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)

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
What is the regulatory mechanism of iodide
Wolf-chaikoff effect
26
Duration: (Wolf-Chaikoff Effect) ▪️<10-14 days: ↓T3, T4 ▪️>14 days: ↑ T3, T4
▪️ Hypothyroidism ▪️ Hyperthyroidism
27
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
Deficiency: Hypothyroidism
28
What are the Tx: Supplementation for Hypothyroidism?
▪️Thyroxine (T4) - Levothyroxine (Euthyrox): prep of choice; maintenance therapy - Dextrothyroxine: 4% of the activity of Levo ▪️Liothyronine: 3-4x more potent than Levothyroxine
29
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
Excess: Hyperthyroidism
30
What are the Antithyroid Agents for Hyperthyroidism?
▪️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
PTU vs Methimazole ▪️DOA: Short ▪️USE: Emergency ▪️SAFETY (pregnancy): ✅️ ▪️T/E: Hepatitis
PTU (Propyluracil)
32
PTU vs Methimazole ▪️DOA: Long ▪️USE: Maitenance ▪️SAFETY (pregnancy): ❌️ [Teratogenic: Aplasia Cutis] ▪️T/E: Obstructive Jaundice
Methimazole (Tapdin)
33
DOC for Amiodarone-induced hyperthyroidism (>14 days)
Anion Inhibitors - Perchlorate, Pertechnetate, Thiocyanate
34
Mgt. of Thyroid Storm (initial use)
▪️Saturates Solution of Potassium Iodide (SSKI) ▪️Lugol's Soln. ▪️Iodides
35
Preferred tx for Hyperthyroidism except pregnancy 1st line tx for Hyperthyroidism induced by Grave's disease
RAI Therapy (131-I)
36
Adrenocortical Hormones Zona Glomerulosa
Mineralocorticoids (Aldosterone)
37
Adrenocortical Hormones Zona Fasciculata
Glucocorticoids (Cortisol)
38
Adrenocortical Hormones Zona Reticularis
Sex Hormones/ Androgens
39
What is stated below: 1. Major: Aldosterone 2. Tx for HyPERaldosteronism 3. Tx for HyPOaldosteronism
1. Mineralocorticoids 2. Aldosterone Antagonists (Spironolactone, Eplerenone) 3. Fludrocortisone - salt retaining agent
40
What drug is given for the management of mineralocorticoid deficiency
Fludrocortisone
41
Major: Cortisol
Glucocorticoids
42
What kind of disease is Glucocorticoid excess?
Cushing Syndrome
43
What kind of disease is Glucocorticoid deficiency?
Addison's Disease
44
What type of Glucocorticoids Drug is the ff: ▪️Prednisone ▪️Hydrocortisone ▪️Meprednisone ▪️Meprednisolone ▪️Cortisone
Short Acting
45
What type of Glucocorticoids Drug is the ff: ▪️Triamcinolone ▪️Fluocinolone ▪️Paramethasone
Intermeciate Acting
46
What type of Glucocorticoids Drug is the ff: ▪️Bethamethasone ▪️Paramethasone ▪️Dexamethasone
Long Acting