Drugs (final) Flashcards
Bromocriptine
Class: Dopamine agonist
TX: GH excess
Octreotide
Class: Somatostatin analog *more specific than GH
TX: GH excess, with less SE
Pegvisomant
Class: GH receptor antagonist
MOA: binds and prevents GH action
TX: GH excess
Sermorelin
Class: synthetic GHRH *not as effective as GH
TX: GH deficiency, ineffective if deficiency is d/t pituitary production defect
Recombinant IGF-1
TX: GH deficiency, for patients with GH receptor mutation
GH
MOA: Activate JAK/STAT signaling
TX: GH deficiency, where no growth by age 2
Vasopressin
MOA: conserve body water by reducing urine output by increasing AQP2 in lumen
TX: Neurogenic diabetes, acute bleeding, CPR, vasodilatory shock
Desmopressin
MOA: Boosts factor VIII concentrations, replacement for vasopressin
TX: Neurogenic diabetes, bedwetting, mild-moderate hemophilia
AVOID in conditions aggravated by water retention, cardiac insufficiency, CF, vascular disease, renal impairment, pregnancy
NSAIDs
MOA: Block prostaglandin synthesis in kidneys to enhance vasopressin action
Lithium
MOA: Antagonizes effect of vasopressin
TX: Used to treat CHF, edema, SIADH
Demeclocycline
MOA: Antagonizes vasopressin and actions downstream of V2R
TX: Used to treat CHF, edema, SIADH, and hyponatremia
Conivaptan
Class: V1a/V2R antagonist
TX: hyponatremia associated with SIADH, edema (CHF, cirrhosis)
Tolvaptan, Lixivaptan
Class: V2R specific antagonist
TX: hyponatremia associated with SIADH, edema (CHF, cirrhosis)
Synthetic oxytocin analogs
MOA: Couples to Gq/IP3 production, which leads to increase of intracellular Ca2+ that leads to smooth muscle contraction
TX: Induce labor
Advantage: fast acting (2-3min when IM), generally no SE
Disadvantage: more expensive than ergometrine, IM/IV only, not heat stable
Ergometrine
MOA: Couples to Gq/IP3 production, which leads to increase of intracellular Ca2+ that leads to smooth muscle contraction
TX: facilitation of placenta and reduce blood flow
Advantage: inexpensive, effect for 2-4hrs
Disadvantage: slow acting (6-7min for IM), increased risk of HTN, vomiting, HA, not heat stable
Syntometrine (ergometrine, oxytocin)
Advantage: rapid effect of oxytocin, sustained action of ergometrine
Disadvantage: HTN, N/V, not heat stable
Misoprostol
Class: Prostaglandin E1 analog
TX: Induce labor, nonsurgical abortions
Advantage: low cost, PO, PV, PR, heat stable
Disadvantage: rare amniotic fluid embolism, possible torn uterus *more common in women who have had previous uterine surgery, C-section
Tamoxifen and bicalutamide
MOA: Bind to ER or PR positive tumors
TX: Breast CA, Prostate CA
Tamoxifen
Class: SERM MOA: -Estrogen-like effects: uterus, bone, lipid metabolism -Anti-estrogen-like effects: breast TX: breast CA
Raloxifene
Class: SERM
MOA:
-Estrogen-like effects: bone, lipid metabolism
-Anti-estrogen-like effects: breast, uterus
TX: uterine and breast CA
*reduce vertebral fractures but undesirable SE: heart risk, blood clots
Idoxifene
Class: SERM
MOA:
-Estrogen-like effects: bone, lipid metabolism
-Anti-estrogen-like effects: breast, uterus
Ospemifene
Class: SERM
Tx: Dyspareunia
*Oral
Clomiphene
Class: partial agonist/antagonist of estrogen
MOA: Blocks estrogen feedback to increase GnRH, LH, FSH
Tx: infertility treatment
Type 1 (steroidal inactivators: androstenedione): Formestane, exemastane Type 2 (nonsteroidal inactivators): Anastrozole, virazole, letrozole Nonselective: aminoglutethimide
Class: aromatase inhibitor
MOA: inhibit aromatase, which converts androgens to estrogens
*second-line tx for breast CA patients when tamoxifen tx unsuccessful
