Drugs For Endocrine System

Question 1

This drug is a GnRH analogue. When________ binds the GnRH receptors in the pituitary, there is an initial release of LH and FSH; however, continued administration of leuprolide leads to the desensitization and downregulation of the GnRH receptors, thereby eventually resulting in decreased release of LH and FSH. Decreased levels of LH and FSH lead to decreased levels of estrogens and testosterone.

Answer 1

leuprolide, Other GnRH analogues include nafarelin and goserelin.

Question 2

Bone cell that promotes bone formation

Answer 2

Osteoblast

Question 3

Osteoporosis

Answer 3

Abnormal loss of bone with increased risk of fractures, spinal deformities, and loss of stature; remaining bone is histologically normal

Question 4

Osteomalacia

Answer 4

A condition of abnormal mineralization of adult bone secondary to nutritional
deficiency of vitamin D or inherited defects in the formation or action of active vitamin D metabolites

Question 5

Osteoclast

Answer 5

Bone cell that promotes bone resorption

Question 6

A bone disorder, of unknown origin, characterized by excessive bone destruction and disorganized repair. Complications include skeletal deformity, musculoskeletal pain, kidney stones, and organ dysfunction secondary to pressure from bony overgrowth

Answer 6

Paget’s disease

Question 7

The same as osteomalacia, but occurs in the growing skeleton

Answer 7

Rickets

Question 8

An osteoblast-derived growth factor that stimulates osteoclast activity and osteoclast precursor differentiation

Answer 8

RANK ligand

Question 9

Beta adrenergic antagonist

Answer 9

Propranolol

Question 10

Other antithyroid agents

Answer 10

Potassium iodide solution
• Radioactive sodium iodide I- 131

Question 11

Identify the sites of action of antithyroid drugs in the biochemical pathway for thyroid hormone synthesis and release.

Question 12

Thyroperoxidase is important

Answer 12

Involved in three different steps in thyroid hormone synthesis
More efficient at combining DIT than MIT, thus more T4 released than T3
Very good drug target
1.
SYNTHESIS OF THYROID HORMONES
Thyroglobulin is synthesized in the thyroid epithelial cell and

Question 13

Levothyroxine (Synthetic T4)

Mechanism of action
Adverse reactions

Drug interactions

Question 14

Adverse reactions Levothyroxine (Synthetic T4)

Answer 14

Tachycardia, heat intolerance, tremors, arrhythmias

Question 15

Levothyroxine (Synthetic T4) Drug interactions

Answer 15

Coffee, fiber, soya products, aluminum hydroxide, calcium supplements, cholestyramine, ferrous sulfate, sucralfate  Reduce absorption
Estrogens, androgens, glucocorticoids alter TBG and TOTAL T3 and T4 levels [Free form is normal]

Question 16

Levothyroxine Mechanism of action

Answer 16

Nuclear receptor Thyroid Receptor with Retinoid X Receptor
Gene transcription Growth, development, and calorigenesis •Stable composition leads to consistent and predictable blood levels •Few allergic reactions, Once-daily dosing

Question 17

Liothyronine (Synthetic T3)

Question 18

Denosumab

Answer 18

Binds to RANKL and prevents it from stimulating osteoclast differentiation and function Mimics OPG

Question 19

Alendronate [Bisphosphonate]

Answer 19

Inhibition of osteoclast mediated bone resorption

Question 20

Raloxifene

Answer 20

Estrogen agonist effect in bone + antagonist in breast and
endometrium

Question 21

Cinacalcet uses

Answer 21

Hyperparathyroidism

Question 22

Activates calcium sensing receptor

Answer 22

Cinacalcet

Question 23

Osteoporosis in postmenopausal women drug to give

Answer 23

Raloxifene

Question 24

Raloxifene A/E

Answer 24

Hot flashes, thromboembolism

Question 25

Hypocalcemia A/E

Answer 25

Cinacalcet

Question 26

Osteoporosis use drug

Answer 26

Denosumab

Question 27

Denosumab A/E

Answer 27

Osteonecrosis of the jaw, risk of infection

Question 28

Esophageal irritation, osteonecrosis of the jaw A/E

Answer 28

Alendronate [Bisphosphonate]

Question 29

Inhibition of osteoclast mediated bone resorption

Answer 29

Alendronate [Bisphosphonate]

Question 30

Give what drug for Osteoporosis, Paget’s disease

Answer 30

Alendronate [Bisphosphonate]

Question 31

What drug is use with Hyperparathyroidism

Answer 31

Cinacalcet

Question 32

Mecasermin

Answer 32

Growth failure in children with severe IGF-1 deficiency unresponsive to growth hormone administration

Question 33

Patients with acromegaly

Answer 33

Lanreotide Octreotide

Question 34

Desmopressin

Answer 34

Diabetes insipidus, children with nocturnal enuresis, hemorrhagic conditions

Question 35

prostate and breast cancer, endometriosis, uterine fibroids, precocious puberty name that drug

Answer 35

Leuprolide

Question 36

Acromegaly in patients who are resistant to somatostatin analogs

Answer 36

Pegvisomant

Question 37

Advanced prostate cancer name that drug

Answer 37

Ganirelix

Question 38

Mecasermin

Answer 38

Growth failure in children with severe IGF-1 deficiency unresponsive to growth hormone administration

Question 39

Diagnostic test for adrenal insufficiency name that drug

Answer 39

Cosyntropin

Question 40

The main adverse effect is hypoglycemia indicated for the treatment of growth failure in children with severe IGF-1 deficiency. recombinant form of human IGF-1

Answer 40

Mecasermin

Question 41

used to treat patients with acromegaly. it has a much longer half-life of about 80 minutes. administered subcutaneously every 8 hours, and its adverse effects include nausea, vomiting, abdominal cramps, steatorrhea (excessive fat in the feces), and gallstones.

Answer 41

octreotide- Somatostatin (growth hormone–inhibiting hormone

Question 42

These drugs are particularly useful in the treatment of persons with elevated growth hormone and prolactin secretion.

Answer 42

In patients with acromegaly, the use of cabergoline

Question 43

pegylated analog of growth hormone that acts as a growth hormone receptor antagonist in target organs and normalizes serum IGF-1 concentrations in 97% of persons with acromegaly

Answer 43

Pegvisomant Growth Hormone Receptor Antagonist

Question 44

The drug appears to have a good safety profile, but it may elevate serum levels of liver enzymes, which should be monitored

Answer 44

Pegvisomant

Question 45

A large number of gonadotropin preparations are available for the treatment of infertility and hypogonadism in men and women

Answer 45

menotropins

Question 46

Gonadotropin-Releasing Hormone Agonists name them. A/E

Answer 46

goserelin, histrelin, leuprolide, nafarelin, and triptorelin Hot flashes

Question 47

Ganirelix, cetrorelix, and degarelix are synthetic peptides that act as___________ All of the agents are absolutely contraindicated during pregnancy. adverse effects of these agents are ________and _________.

Answer 47

Ganirelix, cetrorelix, and degarelix are synthetic peptides that act as competitive antagonists at GnRH receptors in the pituitary gland hypersensitivity allergic reactions, including anaphylaxis

Question 48

Both the idiopathic and secondary forms of hyperprolactinemia can be treated with a

Answer 48

dopamine agonist such as cabergoline or bromocriptine

Question 49

_________and________ are both ergot alkaloid derivatives

Answer 49

Bromocriptine and cabergoline are both ergot alkaloid derivatives

Question 50

_____________selectively activates dopamine D2 receptors in the pituitary gland and suppresses the secretion of prolactin.

Answer 50

Cabergoline

Question 51

The drug has an elimination half-life of about 65 hours and a long duration of action. The most common adverse effects of________ are nausea, headache, and dizziness

Answer 51

cabergoline

Question 52

Synthetic oxytocin (P itocin ) usage

Answer 52

The drug is given to induce contractions during labor, to prevent postpartum uterine hemorrhage, and to stimulate milk let-down in nursing mothers.

Question 53

A deficiency of pituitary vasopressin secretion leads to diabetes insipidus, a condition characterized by excessive water excretion (polyuria) and increased water intake (polydipsia). Diabetes insipidus is usually treated with________

Answer 53

desmopressin

Question 54

Desmopressin solutions are available for injection and as a nasal spray that is used to prevent____. Desmopressin overdose can result in dilutional________.

Answer 54

nocturnal urine production and enuresis in patients with diabetes insipidus. Hyponatremia

Question 55

selective antagonist at V2 receptors. It is indicated for the treatment of euvolemic and hypervolemic hyponatremia in hospitalized patients. Treatment of SIADH

Answer 55

Tolvaptan

Question 56

Which drug is used to reduce the secretion of gonadotropins and gonadal steroids in children with precocious puberty? (A) cabergoline (B) menotropins (C) leuprolide (D) gonadorelin (E) octreotide

Answer 56

C

Question 57

Which drug for treating acromegaly acts by blocking receptors for growth hormone? (A) pegvisomant (B) somatropin (C) octreotide (D) leuprolide (E) cabergoline

Answer 57

A

Question 58

By which mechanism does cabergoline relieve symptoms of hyperprolactinemia in persons with a prolactin-secreting pituitary adenoma? (A) blocks prolactin receptors (B) blocks receptors for prolactin-releasing hormone (C) exerts a cytotoxic effect on pituitary adenoma cells (D) activates receptors for prolactin-inhibiting hormone (E) stimulates the breakdown of prolactin

Answer 58

A

Question 59

Octreotide is correctly described by which of the following statements? (A) It is identical to naturally occurring somatostatin. (B) It is used to treat growth hormone deficiency. (C) It is administered orally. (D) It is a more potent inhibitor of growth hormone secretion than is somatostatin.

Answer 59

D

Question 60

Which sequence of gonadotropin preparations is used to induce ovulation? (A) choriogonadotropin alfa then lutropin alfa (B) follitropin alfa then lutropin alfa (C) choriogonadotropin alfa then follitropin beta (D) chorionic gonadotropin (hCG) then lutropin alfa (E) follitropin alfa then follitropin beta

Answer 60

B

Question 61

Calcitonin therapeutic Uses:

Answer 61

Hypercalcemia Paget’s disease of bone Malignancy Osteoporosis Limited efficacy

Question 62

Calcitonin adverse effects:

Answer 62

Nausea Flushing of face and hands Nasal irritation Injection site inflammation

Question 63

parafollicular (C) cells of thyroid gland Inhibits osteoclastic activity Decreases calcium reabsorption by kidney

Answer 63

CALCITONIN