goserelin GnRH Antagonists: Cetrorelix Ganirelix

estrogen dependent breast CA

tamoxifen

female infertility issues

in sequence: **1st- HMG- for 9-12 days** (develops ovarian follicles) **2nd- HCG- 1 dose** (helps to synthesize progesterone in corpus luteum)

**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)

propylthiouracil | (thioamide derivative)

Testicular deficiency

testosterone methyltestosterone

levothyroxine sodium

(T4) **hypothyroidism** (slow metabolic rate, hypothermia, sensitive to cold, fatigue, bradycardia, thick skin, low BP)

colesevelam

small decrease in A1C decreases LDL

abortion cervical ripening (gel form)

dinoprostone | (prostaglandin)

precocious puberty (males) VERY HIGH DOSE

spironolactactone

SPECIFICALLY TARGETS INSULIN RESISTANCE

pioglitazone rosiglitazone (thiazolidinones)

Fo prostate CA also when you initiate long acting GnRH agonists to suppress the initial surge of androgens

flutamide bicalutamide nilutamide (androgen receptor antagonist)

what do you give for: vasomotor problems: HA, hot flashes GU: dryness, painful sex osteoporosis heart disease

Hormone Replacement Therapy low dose **estrogens** + progesterone (combo to reduce ovarian hyperplasia) **ONLY BENEFICIAL FOR 1ST 5-10 YEARS OF MENOPAUSE**

bromocriptine mesylate

(dopamine agonist) small decrease in A1C reduces FA and TG levels good for the heart

**DOC- POST menopausal breast CA** 2nd line tx- progressive, refractory breast CA

**exemestane** anastrozole letrozole (aromatase inhibitor)

benign prostatic hyperplasia male pattern baldness

finasteride dutasteride (5 alpha reductase inhibitors)

metformin benefits

1st line- big decrease in A1C reduces glucose to euglycemic state good for heart- decreases MIs does not increase weight decreases mortality

**female hypopituitaryism**

Estrogens+ testosterone/methyltestosterone

"glutides" and exenatide benefits

(GLP-1 agonists) big decrease in A1C good for heart- decreases MI weight loss

propanolol

decrease hyperthyroidism sxs (tachycardia, wide pulse pressure, sensitivity to heat, tremor, fatigue, weight loss, diarrhea, increased sensitivity to adrenergic stimulation)

what do you give to girls who don't go through puberty

HRT estrogens + progesterone (combo to reduce ovarian hyperplasia) use low dose

decreases serum calcium stimulated by estrogen

Calcitonin

oxytocin

**DOC to induce labor** (after massage has been tried) prevent hemorrhage after delivery stimulate milk let down

**DOC for infertility in women**

Clomiphene Antagonist: hypothalamus: prevents negative feedback of Estrogen on GnRH, causing more LH and FSH. Agonist: elsewhere

**prevent hemorrhage after delivery or suction abortion** (by causing contractions) not first line (OT)

ergonovine maleate methylergonovine maleate (ergots)

abortion often used in combo w/misoprostol (PG)

mifepristone (anti-progestin, also antagonizes glucocorticoid receptors)

acarbose miglitol

\*T1DM\* and T2DM moderate A1C decrease alphaglucosidase inhibitors

"gliflozins"

(SGLT-2 inhibitors) medium A1C effect good for heart- decreases MI weight loss

pramlintide

(amylin like peptide) used in T1DM and T2DM small decrease in A1C weight loss

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)

liothyronine sodium

(T3) **myxedema coma or severe hypotension** (poorly responsive pt w/ thyroidectomy scar)

combo oral contraceptive that ## Footnote **reduces water retention** **reduces PMDD sxs**

drospirenone/ethinyl estradiol

pioglitazone rosiglitazone

(thiazolidinones) big decrease in A1C SPECIFICALLY TARGETS INSULIN RESISTANCE

Treats osteomalacia

Vitamin D (other: deficiency, rickets, familial hypophosphatemia, hypoparathyroidism)

**DOC for estrogen dependent breast CA**

tamoxifen (anti-estrogen) Agonist: uterus, bone Antagonist: breast

abortion- 2nd trimester

carboprost tromethamine (prostaglandin)

**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)

methimazole (thioamide derivatives)

prevents vertebral compression fractures, but doesn't seem to have an effect other types of fractures

calcitonin

**osteoporosis** not DOC but the **only anabolic menopausal tx**

teriparatide abaloparatide rhPTH (recombinant PTH)