Endocrine and Metabolic Drugs Flashcards
[hypothalamic-pituitary drugs]
treatment of genetic short stature, failure to thrive
somatropin
[hypothalamic-pituitary drugs]
treatment of acromegaly, variceal bleeding
octreotide, somatostatin
[hypothalamic-pituitary drugs]
treatment of hyperprolactinemia, prolactinoma
bromocriptine
[hypothalamic-pituitary drugs]
labor induction/augmentation, control of postpartum hemorrhage
SE: fluid retention
oxytocin
[hypothalamic-pituitary drugs]
treatment of central diabetes insipidus
desmopressin
[thyroid drugs]
treatment of hypothyroidism, myxedema coma
levothyroxine
[thyroid drugs]
inhibits thyroids peroxidase, blocks peripheral conversion to T4 to T3
SE: agranulocytosis,
DOC in pregnant hyperthyroid patients
PTU
[thyroid drugs]
inhibits thyroid peroxidase
SE: agranulocytosis, teratogen (aplasia cutis)
methimazole
[thyroid drugs]
preferred treatment for hyperthyroidism
SE: permanent hypothyroidism
RAI
[thyroid drugs]
reduces size and vascularity of thyroid gland
SSKI (Lugol’s solution)
[thyroid drugs]
symptomatic treatment fo hyperthyroidism, decreases peripheral conversion of T4 to T3
propranolol
differentiate Wolf-Chaikoff effect from Jod-Basedow phenomenon
Wolf-Chaikoff effect ingestion of iodine causes hypothyroidism.
Jod-Basedow phenomenon ingestion of iodine causes hyperthyroidism.
which antithyroid drug inhibit peripheral conversion of T4 to T3?
PTU
Propranolol
Hydrocortisone
what drugs can cause drug-induced hyperthyroidism?
clofibrate
amiodarone
methadone
[corticosteroids]
acute adrenal insufficiency, status asthmaticus, thyroid storm
hydrocortisone
[corticosteroids]
prototype oral glucocorticoid
SE: adrenal suppression, Cushing syndrome
prednisone
[corticosteroids]
hastens fetal lung maturation
betamethasone/ dexamethasone
[corticosteroids]
mineralocorticoid replacement for chronic adrenal insufficiency (Addison disease)
fludrocortisone
mnemonics
Addison’s = Addrenal insufficiency
Conn’s= adrenal exCess
mnemonics
Addison’s = Addrenal insufficiency
Conn’s= adrenal exCess
[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
[female gonadal hormones]
SE: clear cell vaginal adenoCA in daughter
diethystilbesterol
[female gonadal hormones]
prevents estrogen-induced endometrial CA
norgestrel
[female gonadal hormones]
OCP of choice in lactating women
DMPA
[female gonadal hormones]
hormone-responsive breast CA
SE: endometrial CA
tamoxifen
[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
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
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
9%
Calcium content of Ca gluceptate
8%
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
- PTU -blocks thyroid hormone synthesis
- Iodide (KISS) - retards release of thyroid hormone
- Propranolol - controls CVS manifestations
- 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