Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

advanced Pharm > endocrine > Flashcards

endocrine Flashcards

1
Q

Estradiols

A
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

estradiol cypionate

A
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Premarin

A
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

ethinyl estradiol

A
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

biological affection of estradiols

A

female tract development
secondary sexual characteristic

reduce secretion of gonadotropin from pituitary

increase triglyceride, reduce LDL, increase HDL

increase coagulation of blood protein

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

diethylstilbestrol

A

we do not use it anymore
it was use unsuccessfully to prevent miscarriage

it causes severe toxicity
ectopic pregnancy
infertility
vaginal adenocarcinoma

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

DES daughter

A

have increase risk of develop breast cancer and cervical caner

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

DES son

A

have increase risk of develop cryptorchidism
hypospadias
transgenderism, gender dysphoria

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

emergency contraception / post coital contraceptive
( morning after pill )

A

prevent pregnancy if given within 72 hours

can be combination of estrogen and progestin
or progestin only

progesterone only product have fewer side effects

action - inhibit ovulation before LH surge
decrease receptivity in uterine tube endometrium
altered cervical mucous gland function

monophasic or
mulitphasic with placebo week ( sugar pill to get period )

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

oral estrogen

A

Non-contraceptive use

Tx for hypogonadism in sound females

Hormone replacement therapy in females with premature ovarian failure or surgical removal

Hormone replacement therapy in postmenopausal females

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

side effect of oral contraceptive agent / oral estrogen

A

increase risk of endometrial cancer ( prevented by combining with progestin )

increase risk in breast cancer (postmenopausal women)

increase in CV risk in postmenopausal women

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

toxicity / overdose effect of oral contraceptive agent / oral estrogen

A

nausea
great tenderness
migraine
thromboembolic disease
gallbladder disease
Hypertriglyceridemia
hypertension

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

progestins

A

progesterone is the major progestin in human

induces secretion of endometrium, healthy endometrium for pregnancy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

medroxyprogesterone

A

prototypical oral synthetic progestin

synthetic progestin doesn’t support pregnancy

inhibit ovulation

in HRT use as adjunct to reduce the risk of endometrium cancer

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

side effect of progestin

A

affect carb metabolism

stimulate fat deposits
dec HDL
reduce boen density ( long term)

delayed ovulation after cessation

suppress GnRH and LH, FSH

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Selective Estrogen Receptor Modulator ( SERMs)

A

Tamoxifen, Toremifene

Estrogen receptor antagonist in breast tissue - reduce risk of breast cancer

estrogen receptor agonist in endometrial tissue - promote endometrial hyperplasia

increase risk of endometrial cancer

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

side effect of SERMs

A

as antagonist - hot flash

as agonist - increase risk of venous thromboembolism
- increase risk of endometrial cancer

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Selective Estrogen Receptor Modulator ( SERMs)

Raloxifene

A

approved of prevention and treatment of osteoporosis

antagonist effect - reduce breast cancer risk

agonist effect - no estrogenic effect on endometrial tissue ( unlike tamoxifen)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Selective Estrogen Receptor Modulator ( SERMs)

Bazedoxifene

A

use for menopause symptoms and osteoporosis prevention

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Selective Estrogen Receptor Modulator ( SERMs)

Clomiphene

A

reduces negative feedback in pituitary increase LH and FSH
induce ovulation in anovulatory women

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Pure estrogen receptor antagonist

Fulvestrant

A

use in breast cancer with resistance to tamoxifen

use in women with breast cancer with endometrial risk factor

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

non-steroidal competitive aromatase inhibitor ( synthesis inhibitors )

A

anastrozole, letrozole

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

irreversible aromatase inhibitor

A

Exemestane

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

Danazol

A

inhibits enzyme involve in Gn synthesis

weak partial agonist of progestin, androgen and glucocorticoid receptor

use in tx of endometriosis and fibrocystic breast disease of the breast

25
Q

Leuprolide

A

Gonadotropin- releasing hormone analogue

MOA- cont’d stimulation of GnRh receptor suppresses secretion
inhibits ovarian production of estrogen and progesterone

use in Tx of - precocious puberty
- short term tx of endometriosis
- short term tx of fibrosis

26
Q

Gonadotropin- releasing hormone antagonists

A

abarelix, degarelix

use in tx of prostate cancer

27
Q

Mifepristone

A
28
Q

estrogen promotes

A

reproduction : ductal growth in Brest,

thickening of vaginal epithelium

proliferation of uterine epithelium

copious secretion of thicken mucus form endocervical gland
increase vaginal acidity

promote endometrial restoration after menstruation

metabolic : block bone reaborsptlon

promotes epiphyseal closure

lower the risk pf cardiovascular disease

CNS neruprotective

promotes insulin sensitivity and glucose uptake

29
Q

three cause of insulin resistance

A

reduce binding of insulin to ties receptor

reduce receptor numbers

reduced receptor responsiveness

30
Q

criteria for Dx of DM

A

fasting glucose > 126mg/dl

random glucose > 200mg/dl plus symptoms

oral glucose tolerance test: 2 hr plasma glucose > 200mg/dl or Hemoglobin A1c 6.5 or higher

31
Q

criteria for Dx of DM

A

fasting glucose > 126mg/dl

random glucose > 200mg/dl plus symptoms

oral glucose tolerance test: 2 hr plasma glucose > 200mg/dl or Hemoglobin A1c 6.5 or higher

32
Q

preferred agent to manage DM hypertension

A

ARB eg losartan

33
Q
A

1- initiate life style change plus metformin

2- cont’d step 1 and add a second drug, either thiazolidinedione, a DDP-4 inhibitor, a GLp01 receptor agonist. a sulfonyulurea or basal insulin should be considered if pt doesn’t achieve glucose control goal

3- progress to three drug combination therapy

4

34
Q

general glycemic treatment target

A

A1c < 7

peak postal plasma glucose < 180 mg/dl

35
Q

regular insulin. humulin R , novolin R

A

onset 30 - 60
peak 1-5
duration 6-10 hr

36
Q

insulin glargine ( Lantus )

A

long acting

onset 70 min
peak N/A
duration 18-24 hours

37
Q

insulin determir (levemir )

A

long acting
onset 60 - 120 mins
peak 12-24 hrs
duration : depends on dose
0.2 unit / kg 12 hr
0.4 unit / kg 20-24 hr

38
Q

insulin determir (levemir )

A

long acting
onset 60 - 120 mins
peak 12-24 hrs
duration : depends on dose
0.2 unit / kg 12 hr
0.4 unit / kg 20-24 hr

39
Q

NPH ( humbling H)

A

intermediate

onset 60-120
peak 6-14 hrs
duration 16-24hrs

40
Q

MOA of Biguanide ( metformin )

A

decrease glucose production by liver

increase tissue response to insulin

41
Q

adverse effect of metformin

A

GI symptom - decrease appetite, Nausea, diarrhea

lactic acidosis

should be held at hospital to prevent adverse accumulation of drug such as can occur with renal impairment in patients with dehydration or exposed to iodine contrast studies during hospital stay.

42
Q

second gen Sulfonylureas

A

Glimepir-ide
Glipiz-ide
Glybur-ide

-ide take my sulfonylureas

43
Q

MOA of sulfonylureas

A

promote insulin secretion by binding to the K channel

44
Q

adverse effect of sulfonylureas

A

hypoglycemia

weight gain

45
Q

Meglitinides ( Glinides)

A

Nateglinide

Repaglinide

similar to sulfonylureas but binds to a different site Ca channel instead K )

46
Q

Meglitinides ( Glinides)

A

Nateglinide

Repaglinide

47
Q

adverse effect of Meglitnides

A
48
Q

adverse effect of Meglitinides

A

hypoglycemia
weight gain

49
Q

Thiazolidinedione (Glitazones )

A

Pioglitazone

Rosiglitazone

50
Q

MOA of Thiazolidinedione (Glitazones )

A

Thiazolidinedione (Glitazones )

increase insulin sensitivity , increase glucose uptake by muscle and adipose tissue and decrease glucose production by the liver

binding to the proliferator activated receptor gamma (PPAR-gamma ) nuclear factor

bring -glita to the PPAR-ty

51
Q

adverse effect of Thiazolidinedione (Glitazones )

A

heart failure exacerbation in HF patient due to it increase fluid retention in the kidney
fracture
ovulation –> unintended pregnancy

52
Q

DPP-4 inhibitors (gliptins)

A

Sita-gliptin
Saxa-gliptin
Lina-gliptin

53
Q

DPP-4 inhibitors (gliptins)

A

Sita-gliptin
Saxa-gliptin
Lina-gliptin

54
Q

MOA of

A
55
Q

MOA of DPP-4 inhibitors (gliptins)

A

enhance the activity of incretins by inhibiting their breakdown by DPP-4
thereby increase insulin release, reduce glucagon release and decrease hepatic glucose production

56
Q

adverse effect of DPP-4 inhibitors (gliptins)

A

upper respiratory tract infection

pancreatitis

57
Q

sodium - glucose co-transporter 2 inhibitor

A

Canagliflozin

increase glucose excretion via urien by inhibiting SGLT-2 in the kidney tubule
dec glucose level and inducing weight loss

58
Q

Adverse effect of SGLT-2

A

Genital mycotic infection

orthostasis

advanced Pharm (7 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions