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Pharm Part II > E2: Endocrine Pt 3: BONE drugs, Pituitary, Vit D > Flashcards

E2: Endocrine Pt 3: BONE drugs, Pituitary, Vit D Flashcards

1
Q

SERMS – raloxifene (Evista)…Activates _______ receptors in _____…Where does it NOT activate these receptors? How is that helpful?

A

estrogen…bone…does not activate in breast, less risk of cancer!

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2
Q

EVISTA is the only medicine proven to reduce both the risk of spinal fractures due to osteoporosis and the risk of invasive breast cancer in postmenopausal women with osteoporosis.

A

SERMS-raloxifene-EVISTA

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3
Q

SERMS, Ral-ox-ifine (Evista) Summary of effects: has ______ action on bone, there is an Absence of ______ bleeding, Absence of endometrial and ______ stimulation…Most common SIDE EFFECTS: _______ and Leg cramps

A

Anti-resorptive.. vaginal.. breast… Hot flashes

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4
Q

WHAT IS THE BEST AVAILABLE BONE BUILDING DRUG?

A

Bisphosohonate!

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5
Q

Bisphos Mech of Action: Increases _______ …Inhibits _______ activity

A

bone mineral density…. osteoclastic

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6
Q

Bisphos Mech of Action: inhibits bone ________….Inhibits formation, growth and dissolution of bone ________ crystals

A

resorption… hydroxyapatite

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7
Q

What do all the Bisphosphonates end in?

A

“-DRONATE”

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8
Q

What are the three Oral Bisphosphanates?

A

1.Alen-dronate (Fosamax) 2.Rise-dronate (Actonel 3.Iban-Dronate (Boniva)

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9
Q

What is the IV Bisphosphonate that is used BOTH for Tx AND Prevention of bone pathology…What is a DENTAL (rare) side effect?

A

ZOL-E-DRONIC ACID (zometa)….Osteonecrosis of the Jaw

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10
Q

Bisphosphonates have a poor ________, so take on empty stomach Water only (everything else decreases absorption by >___%) Remain upright for at least ___ minutes…No eating for at least ___ minutes

A

bioavailability…..60%!…30 minutes (both)!!

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11
Q

Bisphosphonates: 3 common side effects…

A

1.Erosive Esophagitis 2.Headache 3.GI distress

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12
Q

What is usually the indication for Bisphosphonates when Osteonecrosis of the Jaw occurs?

A

Cancers that have metastasized to bone (breast, prostate)

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13
Q

Pretty interesting: what is the normal half life of Bisphoshonates?

A

10 years! (so will probably be with you for 40+ years!

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14
Q

Most cases of jaw osteonecrosis are in patients undergoing chemotherapy with IV Bisphosphonates who also received _______; possible other risk factors

A

steroids

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15
Q

What are the 3 IV Bisphosphonates?

A

1.Pam-i-dronate (Aredia) 2.Zole-dronic Acid (Zometa) 3.Til-u-dronate (Skelid)

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16
Q

Hormones are produced by ______ glands and are transported by ______ to target cells

A

ductless….body fluids

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17
Q

What are the 4 therapeutic uses of Hormones?

A
  1. Replace 2.Diagnose 3.Stimulate 4.Inhibit
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18
Q

What are the 5 Hypothalamic Releasing Hormones? (just abbreviations will do…) ALSO, what is the ONLY one used as a drug?

A

1.GnRH 2.TRH 3.CRH 4.GHRH 5.SRIF…GnRH is the only one used as a drug

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19
Q

GnRH is the only Hypolathamic Releasing Hormone used as drug…it is used as a synthetic ______ (which has GREATER receptor affinity!)

A

analog

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20
Q

What is the INDICATION for the use of GnRH as a drug in women?

A

Ovulation induction in women with Primary Hypothalamic Amenorrhea (Fertility drug!)

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21
Q

The GnRH drug _______ is used as an OVULATORY stimulant.

A

CLOM-i-phene (CLOMid)

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22
Q

The GnRH drug CLOM-i-phene (CLOMid) Stimulates the release of pituitary ________ and _______.

A

luteinizing hormone (LH)….follicle stimulating hormone (FSH)

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23
Q

CLOM-i-phene (CLOMid) Action is at “______” (testes, ovaries) to induce gametogenesis and gonadal hormone production

A

“end organs”

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24
Q

What is the INDICATION for the use of GnRH as a drug in men?

A

to Tx idiopthic Hypogonadotropic Hypogonadism for achieving more Spermatogenesis

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25
Q

Which Anterior Pituitary Hormone is used to diagnose apparent adrenal dysfunction?

A

ACTH

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26
Q

What hormone is an ALTERNATIVE to CorticoSteroids in inflammatory conditions???

A

ACTH (huh! never heard of that!)

27
Q

ACTH Stimulates release of _________ from adrenal glands and therefore ________ feedback to shut down ACTH output from pituitary

A

glucocorticoids… Cortisone

28
Q

What is the MOST ABUNDANT hormone in the Anterior Pituitary?

A

Growth Hormone

29
Q

Which hormone?? Stimulates growth of epiphysis and all cells in organs and tissues

A

Growth Hormone :)

30
Q

Since therapeutic GH was found to have prions disease from cadavers, where does it come from now?

A

Recombinant DNA techniques

31
Q

Growth Hormone is officially used to Tx _______

32
Q

HOLY A-ROD BAtman! Steroids cost more than $______ per year!!!

33
Q

TSH used as a diagnostic tool to differentiate between _____ and _____ hypothyroidism

A

pituitary and primary hypothyroidism

34
Q

Promotes development of ovarian follicles and maintains spermatogenesis

A

Follicle Stimulating Hormone

35
Q

FSH Deficiency in males causes _______; in females, causes _______ abnormalities

A

sterility… menstrual

36
Q

Induces ovulation and regulates progesterone secretion in women, testosterone secretion in men

A

Luteinizing Hormone

37
Q

What do FSH and LH have in common as it pertains to administration and type of molecule they are?

A

they are both glycoproteins and administered IM

38
Q

Which hormone Induces ovulation in 90% of women…More than one follicle may develop and ovulate (TW-TW-TWINS in 20% of pregnant women)

A

Human Menopausal Gonadotropin (HMG)

39
Q

Which hormone is secreted by fetal placenta as early as day 7…Detected in PREGNANCY TEST (diagnostic use) Used to INDUCE ovulation and pregnancy…MALES Used to stimulate interstitial cells of TESTES to secrete androgen; cryptorchidism…Given by IM

A

Human Chorionic GonadoTropin (HCG)

40
Q

What are the 2 hormones of the POSTERIOR PITUITARY?

A

P.P.O.V…Oxytosin..and..Vasopressin (ADH)

41
Q

Vasoconstrictor and antidiuretic hormone; used for replacement in diabetes insipidus

A

Vasopressin

42
Q

Vasopressin: Vasoconstrictor and antidiuretic hormone; used for replacement in diabetes _______

43
Q

Contracts uterine smooth muscle at term…Induction of labor….Control postpartum bleeding or hemorrhage

44
Q

Saaaay WHaaaat? the posterior pituitary hormones are very similar to each other…_______ slight antidiuretic function and High levels of _______ can trigger uterine contractions..COOOL!

A

oxytosin…. vasopressin

45
Q

Increases plasma calcium and maintains at ___ mg%.. Increases calcium mobilization from bone to plasma…Increases calcium reabsorption in renal tubules

A

Parathyroid hormone…10%

46
Q

What is the HORMONAL form of Vitamin D?

A

CalCiTriOL

47
Q

Calcitriol is produced by the ______ in response to stimulation by the _______ hormone

A

kidneys… parathyroid

48
Q

Calcitriol increases ______ absorption from the intestine

49
Q

_______ limits calcium excretion when blood calcium levels are low

A

Calcitriol

50
Q

thyrocalcitonin (calcitonin)….Synthesized in the ________ and it REVERSES the action of _______ hormone

A

hyroid gland….parathyroid

51
Q

Which hormone decreases plasma calcium and phosphate levels??

A

Thyrocalcitonin (calcitonin)

52
Q

Calcitonin is a ______ regulator of blood calcium compared to the actions of PTH and calcitriol

53
Q

Calcitonin is used in medicine to treat ________

A

hypercalcemia

54
Q

Formed in the skin when a cholesterol precursor, 7-dehydroxycholesterol, is exposed to ultraviolet light…Primary action of _______ = promote gut absorption of calcium by stimulating formation of calcium-binding protein within the intestinal epithelial cells

A

Vitamin D3-Cholecalciferol

55
Q

Which hormone?? In bone, synergistic role with parathyroid hormone (PTH) = stimulates osteoclast proliferation and bone resorption

A

Vitamin D3 (cholecalciferol)

56
Q

Compared to __________, vitamin D exerts a much slower regulatory effect on calcium balance

A

parathyroid hormone (PTH)

57
Q

Look at all these benefits! increases bone mass, decreases fracture rates, decreases PTH which decreases resorption, potentially increases bone formation…SOOO which hormone?

A

Vitamin D! dawg!

58
Q

What is the preparation of Vitamin D?

A

Ergo-calciferol

59
Q

Vitamin D and systemic diseases: with low Vit D there is a higher risk for these 3 cancers:

A

1.Prostate 2.Breast 3.Ovarian

60
Q

Vitamin D and systemic diseases: low sun exposure = increased ________ whaaaaa?

A

Type I diabetes

61
Q

Ok this is just random: Vitamin D and systemic diseases: hypertension increases with distance away from _______

62
Q

Vitamin D and systemic diseases: ________ (pre-vitamin D) = protective

A

calcitriol

63
Q

What should my Vit D level be greater than per day?

Pharm Part II (28 decks)

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