Endo Pharmacology Flashcards by Luke Hayek

what class of drugs for hyperprolactinemia?

dopamine agonists

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name the two dopamine agonist

cabergoline

bromocriptine

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name the two classes of drugs for increased GH release

GH receptor antagonists

somatostatin analogs

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name the two somatostatin analogs to use in GH excess

octreotide

pasireotide

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name the GH receptor antagonist to use in GH excess

pegvisomant

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what drug is given in hypothyroidism from decreases pituitary TSH secretion

levothyroxine

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what drug is given in hypopituitarism with low GH?

somatotropin

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how do we treat adrenal deficiency?

with steroid and mineralocorticoid replacement

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name the steroids we give in adrenal hypocortisolism

hydrocortisone and prednisone

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name the mineralocorticoid we give in adrenal hypoaldosteronism

fludrocortisone

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if you have secondary hypercortisolism from overactive pituitary (ACTH) what drugs can you give?

pasireotide

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what does pasireotide do to prevent further secondary hypercortisolism?

prevents release of ACTH and GH

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if you have primary hypercortisolism from adrenal overactivity, what two drug classes can you give?

glucocorticoid antagonist and synthesis inhibitors

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name the two glucocorticoid antagonists to give with primary hypercortisolism

spiranolactone and mifepristone

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name the two glucocrticoid synthesis inhibitors to give for primary hypercortisolism

ketoconazole and aminoglutethimide

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what is SE of ketoconazole in men?

ant androgenic…decreased sex characteristics…gynecomastia

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what drug for primary hypercortisolism is a CYP induced? what CYP?

ketoconazole…CYP 3A4

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aside from cortisol, what other thing does mifepristone inhibit? what can this lead to?

progesterone, abortion so pregnancy class X

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for primary hyperaldo what do you give?

spiranolactone or epleronone

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for secondary or renovascular cause of hyperaldo what do you give?

ACE or ARB

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what is the main class of osteoporosis drugs?

bisphosphonates

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what is the MoA of bisphosphonates in osteoporosiS?

bind to bone and cause osteoclast death

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name the bisphosphonate drugs for osteoporosis?

Alendronate
Risedronate
Ibandronate
Zoledronate

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what is major SE of bisphosphonates? what must you do to take them?

esophagitis…take with empty stomach and with tons of water

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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?

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