Drugs Flashcards
demeclocycline
-ADH antagonist–>causes Nephrogenic DI
conivaptan,tolvaptan,demeclocycline ?
-ADH antagonist.
-SIADH (volume overloas)–>salt tablets,IN Hypertonic fluids(3%solution), FLUID RESTRICTION.
Lactate Ringer and 5% Dextrose we give it what?
-273 osmolality.
What do you give for the following hypopituitarism?
-GH
-TSH
-ACTH
-
-GH
-Levothyroxine
-Hydrocortisone
-Hydrocortisone
Ocreotide?
-Somatostatin analog–>Pituitary Adenoma relating GH (ACromegaly and Gigantism)
Bromocriptine and Gabergolin ??
-Dopamine agonist
-Use for Prolactinoma.
Reserpine
-Dopamine inhibitor–>causes Prolactinoma
What is treatment for Acromegaly? (2)
-Ocreotide (Somatostatin analog)
-Pegvisomat (GH recep inhibitor)\
Ocreotide other function?
-Treat for Chronic Pancreatitis–>atrophy and calcification that lead to insufficency–>10% of pancrea is working and bot able to secrete H and reabs fat (includes vitamins).Giving drug decr pancreatic workload and help the pain
Where is IGF1 made?
-GH acts liver–>forms IGF1
Leuprolide
-GnRH agonist
Continous–>blocks–>BPH (think pathogenesis)
Pulsatile–>Stimulator.
-Leuprolide is a GnRH agonist used in the **treatment of men with prostate cancer. **Continuous use leads to downregulation of testosterone production. Initially, the agonist action increases testosterone, causing a tumor flare. To prevent this, flutamide, a competitive antagonist of the androgen receptor, is added until downregulation of testosterone is complete.
Mescarmine ?
-IGF-1 analog
-Laron Dwarfisim
Cosyntropin-
-Where do you give it?
Cosyntropin- ACTH agonist
-Diag ACTH defcicency (give it and see).
-Given to differentiate Primary and Secondary adrenal insufficency.
Atosiban
Follitropin-
Leuprolide-
Ganirelix
Bromocriptine
Atosiban - oxytocin and vasopressin antagonist
Follitropin-FSH agonist
Leuprolide- GnRH agonist–>**Pre-cocious puberty. **
Ganirelix – GnRH receptor blocker.Prevention of LH surge
Bromocriptine – D2 receptor agonist
Teriparatide/Naptara??
-Action depends on use: PTH analogs no matter what.
Long term–>bone resorption
Pulsatile (once a day/low dose)–>Bone deposition,Osteoporosis
R.F: incr bone tumors
Alendronate,ibandronate,risedronate*,zoledronate.
Bisphosphonates: inhibits osteoclast ctivity.
Use: Osteoporosis (along side Teriparatide)
,hypercalcemia,Paget disease of bone,metastatic bone disease,osteogenesis imperfecta
Esophagitis (if taken orally,patients are advised to take with water and remain upright for 30 minutes),osteo-necrosis of jaw,atypical femoral stress fractures.
-Esophagitis–>Hematemesis (due to blood in vomiting).
What do you give in patient with Hypocalcemia (CKD,osteoporosis,prevent postmenopausal osteoporosis,HypoPTH
Calcium oxalate and calcium carbonate
A.E:constipation.
Vit D medication and use?
-Cholecalciferol,Ergocarciferol,Calciderol (giving specially in renal insufficecny)
-Use:osteomalacia,ricktess,hypoPTH,vit D defic.
Denusumab
-Monoclonal antibody against RANKL (inhibits gene expression of osteoclast).Mimmics OPG.
Selective estrogen modulator that acts only on bone as agonits estrogen recept.
Raloxifine.
A.E:incr risk of thrombolytic events
-NO risk for endometrial cancer.
Sensitizes calcium-sensing receptor(CaSR) in parathyroid gland to circulating Ca2+ PTH.
Cinacalcet.
-USED:2°hyperparathyroidism in patients with CKD receiving hemodialysis,hypercalcemiain 1°hyperparathyroidism (if parathyroidectomy fails),or in parathyroid carcinoma.
A.E:hypocalcemia.
Levothyroxine (T4)
Liothyronine(T3)
Liotrix (mixed T3 and T4)
Synthetic Thyroid H, weight loss
-Liotrix serves NO other function.
Why Beta blocker like Propanol usefull for Hyperthyroidism?
Blocks effects of excessive Beta recep.
Inhibition of Thyroid peroxidase + 5 deodinase?
-PTU (Propilthirouracil)
-Used for Hyperthyroidism and 1Trimester of pregnancy
Thionamides??
PTU and methimazole
Both inhibit thyroid peroxidase.
AE: Skin rash,agranulocytosis(rare),aplastic anemia,hepatotoxicity.
PTU use has been associated with ANCA-positive vasculitis.
Methimazole is a possible teratogen (can cause aplasia cutis).
What do you treat a patient that comes with hyperthyroidsim and massive incr tempeture, Incr HR–>after acute infection?
-PTU,Prednisone,Iodine,Propanolol
Why PTU is not giving at 2-3 trimester?
-Is **hepatotoxicity. **
PTU and methimatozole mayor side effects?
and how can they present
-Agranulocytosis–> recurrent infections and aplastic anemia.
Methimazole not used in first trimester?
-Aplastic cutis (skin abnormalities),esophageal atresia, choanal atresia.
Finasteride??
-Inhb 5 alpha reductase.
-Given BPH and Hair growth.
Sevelamer??
-Inhib Phosphate reabsp in GI
-Used in CKD Hyperphosphatemia.
Flutamide??
GnRH recep blocker
-Prostate cancer.
What do we treat 1* Hyperaldosteronism?
Spironolactone
Dehidroepiandrosterone
Fludocortisone
Mifepristone
-Androgen agonist
-Minerocorticoid (Aldosterone) agonist.Used:Addison disease.
-Progesterone antagonist (used for abortions)
Metyrapone
11aBeta Hydroxylase inhb.(inhib cortisol syntjesis)
Metronidazole
AE
-Anti-protozoal (Trhiconamos Vaginalis, Bacterial Vaginosis)
-Forms free radicals in bacterial cell–>DNA strand breakage
-Used also in Bacteroides fragilis, Clostridium perfringens, Entamoeba histolytica, Giardia lamblia.
-AE–>Disulfiram Reaction
What bact. treats anaerobic infect above waist and what other treats below waits?
-Above–>Clindamycin
Below–>Metronidazole
Mescarmine
Methimazole
Metyrapone
Metronidazole
-IGF-1 analog
-Thyroid Peroxidase inhib.
-11 Beta Hydoxylase inhibitor
-Anti-tropozoal ( below diaphragm anaerobic organism)
What drugs incr Prolactin rel?
-OCP,Pregnancy–>estrogen
and Antipsycotics–> decr spermatogenesis and mestrual cycle.m
Which anti-psycotic is most likely to cause Hyperprolactenemia?
Haloperidol or rasperidone
Does Lithium have same effects?
Haloperidol–>Typical (2 gen)->higher affinity for D2 receptors.
-Liyhium is NOT a D2 blockers
Leupralide used (3)
-Prostatic Adenocarcinoma, Endometriosis, Precocius puberty.
-GnRH analog–>give it continously –>decr GnRH recep in hypothalamus–>decr LH and FSH–>DECR estrogen and testosterone.
