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M4: Pharmacology-Pharmacokinetics > Endocrine Drugs > Flashcards

Endocrine Drugs Flashcards

1
Q

Green Hormone Regulation produced by which specific cells

A

T3 & T4

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2
Q

What is stated below:

▪️Aka. Sleep-woke cycle/Diurnal Cycle
▪️24h cycle in hormone release
▪️”schedule” of hormone release

A

Circadian Rhythm

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3
Q

What are the two feedback mechanism of the Endocrine System

A
  1. Negative Feedback
  2. Positive Feedback
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4
Q

What type of feedback mechanism is stated below:

▪️Majority
▪️Prevents further hormones secretion once a set point is achieved
▪️Ex. Thyroid Gland

A

Negative Feedback

▪️Stimulus: ↑ PH
▪️Response: ↓RH=↓SH=↓PH

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5
Q

What type of feedback mechanism is stated below:

▪️Rare/uncommon
▪️Only happens in menstrual cycle (ovulation)

A

Positive Feedback

▪️Stimulus: ↑ PH
▪️Response: ↑RH=↑SH=↑PH

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6
Q

What is stated below:
[Hypothalamic or Pituitary]

▪️Drugs: GnRH Analogues [Gonadorelin, Buserelin, Goserelin, Nafarelin, Triptorelin, Histrelin] -relin

  1. Intermittent/Pulsatile
    • POSITIVE feedback
    • ↑ FSH = ↑ Estrogen
    • ↑ LH = ↑ Progesterone
    • mgt. of hypothalamic & hypogonadism
  2. Continuous/Sustained (IM Depot)
    • NEGATIVE feedback
    • ↓FSH & LH =↓Estrogen, Progeste.
    • mgt. of hormone excess states
      (breast CA, prostate CA)
A

Hypothalamic Hormones & Agents

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7
Q

What is stated below:
[Hypothalamic or Pituitary]

▪️ It compose of Anterior and Posterior

A

Pituitary Hormones

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8
Q

Is it Anterior or Posterior PH

▪️From Adenohypophysis
▪️follow the H -> P portal axis system
▪️Ex. Prolactin & Growth Hormone

A

Anterior Pituitary Hormone

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9
Q

Is it Prolactin or Growth Hormone

▪️Regulation composed of Inhibit Dop. with the end product of mammary gland
▪️Effects: TOP & BOTTOM
TOP=GO!
- breast development
- milk production (lactation)

BOTTOM=STOP!
- (-) ovulation & spermatogenesis
[Infertility]

A

Prolactin (PRL)

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10
Q

What is stated below: (under Prolactin of Pituitary Hormone)

▪️ increase prolactin in the blood
▪️causes: prolactinomas (tumor), drug-induced ex. 1st Gen Antipsychotics
▪️sign/sx: Galactorrhea, amenorrhea, infertility

A

Hyperprolactinemia

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11
Q

Is the treatment for hyperprolactinemia

A

Bromocriptine (D2 Agonist)

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12
Q

Is it Prolactin or Growth Hormone

▪️Effects:
- Liver: ↑ somatomedin
- Muscles: ↑ CHON synthesis
- Adipocytes: lipolysis->weight loss
- cells = (-) glucose uptake
▪️ effect of Growth Hormone is inhibiting blood cell that leads to hyperglycemia

▪️Conditions (Deficiency & Excess)

A

Growth Hormone (Somatotropin)

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13
Q

Under Growth Hormone

  1. Deficient
    Onset:
    Pre-puberty: ?
    Post-puberty: ?
  2. Excess
    Onset:
    Pre-puberty: ?
    Post-puberty: ?
A
  1. Deficient
    Onset:
    Pre-puberty: Pituitary Dwarfism
    Post-puberty: ↑ risk of CV Death
  2. Excess
    Onset:
    Pre-puberty: Pituitary Gigantism
    Post-puberty: Acromegaly=Cardiomegaly
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14
Q

What drugs used for Deficiency Disease of Dwarfism (under GH)

A
  1. GHRH (in Hypothalamic Defect)
  2. Somatropin
  3. Mecasermin
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15
Q

What drugs used for Excess Disease of Gigantism & Acromegaly (under GH)

A
  1. Octreotide
  2. Lanreotide
  3. Pegvisomant (GH receptor antagonist)
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16
Q

Is it Anterior or Postetior PH

▪️From Neurohypophysis
▪️Do not follow an axis
▪️Ex. Oxytocin, Vasopressin

A

Posterior Pituitary Hormone

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17
Q

What drug under Posterior Pituitary Hormone is stated below:

▪️Effects:
- stimulates milk-letdown
- stimulus: nipple suckling
- uterine contraction (oxytosis)

A

Oxytocin

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18
Q

What drug under Posterior Pituitary Hormone is stated below:

▪️nasal spray: to stimulate milk let-down
▪️IV: Oxytocic = induction of labor

A

Oxytocin

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19
Q

What drug under Posterior Pituitary Hormone is stated below:

▪️ oxytocin antagonist
▪️ uterine relaxant: Tocolytic
(Tx: Pre-term labor)

A

Atosiban

20
Q

What drug under Posterior Pituitary Hormone is stated below:

▪️ Antidiuretic Hormone
▪️Effects
- V1 = vasoconstriction
- V2 = H2O reabsorption
▪️Clinical Conditions
1. Deficiency: Diabetes Insipidus
2. Excess: SIADH

A

Vasopressin

21
Q

2 Forms of Diabetes Insipidus

A
  1. Central/Neurogenic DI
  2. Nephrogenic
22
Q

What Forms of DI is stated below:

▪️absolute lack of vasopressin (ADH)
▪️tx: V agonist (-pressin)
- Non-selective: Vasopressin
- V2-selective: Desmopressin

A

Central/Neurogenic DI

23
Q

What Forms of DI is stated below:

▪️ relative lack of vasopressin (ADH)
▪️ normal vasopressin (ADH) but receptors are resistant or non-responsive
▪️tx: thiazide diuretics = paradoxical

A

Nephrogenic Diabetes Insipidus

24
Q

What disease is stated below:

▪️Excess
▪️Tx: V-Antagonists: (-vaptan)
- Non-Selective: Conivaptan
- V2-Selective: Tolvaptan
Tetracycline: Demeclocycline

A

Syndrome of Inappropriate ADH Secretion (SIADH)

25
Q

What is the regulatory mechanism of iodide

A

Wolf-chaikoff effect

26
Q

Duration: (Wolf-Chaikoff Effect)

▪️<10-14 days: ↓T3, T4
▪️>14 days: ↑ T3, T4

A

▪️ Hypothyroidism
▪️ Hyperthyroidism

27
Q

What Clinical Conditions is stated below:

▪️Causes: Post-procedural (thyroiodectomy, RAI), Iodine Deficiency, Autoimmune: Hashimoto’s, Drug-induced: Antithyroid Agents-Amiodarone (<10-14 days)

▪️s/sx: weight gain despite ↓ appetite

A

Deficiency: Hypothyroidism

28
Q

What are the Tx: Supplementation for Hypothyroidism?

A

▪️Thyroxine (T4)
- Levothyroxine (Euthyrox): prep of choice; maintenance therapy
- Dextrothyroxine: 4% of the activity of Levo

▪️Liothyronine: 3-4x more potent than Levothyroxine

29
Q

What Clinical Conditions is stated below:

▪️Causes: Autoimmune (Grave’s Disease), Hyperfunctioning Nodules, Drug-induced: Amiodarone Iodide = >14 days

▪️s/sx: weight loss despite ↑ appetite

A

Excess: Hyperthyroidism

30
Q

What are the Antithyroid Agents for Hyperthyroidism?

A

▪️Thoamides-(-)peroxidase enzyme
1. PTU (Propylthiouracil)
2. Methimazole/Thiamazole (Tapdin) (Tapazole)
3. Carbimazole - prodrug of Methimazole

▪️Anion Inh.
1. Perchlorate, Pertechnetate, Thiocyanate

▪️Iodides
1. SSKI (Saturated asolution of Potassium Iodide) Lugol’s Soln.

▪️ RAI (Radioactive Iodide)
1. 131-I

▪️B-Blockers
1. Propranolol, Carvedilol

▪️Dexamethasone

31
Q

PTU vs Methimazole

▪️DOA: Short
▪️USE: Emergency
▪️SAFETY (pregnancy): ✅️
▪️T/E: Hepatitis

A

PTU (Propyluracil)

32
Q

PTU vs Methimazole

▪️DOA: Long
▪️USE: Maitenance
▪️SAFETY (pregnancy): ❌️
[Teratogenic: Aplasia Cutis]
▪️T/E: Obstructive Jaundice

A

Methimazole (Tapdin)

33
Q

DOC for Amiodarone-induced hyperthyroidism (>14 days)

A

Anion Inhibitors
- Perchlorate, Pertechnetate, Thiocyanate

34
Q

Mgt. of Thyroid Storm (initial use)

A

▪️Saturates Solution of Potassium Iodide (SSKI)
▪️Lugol’s Soln.
▪️Iodides

35
Q

Preferred tx for Hyperthyroidism except pregnancy

1st line tx for Hyperthyroidism induced by Grave’s disease

A

RAI Therapy (131-I)

36
Q

Adrenocortical Hormones

Zona Glomerulosa

A

Mineralocorticoids (Aldosterone)

37
Q

Adrenocortical Hormones

Zona Fasciculata

A

Glucocorticoids (Cortisol)

38
Q

Adrenocortical Hormones

Zona Reticularis

A

Sex Hormones/ Androgens

39
Q

What is stated below:

  1. Major: Aldosterone
  2. Tx for HyPERaldosteronism
  3. Tx for HyPOaldosteronism
A
  1. Mineralocorticoids
  2. Aldosterone Antagonists (Spironolactone, Eplerenone)
  3. Fludrocortisone - salt retaining agent
40
Q

What drug is given for the management of mineralocorticoid deficiency

A

Fludrocortisone

41
Q

Major: Cortisol

A

Glucocorticoids

42
Q

What kind of disease is Glucocorticoid excess?

A

Cushing Syndrome

43
Q

What kind of disease is Glucocorticoid deficiency?

A

Addison’s Disease

44
Q

What type of Glucocorticoids Drug is the ff:

▪️Prednisone
▪️Hydrocortisone
▪️Meprednisone
▪️Meprednisolone
▪️Cortisone

A

Short Acting

45
Q

What type of Glucocorticoids Drug is the ff:

▪️Triamcinolone
▪️Fluocinolone
▪️Paramethasone

A

Intermeciate Acting

46
Q

What type of Glucocorticoids Drug is the ff:

▪️Bethamethasone
▪️Paramethasone
▪️Dexamethasone

A

Long Acting

M4: Pharmacology-Pharmacokinetics (50 decks)

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