Endocrine and Metabolic Drugs Flashcards by Rhaizza Mae Guerra

[hypothalamic-pituitary drugs]

treatment of genetic short stature, failure to thrive

somatropin

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[hypothalamic-pituitary drugs]

treatment of acromegaly, variceal bleeding

octreotide, somatostatin

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[hypothalamic-pituitary drugs]

treatment of hyperprolactinemia, prolactinoma

bromocriptine

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[hypothalamic-pituitary drugs]
labor induction/augmentation, control of postpartum hemorrhage
SE: fluid retention

oxytocin

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[hypothalamic-pituitary drugs]

treatment of central diabetes insipidus

desmopressin

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[thyroid drugs]

treatment of hypothyroidism, myxedema coma

levothyroxine

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[thyroid drugs]
inhibits thyroids peroxidase, blocks peripheral conversion to T4 to T3
SE: agranulocytosis,
DOC in pregnant hyperthyroid patients

PTU

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[thyroid drugs]
inhibits thyroid peroxidase
SE: agranulocytosis, teratogen (aplasia cutis)

methimazole

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[thyroid drugs]
preferred treatment for hyperthyroidism
SE: permanent hypothyroidism

RAI

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[thyroid drugs]

reduces size and vascularity of thyroid gland

SSKI (Lugol’s solution)

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[thyroid drugs]

symptomatic treatment fo hyperthyroidism, decreases peripheral conversion of T4 to T3

propranolol

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differentiate Wolf-Chaikoff effect from Jod-Basedow phenomenon

Wolf-Chaikoff effect ingestion of iodine causes hypothyroidism.
Jod-Basedow phenomenon ingestion of iodine causes hyperthyroidism.

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which antithyroid drug inhibit peripheral conversion of T4 to T3?

PTU
Propranolol
Hydrocortisone

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what drugs can cause drug-induced hyperthyroidism?

clofibrate
amiodarone
methadone

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[corticosteroids]

acute adrenal insufficiency, status asthmaticus, thyroid storm

hydrocortisone

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[corticosteroids]
prototype oral glucocorticoid
SE: adrenal suppression, Cushing syndrome

prednisone

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[corticosteroids]

hastens fetal lung maturation

betamethasone/ dexamethasone

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[corticosteroids]

mineralocorticoid replacement for chronic adrenal insufficiency (Addison disease)

fludrocortisone

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mnemonics
Addison’s = Addrenal insufficiency
Conn’s= adrenal exCess

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[female gonadal hormones]
most frequently used synthetic estrogen in OCPs
SE: hypertension, DVT/PE, endometrial CA,
contraindicated in women (age >35) who are heavy smokers

ethinyl estradiol

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[female gonadal hormones]

SE: clear cell vaginal adenoCA in daughter

diethystilbesterol

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[female gonadal hormones]

prevents estrogen-induced endometrial CA

norgestrel

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[female gonadal hormones]

OCP of choice in lactating women

DMPA

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[female gonadal hormones]
hormone-responsive breast CA
SE: endometrial CA

tamoxifen

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[female gonadal hormones] ovulation induction SE: multiple pregnancies

clomiphene

[female gonadal hormones] | treatment of endometriosis

danazol

[female gonadal hormones] | medical abortion

"3 Ms" mifepristone methotrexate misoprostol

[male gonadal hormones] treatment of male hypogonadism SE: virilization, paradoxical feminization

testosterone

[male gonadal hormones] | anabolic steroids, illegal performance enhancers

oxandrolone

[male gonadal hormones] | treatment of prostate cancer

flutamide

[male gonadal hormones] | treatment of prostate cancer, coadministered to prevent acute flare-ups of tumor

flutamide + leuprolide

[male gonadal hormones] | 5-alpha reductase inhibitor, treatment of benign prostatic hyperplasia and male pattern baldness

finasteride

mnemonic: FinAsteRIde Five Alpha Reductase Inhibitor

FinAsteRIde | Five Alpha Reductase Inhibitor

mnemonic: | Clone Me Phlease = Clomiphene

[antidiabetic agents] most efficacious antidiabetic drug, activates tyrosine kinase SE: hypoglycemia, lipodystrophy

insulin

[antidiabetic agents] 1st generation SU SE: hypoglycemia, weight gain, disulfiram reaction

chlorpropamide

[antidiabetic agents] 2nd generation SU SE: hypoglycemia, weight gain, disulfiram reaction

glipizide

[antidiabetic agents] newer insulin secretagogue NO hypoglycemia

repaglinide

[antidiabetic agents] first line antidiabetic drug, decreases gluconeogenesis SE: lactic acidosis, weight loss (DOC for obese diabetics), GI upset

metformin

[antidiabetic agents] TZD, acts on PPAR-gamma, insulin senitizer SE: CHF

pioglitazone

[antidiabetic agents] alpha-glucosidase inhibitor SE: flatulence

acarbose, miglitol

[antidiabetic agents] DPP4 inhibitor SE: pancreatitis

sitagliptin

[antidiabetic agents] GLP-1 analogue SE: weight loss

exenatide

[insulin type] | rapid acting

lispro, aspart, gluiisine | 3-4 hrs

[insulin type] | short acting

regular | 5-7 hrs

[insulin type] | intermediate acting

NPH, lente | 18-24 hrs

[insulin type] | long acting

ultralente | 18-28 hrs

[insulin type] | ultra long acting

glargine detemir lantus >24 hrs

mnemonic: LISpro= mabiLIS gLARGgine = Go Large! LANTus = LANTa na sa sobrang tagal

why is there paradoxical improvement of diabetes in patients with end-stage renal disease?

insulin has prolonged half-life due to decreased clearance

which patients are more prone to developing hypoglycemia with insulin use?

prone to hypoglycemia: advanced renal disease elderly children younger than 7 years

[drugs for bone metabolism] | inactive vitamin D, treatment of rickets and osteomalacia

ergocalciferol

[drugs for bone metabolism] | active vitamin D, treatment of secondary hyperparathyroidism

calcitriol

[drugs for bone metabolism] | treatment of Paget disease of bone, hypercalcemia, tumor marker for medullary thyroid CA

calcitonin

[drugs for bone metabolism] suppresses osteoclast activity, treatment of Paget disease of bone and osteoporosis SE: esophagitis

alendronate (bisphosphonates)

[drugs for bone metabolism] | phosphate-binding resin

sevelamer

Calcium content of Ca carbonate

40%

Calcium content of tricalcium phosphate

39%

Calcium content of Ca chloride

27%

Calcium content of Ca acetate

25%

Calcium content of Ca citrate

21%

Calcium content of Ca lactate

13%

Calcium content of Ca gluconate

Calcium content of Ca gluceptate

Calcium content of Ca glubionate

6.5%

describe the function of osteoblasts and osteoclasts

``` osteBlast = builds bone osteoCLast = CLeaves / resorbs bone ```

function of PTH

ParaThyroid Hormone (PTH) phosphate thrashing hormone

what are the signs and symptoms of excess PTH?

``` HYPERPARATHYROIDISM painful bones renal stones abdominal groans psychiatric overtones ```

what is the function of calcitonin?

CalciTONin = TONes down Calcium | reduces blood Ca, decreases bones resorption

Myxedema Coma Treatment

IV loading dose of Levothyroxine (300-400 mcg), followed by 50-100 mcg daily IV Hydrocortisone is indicated if the patjent has associated adrenal or pituitary insufficiency

Anti thyroid drugs inhibiting peripheral conversion of T4 into T3

Hydrocortisone PTU Propranolol

Drugs that cause drug-induced hyperthyroidism

Clofibrate Amiodarone Methadone

Iodine ingestion cause hypothyroidism

Wolf-Chaikoff Effect

Iodine ingestion cause hyperthyroidism

Jod-Basedow Phenomenon

Thyroid Storm treatment

1. PTU -blocks thyroid hormone synthesis 2. Iodide (KISS) - retards release of thyroid hormone 3. Propranolol - controls CVS manifestations 4. Hydrocortisone - protects against shock and blocks peripheral conversion of T4 to T3

MOA: inhibits desmolase, blocking conversion of cholesterol to pregnenolone; reduces synthesis of all hormonally active steroids Uses: breast cancer; Cushing syndrome Abused by body builders to lower circulating levels of cortisol in the body and prevent muscle loss

Aminoglutethimide

DOC for pregnant patient with Cushing syndrome MOA: selective inhibitor of steroid 11-hydroxylation, interfering with cortisol and corticosterone synthesis Uses: diagnostic testing for adrenal function; Cushing syndrome

Metyrapone

MOA: reduces estrogen synthesis by inhibiting aromatase Uses: breast cancer, precocious puberty Effective against breast cancers that have become resistant to Tamoxifen

Anastrozole, Letrozole | Exemestane (an irreversible inhibitor)

A synthetic steroid with weak estrogenic, proestrogenic and androgenic activity, and hence is an agonist of the estrogen, progesterone and androgen receptor. It is primarily used in menopausal hormone therapy, postmenopausal osteoporosis and endometriosis

Tibolone

MOA: COC, activates estrogen and progesterone receptors, inhibits ovulation, effects on cervical mucus gland, uterine tubes and endometrium lead to decreased affinity, inhibit ovulation when given before LH surge Uses: contraception, hypogonadism, acne, hirsutism, dysmenorrhea, endometriosis

Estradiol + Norethindrone (ethinyl estradiol + desorgestrel / Norgestrel/ Drospirenone/ Norgestimate/ Noresthisterone)

MOA: activates progesterone receptors; prevents contraception by altering cervical mucus and creating a hostile endometrium Uses: contraception, HRT

Medroxyprogesterone Acetate | IM depot preparation: Depoprovera

MOA: activates estrogen and/or progesterone receptors; thicken cervical mucus; inhibits ovulation Uses: emergency contraception Must be taken within 72 hours of unprotected sexual intercourse

Levonorgestrel | Ethinyl Estradiol + Levonorgestrel

For salt retaining effect in patients with congenital adrenal hyperplasia, the drug of choice is

Fludrocortisone

Used to stimulate spermatogenesis in males with isolated gonadotropin deficiency

Menotropin