Drugs

Question 1

Fludrocortisone

Answer 1

Mineralocorticoid agonist used in the treatment of chronic adrenal insufficiency and CAH
Acts through MC receptors to increase Na+ retention and secrete K+, H+

Question 2

Bromocryptine and cabergoline

Answer 2

Dopamine receptor agonist at anterior pituitary to block PRL and GH secretion (pituitary adenomas)

Cabergoline is used for Cushing’s as an ACTH antagonist

SE: orthostatic HTN, nausea , cardiac valvulopathy, psychiatric manifestations

Question 3

Wolff-Chaikoff Effect

Answer 3

Too much iodine can block thyroid gland function by inhibiting iodine coupling and blocking entry of DIT into the second site

Question 4

Assessing adequacy of corticosteroid replacement therapy

Answer 4

Disappearance of hyperpigmentation
Resolution of electrolyte abnormalities
Plasma ACTH levels should be used to assess overtreatment

Question 5

Jod-Basedow phenomenon

Answer 5

hyperthyroidism following administration of iodine

Question 6

Radioactive Iodine

Answer 6

Used to kill the thyroid in Graves’ disease, toxic nodules, and thyroid cancer

Question 7

Somatotropin

Answer 7

Recombinant GH used in patients with GH deficiency, Prader-Willi, Turner, Noonan, idiopathic short stature

Can cause pseudotumor cerebri, scoliosis, edema, hyperglycemia, carpal tunnel

Question 8

Mecasermin

Answer 8

Recombinant IGF-1 in children with growth failure from IGF-1 deficiency

Can cause hypoglycemia, so take with food

Question 9

Clinical use of gonadotropins

Answer 9

Stimulation of ovulation/spermatogenesis to address infertility

Used for controlled ovarian hyperstimulation with IVF

SE: ovarian hyperstimulation (ovarian enlargement, ascites, hydrothroax, hypovolemia), multiple pregnancies

Question 10

GnRH receptor antagonists

Answer 10

Ganirelix, cetrorelix, degarelix

Inhibit secretion of FSH and LH

Used for controlled ovarian hyperstimulation, advanced prostate cancer

Question 11

Oxytocin

Answer 11

Increases frequency and force of uterine contractions to induce labor

Synthetic oxytocin = pitocin

Question 12

KI

Answer 12

Used to achieve Wolff–Chaikoff Effect

Question 13

Growth Hormone

Answer 13

Aka somatotropin
Associated with JAK-tyrosine kinase receptor; stimulates liver to produce IGF-1

Used in GH deficiency or short stature unrelated to GH deficiency (Prader Willi, Turner, Noonan, idiopathic short stature)

SE:
Children: Pseudotumor cerebri (increased intracranial pressure), scoliosis, edema, hyperglycemia; check for deficiencies of other ant pit hormones
Adults: edema, myalgias, arthralgias,

Question 14

Ganirelix, cetrorelix, degarelix

Answer 14

GnRH receptor antagonists

Used in controlled ovarian hyperstimulation, advanced prostate cancer

Question 15

Metyrapone

Answer 15

Selective inhibitor or P450C11 to inhibit steriod biosynthesis (production of cortisol and aldosterone)
Treatment of Cushing’s

Question 16

Metyrosine

Answer 16

Competitively inhibits
tyrosine hydroxylase to lower BP associated with pheochromocytoma
Can cause extrapyramidal side effects

Question 17

Pasireotide

Answer 17

Somatostatin receptor agonist specific for receptors expressed in pituitary adenomas; decreases release of ACTH from pituitary
Used to treat cushing’s disease

Question 18

Mifepristone

Answer 18

Progesterone receptor antagonist that can be used as post-sex contraception

Other use: glucocorticoid receptor inhibitor used to treat excess cortisol in Cushing’s syndrome/disease

Question 19

Fulvestrant

Answer 19

Pure ER receptor antagonist

Used for tamoxifen-resistant breast cancer

Question 20

Contraindications to birth control with estrong

Answer 20

History of leg clots, liver disease, gallbladder disease, heart disease, migraine with aura, or smoker over 35

Question 21

Ceftriaxone

Answer 21

3rd generation cephalosporin, which inhibits bacterial cell wall production (BACTERICIDAL)
Only administered IV
Used for gonorrhea

Question 22

Macrolides

Answer 22

Azithromycin; inhibit bacterial protein synthesis at 50s resulting in inhibition of bacterial growth

used to treat chlamydia

Question 23

Tetracycline

Answer 23

Doxycycline; inhibit bacterial protein synthesis at 30s resulting in inhibition of bacterial growth

used to treat chlamydia

Question 24

Metronidazole

Answer 24

Treatment for trichomonas
Activated inside of the protozoa by PFOR< causing free radicals to damage DNA

Single dose
Contraindicated in the first trimester; in breast milk