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Endocrine Flashcards

1
Q

Drug class for Levothyroxine

A

thyroid agent (T4)

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2
Q

MoA for Levothyroxine

A

replacement T4 converted to T3 in peripheral tissues -> nuclear receptors -> protein synthesis, metabolic rate, promotes gluconeogenesis

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3
Q

Indications for Levothyroxine

A

hypothyroidism, thyroid cancer

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4
Q

Drug class for Liothyronine

A

thyroid agent (T3)

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5
Q

MoA for Liothyronine

A

T3 in peripheral tissues -> nuclear receptors -> protein synthesis, metabolic rate, promotes gluconeogenesis

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6
Q

Indications for Liothyronine

A

hypothyroidism not responsive to T4 therapy; tx of myxedema coma

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7
Q

Drug class for Radioactive Iodine

A

antithyroid agent

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8
Q

MoA for Radioactive Iodine

A

radioactive iodine is concentrated in thyroid gland w/ death of gland cells over 6-8 weeks

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9
Q

Indications for Radioactive Iodine

A

thyroid ablation without surgery

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10
Q

Drug class for Methimazole

A

antithyroid agents

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11
Q

MoA for Methimazole

A

blocks oxidation of iodine in thyroid gland preventing iodine combining w/ tyroisin to form T4, T3; doesn’t inactivate circulating T4, T3

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12
Q

Indications for Methimazole

A

hyperthyroidism

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13
Q

Drug class for Prophylthiouracil [PTU]

A

anti-thyroid drug

thiamine

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14
Q

MoA for Prophylthiouracil [PTU]

A

interfere w/ thyroid hormone synthesis; inhibits conversion of T4 to T3; has immunosuppressive effects (bone marrow)

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15
Q

Indications for Prophylthiouracil [PTU]

A

Graves disease, pre-thyroid surgery or RAI131 therapy, thyrotoxic crisis

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16
Q

Drug class for Prednisone

A

glucocorticoids

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17
Q

Drug class for Prednisolone

A

glucocorticoids intermediate acting

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18
Q

Drug class for Dexamethasone

A

glucocorticoids long acting

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19
Q

MoA for Prednisone, Prednisolone, Dexamethasone

A

suppresses adrenal function at high dose; dec leukocyte migration; enters cell nucleus to alter synthesis of protein

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20
Q

Indications for Prednisone, Prednisolone, Dexamethasone

A

multiple; immunosuppressive functions

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21
Q

Drug class for Fludrocortisone

A

mineralcorticoids

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22
Q

MoA for Fludrocortisone

A

promotes increased distal renal tubule absorption of Na+ and loss of K+

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23
Q

Indications for Fludrocortisone

A

Addison’s disease (adrenocortical insufficiency); resistant orthostatic hypotension

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24
Q

Drug class for Propanolol

A

adjunct drugs: nonselective beta blocker

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25
Q

MoA for Propanolol

A

adrenergic B1 & B2 receptor inhibitor; reduction in myocardial oxygen demand

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26
Q

Indications for Propanolol

A

angina, HTN, tachycarrhythmias, essential tremor, migraine Pa, anxiety

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27
Q

Drug class for Metoprolol

A

adjunct drugs: selective beta blockers (B1)

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28
Q

MoA for Metoprolol

A

selective B1 adrenergic receptor inhibitor

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29
Q

Indications for Metoprolol

A

angina, HTN, hemodynamically stable MI

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30
Q

Drug class for Raloxifine

A

selective estrogen receptor modulators (SERMs)

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31
Q

MoA for Raloxifine

A

binds to selected estrogen receptors & dec bone resorption

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32
Q

Indications for Raloxifine

A

px/tx osteoporosis

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33
Q

Drug class for Alendronate

A

bisphosphenate: oral

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34
Q

MoA for Alendronate

A

decrease rate of bone resorption

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35
Q

Indications for Alendronate

A

px/tx of osteoporosis in women; tx in men; Paget’s disease

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36
Q

Drug class for Zoledronic Acid

A

bisphosphenate: IV

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37
Q

MoA for Zoledronic Acid

A

inhibits osteoclast activity & skeletal calcium release

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38
Q

Indications for Zoledronic Acid

A

px/tx osteoporosis; tx multiple myeloma, metastatic bone lesions, hypercalcemia of malignancy, Paget’s disease

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39
Q

Drug class for Calcitonin Salmon

A

calcitonin

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40
Q

MoA for Calcitonin Salmon

A

protein sequence similar to human calcitonin; antagonizes impact of parathyroid hormone & inhibits osteoclast activity

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41
Q

Indications for Calcitonin Salmon

A

osteoporosis, Paget’s disease, hypercalcemia

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42
Q

Drug class for Teriparatide

A

recombinant human parathyroid hormone

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43
Q

MoA for Teriparatide

A

recombinant form PTH (1-34); stimulates new bone formation

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44
Q

Indications for Teriparatide

A

tx severe/tx-resistant osteoporosis (max 2 yrs use)

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45
Q

Drug class for Denosumab

A

RANK ligand inhibitor

46
Q

MoA for Denosumab

A

human monoclonal antibody which attaches to RANKL blocking ability to bind to RANK receptor on surface of osteoclast thereby inhibiting osteoclastogenesis & increasing osteoclast apoptosis

47
Q

Indications for Denosumab

A

males & postmenopausal females at high fracture risk due to osteoporosis; men on androgen-deprivation therapy & women receiving aromatase-inhibitor therapy

48
Q

Drug class for Glipizide

A

sulfonylureas

49
Q

MoA for Glipizide

A

stimulates pancreatic beta cell release of insulin (closes KATP channels -> (+) insulin)

50
Q

Indications for Glipizide

51
Q

Drug class for Repaglinide

A

Meglitinides

52
Q

MoA for Repaglinide

A

binds to adjacent receptor to sulfonylurea receptor on beta cell to stimulate insulin release

53
Q

Indications for Repaglinide

A

T2DM; reduction of postprandial glucose levels; sulfa allergy

54
Q

Drug class for Metformin

A

biguanides

55
Q

MoA for Metformin

A

decrease hepatic glucose production, decrease renal gluconeogenesis, slow intestinal absorption glucose, increase glucose conversion to lactate by enterocytes, stimulate tissue glycolysis, increase glucose removal from blood, decrease plasma glucagon levels

56
Q

Indications for Metformin

57
Q

Drug class for Pioglitizone

58
Q

MoA for Pioglitizone

A

decrease insulin resistance by activation of nuclear PPAR-gamma in myocytes, hepatocytes; most potent insulin sensitizer, increase trig metabolism (site: muscle, fat, liver cells)

59
Q

Indications for Pioglitizone

60
Q

Drug class for Acarbose

A

alpha-glucosidase inhibitor

61
Q

MoA for Acarbose

A

reduces postprandial glucose levels by inhibition of intestinal alpha-glucosidase conversion polysaccharides to monosaccharides; delays absorption & levels of blood glucose

62
Q

Indications for Acarbose

A

T1DM, T2DM

63
Q

Drug class for Sitagliptin

A

dipeptidul peptidase-4 inhibitor

64
Q

MoA for Sitagliptin

A

inhibits DPP-4 to reduce degradation of GLP-1 -> increases levels of CLP-1; reduces postprandial glucose levels

65
Q

Indications for Sitagliptin

66
Q

Drug class for Lispro

A

rapid acting insulin

67
Q

MoA for Lispro

A

insulin replacement, supplement

68
Q

Indications for Lispro

A

T1DM, T2DM

69
Q

Drug class for Regular

A

short acting insulin

70
Q

MoA for Regular

A

insulin replacement, supplement

71
Q

Indications for Regular

A

T1DM, T2DM

72
Q

Drug class for Neutral Protamine

A

intermediate acting insulin

73
Q

MoA for Neutral Protamine

A

insulin replacement, supplement

74
Q

Indications for Neutral Protamine

A

T1DM, T2DM

75
Q

Drug class for Insulin Glargine

A

long acting insulin

76
Q

MoA for Insulin Glargine

A

insulin replacement, supplement

77
Q

Indications for Insulin Glargine

A

T1DM, T2DM

78
Q

Drug class for Human rDNA Insulin

A

oral inhalation, rapid acting insulin

79
Q

MoA for Human rDNA Insulin

A

inhaled insulin

80
Q

Indications for Human rDNA Insulin

A

T1DM, T2DM used w/ long acting insulin

81
Q

Drug class for Pramlintide

A

amylin analogue

82
Q

MoA for Pramlintide

A

amylin analogue (decrease gastric emptying, decrease glucagon secretion, decrease appetite)

83
Q

Indications for Pramlintide

A

T1DM, T2Dm to lower PP glucose levels

84
Q

Drug class for Exenatide

A

incretin mimetic: GLP-1 agonist

85
Q

MoA for Exenatide

A

increase insulin release; decrease glucagon release; slows gastric emptying; decrease appetite; stimulates insulin secretion in presence of glucose

86
Q

Indications for Exenatide

A

T2DM w/ metformin +/- sulfonylurea to lower PP glucose levels

87
Q

Drug class for Liraglutide

A

incretin mimetic: GLP-1 agonist

88
Q

MoA for Liraglutide

A

increase insulin release; decrease glucagon release; slows gastric emptying; decrease appetite; increase beta cell growth/replication

89
Q

Indications for Liraglutide

A

T2DM w/ metformin +/- sulfonylurea to lower PP glucose levels

90
Q

Drug class for Canaglifloxin

A

SGLT2 inhibitor

91
Q

MoA for Canaglifloxin

A

inhibits glucose resorption in proximal renal tubule

92
Q

Indications for Canaglifloxin

A

adjunct therapy in T2DM

93
Q

Drug class for Colesevelam

A

bile acid sequestrant

94
Q

MoA for Colesevelam

A

decrease intestinal glucose absorption

95
Q

Indications for Colesevelam

A

hypercholesterolemia, adjunct to metformin, sulfonylureas, insulin in T2DM

96
Q

Drug class for Desmopressin

A

vasopressin receptor agonist

97
Q

MoA for Desmopressin

A

increase permeability of renal tubular cells to water resorption -> decrease urine volume, increase vonW factor, VIII, t-PA levels

98
Q

What does parathyroid hormone stimulate?

A

stimulates bone resorption

99
Q

What are the main cells in the ileum & what do they release?

A

L cells release glucagon-like peptide-1 (GLP-1)

100
Q

What are the main cells in the jejunum & what do they release?

A

K cells release glucose-dependent insulinotropic polypeptide (GIP)

101
Q

What to acing cells secrete?

A

digestive enzymes

102
Q

What are the two types of cells in the Islets of Langerhans?

A

alpha & beta cells

103
Q

What to alpha cells do?

A

secrete glucagon -> hepatic glycogenolysis -> glucose between meals

104
Q

What do beta cells do?

A

secrete insulin -> glucose entry into cells

secrete amylin -> inhibits gastric emptying, glucagon release

105
Q

What do delta cells do?

A

secrete somatostatin -> acts locally to decrease beta cell release of insulin, amylin production

106
Q

What are the functions of insulin?

A
  • promote glucose uptake by tissue cells
  • promotes protein synthesis
  • provides for glucose storage
  • prevents fat & glycogen breakdown
  • inhibits gluconeogenesis
107
Q

Which drugs increase insulin secretion in T2DM?

A

sulfonylureas, meglitinides, uncertain mimetic, gut-derived hormone analogues, DPP-4 inhibitors

108
Q

Which drugs decrease insulin resistance in T2DM?

A

biguanides, TZDs

109
Q

Which drugs decrease hepatic gluconeogenesis in T2DM?

A

biguanides, amylin analogue

110
Q

Which drugs decrease glucose absorption in T1DM & T2DM?

A

alpha-glucosidase inhibitors, bile acid sequestrants

Pharmacology (16 decks)

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