Endocrine Drugs Flashcards by Joanna Rivera

What drug is used in management of short stature that acts by increasing release of IGF-1 in the liver and cartilage, stimulating skeletal muscle growth, amino acid transport, protein synthesis and cell proliferation?

Somatropin

Growth hormone

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What drug is used as performance-enhancing drug that is banned by athletic committees?

Somatropin

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What is the somatostatin analog used in treatment for acromegaly, pituitary adenoma, carcinoid, gastrinoma, glucagonoma, variceal bleeding?

Octreotide

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Drug used to activate FSH receptors for controlled ovarian hyperstimulation and for management of infertility due to hypogonadism in men

Follitropin Alfa

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LH analog

Choriogonadotropin alfa
HCG
Menotropins
Lutropin

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GnRH analog which increases LH and FSH with intermittent administration and reduces LH and FSH with prolonged continuous administration.
Used for the treatment of endometriosis, myoma uteri, precocious puberty and prostate cancer

Leuprolide

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GnRH antagonist used in prostate cancer and prevention of premature LH surge

Ganirelix
Cetrorelix
Abarelix
Degarelix
Note: does not cause a tumor flare up when used for treatment of advanced prostate cancer

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Dopamine agonist but a partial agonist at dopamine D2 receptors in the brain to inhibit prolactin release

Bromocriptine
Pergolide
Carbergoline
Quinagolide

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What is the side effect of bromocriptine other than erythromelalgia and pulmonary fibrosis?

raynaud phenomenon

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What is the drug of choice for treatment of pregnant hyperthyroid patients which has a slow onset of action (3-4 weeks to take full effect)

Propylthiouracil

Drug class: Thioamide

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What is the mechanism of action of propylthiouracil?

It inhibits thyroid peroxidase reactions

It inhibits iodine organification and peripheral conversion of T4 and T3

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What is the treatment of choice for Myxedema coma (progressive weakness, stupor, hypothermia, hypoventilation, hypoglycemia, hyponatremia, water intoxication, shock and death due to severe hypoglycemia)

IV loading dose of Levothyroxine 300-400 mcg

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What are the side effects of Propylthiouracil?

Agranulocytosis, Urticaria, Fulminant Hepatitis, Lupus-like syndrome, vasculitis, Hypoprothrombinemia, Exfoliative dermatitis, Polyserositis, Arthralgia

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Prenatal exposure to Methimazole results to?

Aplasia cutis congenita

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What is the treatment that reduces the size and vascularity of thyroid gland. MOA includes inhibiting iodine organification and hormone release?

Lugol’s solution

Potassium Iodide

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What do you call the phenomenon in which the ingestion of iodine causes hypothyroidism?

Wolf-Chaikoff effect

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What do you call the phenomenon in which the ingestion of iodine causes hyperthyroidism?

Jod-Basedow effect

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What is the drug that cause clinical improvement without altering thyroid hormone levels. It inhibits peripheral conversion of T4 and T3

Propranolol

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What are the three drugs that inhibits peripheral conversion of T4 to T3

Propylthiouracil
Propranolol
Hydrocortisone

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What is the drug of choice for thyroid storm?

Propylthiouracil then Iodides to retard release of thyroid hormones

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Give three drugs that induces hyperthyroidism?

Clofibrate
Amiodarone
Methadone

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What drug induces hypo and hyperthyroidism?

Amiodarone

Has the ability to block the peripheral conversion of T4 to T3 (Tx: Levothyroxine)
Iodine induced mechanism in persons with an underlying disease or through an inflammatory mechanism that causes leakage of thyroid hormone
(tx: Thioamides or corticosteroids)

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What glucocorticoid synthesis inhibitor that inhibits desmolase and reduced synthesis of all hormonally active steroids used in the treatment of breast cancer and cushing syndrome?

Aminogluthemide

Note: Used by body builders to lower circulating levels of cortisol in the body and prevent muscle loss

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Which among the azole antifungals inhibits cholesterol side-chain cleavage, cytochrome P450 and other enzymes necessary for synthesis of all steroids? Used in the treatment of adrenal carcinoma, hirsutism, breast cancer, prostate cancer, cushing’s syndrome and fungal infections

Ketoconazole

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What glucocorticoid synthesis inhibitor that selectively inhibits steroid 11-hydroxylation used in the diagnostic testing for Cushing's syndrome? This is also the drug of choice for pregnant patients with cushing's syndrome

Metyrapone

Examples of progestins

``` Norgestrel Norethindrone Ethynodiol Megestrol Desogestrel Norelgestromin Norgestimate Etonorgestrel ```

What are the side effects of progestins?

Decreased HDL and Weight gain

What progestin is used as an appetite stimulant

Megestrol

What is the drug used as an emergency contraception

Levonorgestrel | YUZPE regimen

What is the drug used as a progestin-only pill?

Medroxyprogesterone acetate | IM: Devo-Provera

What is the selective estrogen receptor modulator (SERM) that has an antagonistic effect on the breast tissue and CNS but has an agonist effect in uterus, liver and bone?

Tamoxifen | Toremifene

Side effect of tamoxifen

Increases the risk of endometrial cancer | Note: It prevents osteoporosis and decreases risk of atherosclerosis

SERM that has an antagonist effect in breast tissue, uterus and CNS but has an agonistic effect on the liver and bone. Used in the prevention of breast cancer and increases bone mineral density

Raloxifene | Note: no estrogenic effcts on endometrial cancer

SERM which has a partial agonist in the pituitary. Reduces negative feedback by estriol and Increases FSH and LH output. Used in induction of ovulation

Clomiphene | Note: increases risk of low-grade ovarian cancer with long-term use

Estrogen synthesis inhibitors which acts by inhibiting aromatase and used in the treatment of breast cancer and precocious puberty. Effective in breast cancer which becomes resistant to Tamoxifen

Anastrozole Letrozole Exemestane

Antiandrogen that acts as a weak cytochrome P450 and partial agonist of progestin and androgen receptors used in the treatment of endometriosis, fibrocystic disease, hemophilia, angioneurotic edema

Danazol

What are the side effects of danazol

Weight gain Hirsutism Note: Contraindicated during pregnancy and breast feeding

What drug is a glucocorticoid receptor antagonist and progesterone receptor used in medical abortion and treatment for Cushing's syndrome

Mifepristone (RU-486)

What drug activates androgen receptors and is used as an illegal performance enhancement drug in atheletes

Oxandrolone

What is an androgen competitive antagonist which is used in the treatment of prostate cancer and in surgical castration?

Flutamide Bicalutamide Nilutamide (surgical castration)

Which drug should be administered with flutamide to avoid tumor-flare up in prostate cancer?

Leuprolide

Which androgen antagonist that has a marked progestational effect that suppresses the feedback enhancement of LH and FSH? It has an orphan drug status and is used for treatment of hirsutism and it decreases sexual drive in men

Cyproterone

What is the androgen synthesis inhibitor that acts by inhibiting 5-alpha reductase and is used in the treatment for BPH

Finasteride | Dutasteride

Examples of Rapid acting Insulins

Lispro Aspart Glulisine

What is an androgen competitive antagonist which is used in the treatment of prostate cancer and in surgical castration?

Flutamide Bicalutamide Nilutamide (surgical castration)

Which drug should be administered with flutamide to avoid tumor-flare up in prostate cancer?

Leuprolide

Cyproterone

What is the androgen synthesis inhibitor that acts by inhibiting 5-alpha reductase and is used in the treatment for BPH

Finasteride | Dutasteride

Example of Short acting insulin

Regular Insulin (Humalog)

Examples of Intermediate acting insulin

NPH | Lente

Example of Long acting insulin

Ultralente

Examples of ultra-long acting insulin

Glargine Detemir Lantus

Happens when the evening dose of intermediate insulin is high and hypoglycemia develops around 3:00 AM. As a result, counter-regulatory hormones are produced, resulting in pre-breakfast hyperglycemia

Somogyi effect

When the evening dose of intermediate insulin is low, hyperglycemia will be present both at 3:00AM and 7:00 AM

Waning of insulin dose

Insulin sensitivity becomes low between 6:00 AM and 7:00 AM due to the growth hormone spike. As a result, mild hyperglycemia occurs in the early morning but the 3:00 Am glucose levels will be normal.

Dawn Phenomenon

Increases insulin secretion from pancreatic beta cells by closing ATP sensitive K+ channels

Sulfonylureas

Examples of 1st generation Sulfanylurea

Chlorpropamide Tolbutamide Tolazamide

Examples of 2nd generation Sulfanylureas

``` Glipizide Glimepiride Glyburide Glibenclamide Gliclazide ```

Which class of drugs that increases target tissue sensitivity to insulin by activating the peroxisome proliferator receptor gamma nuclear receptor (PPAR-gamma)? This reduces fasting and postprandial hypoglycemia

Thiazolidenedione | (Pioglitazone, Troglitazone, Rosiglitazone)otoxicity

Which class of antidiabetics acts as an insulin secretagogue but is used in postprandial hyperglycemia and in patients with sulfa allergies

Class: Meglitinide | Repaglitinide, Nateglinide, Mitiglinide

Which among the meglitinides has the least incidence of hypoglycemia and may be used in CKD patients?

Nateglinide

Which class of antidiabetics that activates AMP-stimulated protein kinase leading to inhibition of hepatic and renal gluconeogenesis? This reduces postprandial and fasting glucose levels.

Biguanides (Metformin)

Thiazolidenedione

What are the side effects of thiazolidenediones

Fluid retention, weight gain, CHF, macular edema and dyslipidemia

What is an incretin modulator that inhibits dipeptidyl peptidase-4 that degrades GLP-1 and other incretins

Sitagliptin

What thiazolidenedione reduces mortality and macrovascular events?

Pioglitazone

What drug is an amylin analog that suppresses glucagon release, delays gastric emptying, stimulates CNS to reduce appetite (anorectic effect)?

Pramlintide

What is an incretin modulator (GLP-1 agonist) that augments glucose-stimulated insulin release from pancreatic B cells, retards gastric emptying and inhibits glucagon secretion, and produces satiety?

Exenatide

What is an incretin modulator that inhibits dipeptidyl peptidase-4 that degrades GLP-1 and other incretins

Sitagliptin

What antiobesity drug that inhibits gastrointestinal and pancreatic lipases and reduces absorption of fats

Orlistatn

Side effects of orlistat?

steatorrhea | rebound weight gain upon discontinuation

What antiobesity drug that inhibits norepinephrine and serotonin reuptake in the CNS and reduces appetite?

Sibutramine | Note: withdrawn due to increased risk of cardiovascular events and strokes

What antiobesity drug that selectively blocks cannabinoid-1 (CB-1) receptor that reduces appetite and is used in obesity, smoking cessation and drug addiction?

Rimonabant

What thyroid hormone acts as a calcitonin and is administered as a nasal spray

Salcitonin

Example of a recombinant parathyroid hormone

Teripatide

Inactive form of Vitamin D

Ergocalciferol | Cholecalciferol

What drug is an active Vitamin D used in the treatment of psoriasis

Calcipotriene

What thyroid hormone acts as a calcitonin and is administered as a nasal spray

Salcitonin

Examples of bisphosphanates

``` Alendronate Etidronate Ibandronate Pamidronate Risedronate Tiludronate Zoledronic acid ```

What are the side effects of bisphosphanates

Adynamic bone Esophagitis Osteonecrosis of the jaw Renal impairment

Phosphate binding resin which is used in the treatment for hyperphosphatemia in CKD, Hypoparathyroidism, Vitamin D intoxication

Sevelamer

What is one of the effects of phosphate binding resins

Can significantly reduce uric acid levels