Endocrine drugs Flashcards
what is a drug that acts on growth hormone?
somatotropin
what does somatotropin do?
release IGF-1 promoting skeletal growth
when do you use somatotropin?
dwarfism
Turner’s
Chronic Renal Failure
what drugs have an effect in Growth Hormone Inhibiting Hormone ?
Octreotide
Pegvisomant
how does octreotide work?
Inhibits release of GH, insulin, glucagon, and gastrin.
When is Octreotide used?
Acromegaly
diarrhea of Carcinoid Syndrome
what is the drug of choice for Acromegaly?
octreotide
what drugs are used to stimulate follicle stimulating hormone?
follitropin alpha
follitropin beta
from where is follitropin acquired?
from post-menopausal women urine
when is follitropin used?
infertility due to anovulation in women
Ex: polycystic ovary disease
hypogonadism and undescended testicles in men
what hormones do you look for in polycystic ovary disease?
what hormones do you look for in a lab report in hypogonadism?
what hormones do you look for in a lab report in undescended testes?
hCG and menotropins
hCG
hCG
follitropin toxicity can cause what?
Ovarian Hyperstimulation Syndrome
- uncomplicated ovarian enlargement
- ascities
- hydrothorax
- hypovolemia
what drugs act by stimulating Gonadotropin Releasing Hormone?
- Gonadorelin
- Leuprolide
- Goserelin
- Buserelin
- Histerelin
- Nafare
What will pulsatile adminstration of gonadorelin do?
Pulsatile administration stimulates the release of FSH and LH
when do you use gonadorelin?
in infertility
when are leuprolide, goserelin, buserelin used?
Prostate cancer
Controlled Ovarian Hyperstimulation for In Vitro Fertilization
What drugs are given in prostate cancer?
Leuprolide and Flutamide because they are androgen antagonist
what drug is used for treatment of Controlled Ovarian Hyperstimulation for In Vitro Fertilization?
Leuprolide
what drugs are for stimulating Gonadotropin Releasing Inhibiting Hormone?
- Cetrorelix
- Ganirelix
when do you use Cetrorelix, Ganirelix ?
for Controlled Ovarian Hyperstimulation: in vitro fertilization
what drugs work by stimulating Prolactin Inhibiting Hormone?
Bromocriptine, Cabergoline, Pergolide
what drugs inhibit prolactin?
Dopamine agonists
What will Bromocriptine, Cabergoline, and Pergolide do?
- Decrease prolactin release
- Increase GH in normal persons but decrease GH in patients with acromegaly
when do you want to use dopamine agonist drugs?
in Hyperprolactinemia, Acromegaly, Parkinsonism, suppression of lactation and breast engorgement
how does oxytocin work?
causes milk ejection in lactating woman and stimulates uterine contractions
when is oxytocin used?
Induce uterine contractions during labor
Prevent post-partum hemorrhage
Milk let down reflex in nursing mothers
when is oxytocin contraindicated?
Contraindicated in fetal distress and cephalopelvic disproportion
what drugs work by stimulating vasopressin?
vasopressin and desmopressin
how does vasopressin and desmopressin work?
by stimulating V1 and V2 receptors
V1 = blood vessels vasoconstrict
V2 = antidiuretic
will desmopressin or vasopressin have more effect in V2 receptor?
desmopressin
when do you use desmopressin and vasopressin?
Neurogenic diabetes insipidus
esophageal varices
haemophilia
what are the natural estrogen drugs?
estradiol
estrone
estriol
what are the synthetic steroidal estrogen drugs?
ethinyl estradiol
mestronol
quinestrol
what are the Synthetic Non-Steroidal Estrogens?
diethyl stillbesterol
when do you use estrogen drugs?
Post-Menopausal Hormone Replacement Therapy
For cardioprotection:
- decrease LDL
- increase HDL
- increase coagulation (factors II, VII, IX, and X)
- decrease anti-thrombin
As a contraceptive:
- thickens cervical mucus (hostile for sperm)
- inhibits release of FSH and LH, inhibits ovulation
- Uterine & tubal contractions: prevent fertilization
- Endometrium: hypersecretory, no implantation
what are the side effects of using estrogen drugs?
vomiting
migraine
↑ risk of endometrial carcinoma and breast carcinoma
↑ risk of myocardial infarction
stroke
gall stones
pulmonary embolism
what drugs work as progesterone derivatives?
Medroxy Progesterone Acetate
how does medroxy progesterone acetate work?
it antagonizes the effect of estrogens on the lipids
what drugs act as 19-Nor-testosterone Derivatives?
Norethindrone, Levonorgestrel, Desogestrel, Norgestimate
19-Nortestosterone Derivative drugs have what actions?
- Antiovulatory action: used as oral contraceptives because of inhibition of ovulation by negative feedback on FSH and LH
- Lower androgenic activity: do not antagonize the beneficial action of estrogens on lipid profile
when do you want to use Progesterone Derivatives 19-Nortestosterone Derivatives?
- Post-Menopausal Hormone Replacement Therapy: to prevent endometrial cancer
- contraceptives
what are signs of Progesterone Derivatives and 19-Nor-testosterone Derivatives toxicity?
- Breast engorgement
- irregular bleeding
- Decreased HDL levels: atherogenesis, more androgenic progestins, medroxyprogesterone
how will Progesterone Derivatives and 19-Nortestosterone Derivatives work as contraceptives?
- inhibits release of FSH and LH inhibiting ovulation
- Cervical mucus becomes thick & hostile for sperm
- endometrium becomes hypersecretory
what drugs work as Anti-Estrogens?
- Chlomiphene Citrate
- Tamoxifen Citrate
- Raloxifene
- Toremifene
what drug is a pure estrogen antagonist?
chlomiphene
how does chlomiphene work?
it is a competitive antagonist in estrogen receptors in hypothalamus and pituitary
when is chlomiphene used?
Infertility due to anovulation.
To aid in vitro fertilization
which anti-estrogens are SERM’s?
Tamoxifene Citrate
Raloxifene
for what is tamoxifene citrate used?
breast cancer
tamoxifene works as an antagonist of estrogen in what body structure?
where will it act as an agonist?
breasts
in bone and endometrium
when is raloxifene used?
in post-menopausal osteoporosis
what drug works as a anti-progestin?
mifepristone
when do we use mifepristone?
- Post-Coital Contraceptive Effect
- Termination of Early Pregnancy given with misoprostol
what is finasteride?
what is it used for?
a 5-alpha reductase inhibiting drug
used for treatment of benign prostatic hyperplasia
name 3 anabolic steroid drugs
- Nandrolonedecanoate
- Oxandrolone
- Oxymetholone
what activity do anabolic steroids have?
High anabolic and low androgenic activity
when are anabolic steroids used?
- Androgen Replacement therapy in hypogonadism
- Chronic catabolic states: AIDS, chronic renal failure
- Aplastic anemia
- Osteoporosis
- To enhance physical ability in athletes: abused
what effects can be seen with anabolic steroid toxicity?
- Gynecomastia
- hirsutism
- acne
- deep voice
- cholestatic jaundice
- hepatic carcinoma
what is Flutamide?
what is it used for?
a androgen blocker
used for Prostate Cancer along with Leuprolide
(GnRH agonist, to decrease LH and testosterone secretion)
what is Finasteride?
what is it used for?
5alpha-reductase inhibitor (inhibits conversion of testosteron to DHT)
benign prostatic hypertrophy and male baldness
what are the 2 combined estrogen and progestin types of doses?
- Monophase:
- fixed dose of estrogen and progestin
- Biphasic:
- fixed dose of estrogen
- progestin is lowered in 2nd phase
What are the 3 Progesting Alone Preparations?
also mention the drug name for each.
Oral: Norethindrone, Levonorgestrel
Implants: Levonorgestrel
Injectable: Medroxy Progesterone Acetate
Estrogen + Progestin or Progestin alone can lead to mild or moderate toxicities, what are these?
Mild: nausea, vomiting, muscle pain, headache
Moderate: weight gain and acne, skin pigmentation
