Endo Pharmacology Flashcards
what class of drugs for hyperprolactinemia?
dopamine agonists
name the two dopamine agonist
cabergoline
bromocriptine
name the two classes of drugs for increased GH release
GH receptor antagonists
somatostatin analogs
name the two somatostatin analogs to use in GH excess
octreotide
pasireotide
name the GH receptor antagonist to use in GH excess
pegvisomant
what drug is given in hypothyroidism from decreases pituitary TSH secretion
levothyroxine
what drug is given in hypopituitarism with low GH?
somatotropin
how do we treat adrenal deficiency?
with steroid and mineralocorticoid replacement
name the steroids we give in adrenal hypocortisolism
hydrocortisone and prednisone
name the mineralocorticoid we give in adrenal hypoaldosteronism
fludrocortisone
if you have secondary hypercortisolism from overactive pituitary (ACTH) what drugs can you give?
pasireotide
what does pasireotide do to prevent further secondary hypercortisolism?
prevents release of ACTH and GH
if you have primary hypercortisolism from adrenal overactivity, what two drug classes can you give?
glucocorticoid antagonist and synthesis inhibitors
name the two glucocorticoid antagonists to give with primary hypercortisolism
spiranolactone and mifepristone
name the two glucocrticoid synthesis inhibitors to give for primary hypercortisolism
ketoconazole and aminoglutethimide
what is SE of ketoconazole in men?
ant androgenic…decreased sex characteristics…gynecomastia
what drug for primary hypercortisolism is a CYP induced? what CYP?
ketoconazole…CYP 3A4
aside from cortisol, what other thing does mifepristone inhibit? what can this lead to?
progesterone, abortion so pregnancy class X
for primary hyperaldo what do you give?
spiranolactone or epleronone
for secondary or renovascular cause of hyperaldo what do you give?
ACE or ARB
what is the main class of osteoporosis drugs?
bisphosphonates
what is the MoA of bisphosphonates in osteoporosiS?
bind to bone and cause osteoclast death
name the bisphosphonate drugs for osteoporosis?
Alendronate
Risedronate
Ibandronate
Zoledronate
what is major SE of bisphosphonates? what must you do to take them?
esophagitis…take with empty stomach and with tons of water
what is an oral SE of bisphosphonates?
osteonecrosis of the jaw
what does SERM stand for?
selective estrogen receptor modulator
what are SERMs used in treatment for?
osteoporosis
what is the SERM to know?
Raloxifene
how does raloxifene work?
is pro estrogenic in bone so reverses osteoporosis effects
what does estrogen do in bone?
activate osteoblasts and inhibit osteoclasts
what is major SE with raloxifene?
VTE stroke/death
what is RANKL in osteoporosis?
molecule that blasts use to activate clasts in bone breakdown
what is drug that inhibits RANKL in osteoporosis?
Denosumab
what is SE of denosumab?
osteonecrosis of the jaw
what is normal role of PTH
increase calcium release from bone
what is teriparatide and abaloparatide derived from?
PTH
even though teriparatide and abaloparatide are derived from PTH, what do they actually do?
stimulate osteoblasts not clasts in bone
what happens to T4 once it enters cells?
it is converted into T3
what do you give for Rx of primary hypothyroidism?
levothyroxine and liothyronine
what is levothyroxine an analog of?
T4
why give T4 and not T3 in hypothyroid?
because the cells can still control how much they want since they switch T4 to T3, where if you gave T3 it would go to all tissues
what is the drug that inhibits thyroid hormone synthesis?
potassium iodide
when do you give potassium iodide?
hyperthyroidism
what is MoA of iodine 131?
kills follicular cells of thyroid
what drug kills follicular cells of thyroid in Rx of hyperthyroid?
iodine 131
name the two drugs that inhibit oxidation of iodine in thyroid hormone synthesis
propylthiouracile and methimazole
propylthiouracile and methimazole prevent what in thyroid?
thyroid hormone prdxn by not allowing iodine oxidation
when do we use propylthiouracile and methimazole ?
in hyperthyroidism
which of propylthiouracile and methimazole is teratogenic?
methimazole
what is major toxicity of propylthiouracile and methimazole?
agranulocytosis..neutropenia
what does T3 stimulate in the heart?
B1 receptors
since T3 stims B1 in heart, what can you give in hyperthyroid to help stop this?
B blockers…atenolol, propanolol, metoprolol
how do you treat type 1 diabetes?
just give insulin
what is issue in type 2 diabetes?
cells arent really responding to insulin
explain how beta cells in pancreas monitor the serum glucose and determine when to release insulin
high blood glucose lead to high ATP and K+ channel closing, this causes depolarization of beta cell which then causes inward Ca2+ voltage gated channels to open and the Ca2+ initiates insulin vesicle membrane fusion for insulin release
what three locations in body respond to insulin?
liver
muscle and adipose tissue
what type of receptor is the insulin receptor
tyrosine kinase
what does high glucose cause to happen in kidneys?
less reuptake of Na and water so increases urine volume
what is tricky about treatment of type1 dm?
need to give insulin in high push prior to meals but keep basal level throughout night
name the bolus administration type 1 DM insulins
aspart
glulisine
lispro
regular insulin
name the basal administration type 1 DM insulins
NPH and
glargine
detimir
what is the most commonly used drug for type II DM?
metformine
what is MoA of metformin?
gluconeogenesis inhibitor
what is toxicity of metformin?
lactic acidosis or exacerbation of existing lactic acidosis
name three conditions that contraindicate metformin
renal insufficiency
liver failure and
anaerobic favoring conditions (COPD)
what is MoA of pioglitazone
increases synthesis of glucose transporters
what is drug that increases glucose transporters into liver muscle and adipose tissue?
pioglitazone
what can you do in GI tract to lower glucose levels?
inhibit breakdown of sacccharides into monosaccharides so limit uptake
name the drug that effects the GI tract by limiting saccharide breakdown
acarbose and miglitol
what is tox of acarbose and miglitol?
diarrhea, flatulence
what can you do in kidney to lower glucose in glood?
block SGLT2
name the drugs that block SGLT2 in kidney and work for type 2 DM?
canagliflozin
dapagliflozin
empagliflozin
what are three SEs of canagliflozin?
increased urination and hypotension
and
increased UTI
