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E1.2 Drugs > Drugs Week 3 > Flashcards

Drugs Week 3 Flashcards

1
Q

MOA of Prednisone, prednisolone, hydrocortisone, dexamethasone

A

Replaces endogenous cortisol, causes inhibition of phospholipaseA2; ↓ Cyclooxygenase (prostaglandins, leukotriene), Cytokines (Tumor necrosis factor, IL-3,4,5,13, Granulocyte-Macrophage Stimulating factor)

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2
Q

Adverse effects of Prednisone, prednisolone, hydrocortisone, dexamethasone

A

Acute: mood changes, hypokalemia, GI upset/ulcer, hyperglycemia. Chronic: HPA-axis suppression, muscle wasting, cushingnoid, gluconeogenesis, salt&water retention, GI ulcer, osteoporosis, psychosis, immunosuppression, thin skin, cataract, glaucoma.

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3
Q

Prednisone must be converted to what and where?

A

Prednisone is a prodrug and must be converted to prednisolone by the liver before it becomes active

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4
Q

MOA of Fludrocortisone

A

Very potent affinity for mineralocorticoid receptor (↑ Na+/K+ATPase & ENaC expression) leads ↑ Na+ reabsorption and K+ excretion in distal tubules

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5
Q

Adverse effects of Fludrocortisone

A

Hypertension, edema, headache, hypokalemia, weight gain.

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6
Q

MOA of Ketoconazole

A

Inhibits cytochrome P450-dependent enzymes~cortisol synthesis

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7
Q

Adverse effects of Ketoconazole

A

Nausea, vomiting, headache, impotence and hepatotoxicity

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8
Q

Ketoconazole is used for what disease?

A

Cushing’s disease

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9
Q

What is Mitotane
used for?

A

Inoperable adrenocortical carcinoma; Cushing’s syndromee (off label)

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10
Q

MOA of Mitotane

A

Cytotoxic drug that suppreses ACTH secretion and reduces synthesis of cortisol.

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11
Q

Adverse effects of Mitotane

A

Nausea, vomiting, diarrhea and tiredness

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12
Q

MOA of Metyrapone

A

Decreases cortisol synthesis by inhibition of 11-hydroxylase activity

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13
Q

Purpose of Metyrapone

A

Cushing’s syndrome (off label)

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14
Q

Adverse effects of Metyrapone

A

Nausea, vomiting, dizziness and sedation

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15
Q

MOA of Levothyroxine (T4)

A

Activation of nuclear receptors, gene expression, and protein synthesis

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16
Q

Adverse effects of Levothyroxine (T4)

A

Cardiovascular (tachycardia, arrhythmia, MI), CNS (headache, nervousness, insomnia, irritability, GI (diarrhea, vomiting, cramps), weight loss

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17
Q

Purpose of Propylthiouracil

A

Hyperthyroidism (Methimazole is preferred to PTU except in the 1st trimester of pregnancy and in thyroid storm)

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18
Q

MOA of Propylthiouracil

A

Inhibits both thyroid peroxidase reactions and 5’-deiodinase

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19
Q

Adverse effects of Propylthiouracil

A

Nausea, GI distress, hepatitis (black box warning), hypothyroidism, agranulocytosis is rare but life-threatening side effect of thiomides. PTU has higher hepatotoxicity than methimazole.

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20
Q

MOA of Methimazole (hyperthyroidism)

A

Inhibits thyroid peroxidase reactions

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21
Q

Adverse effects of Methimazole

A

Nausea, GI distress, hepatitis (black box warning), hypothyroidism, agranulocytosis is rare but life-threatening side effect of thiomides. Methimazole causes serious congenital defects.

22
Q

MOA of Potassium Iodide (SSKI) [aka Lugol’s solution]

A

Inhibit iodine organification and hormone release; reduce size and vascularity of thyroid gland

23
Q

Purpose of Potassium Iodide (SSKI) [aka Lugol’s solution]

A

Preparation for surgical thyroidectomy; Thyroid storm

24
Q

MOA of Propranolol

A

Inhibition of β receptors; inhibition of conversion of T4 to T3

25
Q

Adverse effects of Propranolol

A

Asthma, AV blockade, hypotension, bradycardia

26
Q

Clinical use of Propranolol

A

Thyroid storm

27
Q

MOA of Somatropin

A

Recombinant form of human GH. Binds to GH receptors and increases production of IGF-1

28
Q

Adverse effects of Somatropin

A

Gynecomastia, hyperglycemia, scoliosis, arthritis

29
Q

Clinical use of Somatropin

A

Treatment of growth failure in children with GH deficiency, short stature, turner syndrome, chronic kidney disease, short bowel syndrome, wasting in HIV infection

30
Q

MOA of Somatostatin analogs: Octreotide, Lanreotide, Pasireotide

A

Agonist at somatostatin receptors; inhibits production of GH and to a lesser extent, of TSH, glucagon, insulin, and gastrin.

31
Q

Clinical use of Somatostatin analogs: Octreotide, Lanreotide, Pasireotid

A

Acromegaly and several other hormone-secreting tumors and acute control of bleeding from esophageal varices

32
Q

Adverse effects of Somatostatin analogs: Octreotide, Lanreotide, Pasireotide

A

GI, gallstones, bradycardia, cardiac conduction problems, hypothyroidism, hyperglycemia

33
Q

MOA of Pegvisomant

A

Blocks GH receptors

34
Q

Clinical use of Pegvisomant

A

Acromegaly; used in patients with inadequate response to surgery, radiation, or other therapies.

35
Q

Adverse effects of Pegvisomant

A

Infection, pain, nausea, diarrhea, increased liver enzymes.

36
Q

What are examples of glucocorticoids?

A

Prednisone, prednisolone, hydrocortisone, dexamethasone

37
Q

What is an example of a mineralocorticoid?

A

Fludrocortisone

38
Q

Glucocorticoids

A

Prednisone, prednisolone, hydrocortisone, dexamethasone

39
Q

Mineralocorticoid

A

Fludrocortisone

40
Q

Hypercortisolism drugs:

A

Ketoconazole

41
Q

Hypercortisolism drugs:

42
Q

Hypercortisolism drugs:

A

Metyrapone

43
Q

Hypothyroid drugs:

A

Levothyroxine (T4)

44
Q

Hyperthyroid drugs:

A

Propylthiouracil

45
Q

Hyperthyroid drugs:

A

Methimazole

46
Q

Hyperthyroid drugs:

A

Potassium Iodide (SSKI) [aka Lugol’s solution]

47
Q

Hyperthyroid drugs:

A

Propranolol

48
Q

Growth Hormone deficiency drugs:

A

Somatropin

49
Q

Growth Hormone excess drugs:

A

Somatostatin analogs: Octreotide, Lanreotide, Pasireotide

50
Q

Growth Hormone excess drugs:

A

Pegvisomant

E1.2 Drugs (3 decks)

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