Drugs

Question 1

Digoxin

Answer 1

Supposed heart medication

Complications in elderly

Question 2

Hydroxychloroquine and Azithromycin

Answer 2

Supposed COVID-19 medication

Question 3

Cortisol

Answer 3

Adrenal cortex steroid hormone

Glucocorticoid

Anti-inflammatory (suppress transcription of COX2) and Catabolic effects

Question 4

Aldosterone

Answer 4

Adrenal cortex steroid hormone

Mineralcorticoid

Increase salt/water reabsorption and increase blood volume/pressure

Question 5

Cortisone

Answer 5

Inactive cortisol

Question 6

11beta-hydroxysteroid dehydrogenase, type 1

Answer 6

Activates cortisol (adipose, muscle, liver, glucocorticoid targets)

Converts cortisone into cortisol

Question 7

Prednisone

Answer 7

Glucocorticoid, Prodrug

Oral intake, small topical effect

Question 8

Prednisolone

Answer 8

Glucocorticoid, Strong topical effect
Active form of prednisone

Activated by first pass metabolism

Question 9

11beta-hydroxysteroid dehydrogenase, type 2

Answer 9

Inactivates cortisol (Kidney cells, mineralocorticoid targets)

Question 10

Glucocorticoids / Anti-inflammatory

Answer 10

Suppress transcription of COX-2 gene, affecting early on in inflamation

Question 11

Annexin A-I

Answer 11

Lipocortin

Inhibits Leukocytes tissue infiltration

Suppress phospholipase A2 activity –> No arachidonic acid, very powerful and broad effects

Question 12

Cyclosporine

Answer 12

Calcineurin Inhibitor

Binds to cyclophilin

Inhibits calcineurin, NFAT is not phosphorylated, no expression of IL-2, no proliferation of T-cells

Question 13

Tacrolimus

Answer 13

Calcineurin Inhibitor

Binds to FKBP

Inhibits calcineurin, NFAT is not phosphorylated, no expression of IL-2, no proliferation of T-cells

Question 14

FKBP

Answer 14

Forms complex with tacrolimus

Forms complex with rapamycin

Question 15

Cyclophilin

Answer 15

Forms complex with cyclosporin

Question 16

Rapamycin

Answer 16

AKA sirolimus
Proliferation Signal Inhibitors

Binds to FKBP

Inhibits mTOR suppressing downstream effects of IL-2 receptor activation, preventing cell growth and division

Question 17

Cyclophosphamide

Answer 17

Cytotoxic agent (alkylating agent)

Causes cross-linking of neighbouring bases, interferes with DNA replication

Question 18

Azathioprine

Answer 18

Cytotoxic agent

Metabolized to 6-mercaptopurine (6-MP)

Fraudulent nucleotide prevents synthesis of nucleotides and interferes with cell division

Question 19

Alemtuzumab

Answer 19

Humanized IgG1 binds CD52

Labels phagocytic immune cells early in immune response targets them for destruction by lysis or phagocytosis

Destructive

Question 20

Basiliximab

Answer 20

Chimeric mouse-human IgG1 binds to CD25

IL-2 antagonist prevents binding to lymphocytes, immunosuppresion

Question 21

Retinoic Acid Receptor

Answer 21

T3 binding to nucleus causes recruitment of RXR to form a heterodimer with the thyroid hormone receptor

Recruits co-activators leading to enhanced transcription of target genes

Question 22

Levothyroxine

Answer 22

Synthetic T4, used to treat hypothyroidism

Question 23

Methimazole

Answer 23

Thioamide

Prevents condensation and coupling step by binding to thyroperoxidase

Question 24

RANKL

Answer 24

Secreted by osteoblasts and activates osteoclasts to break down bone and release calcium (resorption)

Question 25

Parathyroid Hormone

Answer 25

Peptide Hormone Bone resorption: Calcium and Phosphate Kidney Reabsorption: Calcium Kidney Excretion: Phosphate Stimulates Vit D processing

Question 26

Calcitriol

Answer 26

1,25-dihydroxycholecaliferol / 1,25-hydroxy vitamin D3 Active metabolite, steroid hormone Released when PTH present and Low Calcium levels Increase Kidney reabsorption of Calcium and Phosphate Increase Gut reabsorption of Calcium and Phosphate Increase Bone resorption of Calcium and Phosphate

Question 27

Secalciferol

Answer 27

24,25-hydroxy D3 Weak activity, steroid hormone Released when 1,25-OH-D3 is present and High Calcium levels

Question 28

FGF23

Answer 28

Anti-PTH effects Inhibit bone reabsorption Inhibit D3 metabolism Inhibit PTH production

Question 29

Calcitonin

Answer 29

Secreted from thyroid Inhibit bone resorption Inhibit calcium and phosphate reabsorption in Kidney

Question 30

Glucocorticoids / Calcium

Answer 30

Blocks calcium reabsorption in gut Blocks calcium reabsorption in kidney Prolonged use can cause osteoporosis

Question 31

Estrogens / Calcium

Answer 31

Prevent bone loss Prevents PTH bone resorption

Question 32

Calcimimetics

Answer 32

Mimics the effect of calcium to cause negative feedback on parathyroid

Question 33

Teriparatide

Answer 33

Recombinant PTH 1-34 fragment Activates primarily osteoblasts, activating RANKL, activating osteoclasts Does not last long enough for osteoclast activity, requires proper timing of dosages to favour osteoblast activity

Question 34

Alendronate

Answer 34

Bisphosphonate Inhibit osteoclast resorption of bone and has toxic effects on osteoclasts May also inhibit glucocorticoid effects High affinity for Ca2+

Question 35

Osteoprotegerin

Answer 35

Competes with osteoclasts RANK receptors Binds to RANKL to prevent activation of osteoclasts and bone resorption

Question 36

Denosumab

Answer 36

Monoclonal antibody Competes with osteoclasts RANK recepors Binds to RANKL to prevent activation of osteoclasts and bone resorption