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Pharmacology > Endocrine drugs ONLY > Flashcards

Endocrine drugs ONLY Flashcards

1
Q

NPH

A

Intermediate-acting insulin
Can be combined with short-acting insulin

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2
Q

Detemir

A

Long-acting insulin
Usually wears off during sleep

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3
Q

Glargine

A

Longest-acting insulin
No peak time of activity

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4
Q

Aspart

A

Short-acting insulin

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5
Q

Lispro

A

Short-acting insulin

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6
Q

Glulisine

A

Short-acting insulin

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7
Q

Metformin

A

Biguanide
Actions:
- Inhibits liver glucose production
- Sensitizes insulin receptors
- Reduces gut glucose absorption
AE:
- Dec. B12 and folate absorption
- Lactic acidosis w/ toxicity
- GI upset upon initiation

Drug of choice for initial therapy in type 2

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8
Q

Glipizide

A

Sulfonylurea
Actions: Promotes insulin release
AE:
- Hypoglycemia
- Weight gain
- Disulfiram reaction with alcohol

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9
Q

Glyburide

A

Sulfonylurea
Actions: Promotes insulin release
AE:
- Hypoglycemia
- Weight gain
- Disulfiram reaction with alcohol

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10
Q

Glinides

A

Meglitinide
Actions: Promotes insulin release
AE:
- Hypoglycemia
- Weight gain

Shorter acting than Sulfonylureas

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11
Q

Glitazones

A

Thiazolidinediones
Actions: Inc. insulin response from cell
AE:
- HF due to fluid retention
- Upper respiratory infections, headaches, sinusitis, myalgia
- Bladder carcinoma from long-term/high dose therapy

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12
Q

Acarbose

A

Alpha-glucosidase inhibitors
Actions: Inhibit brush border enzymes -> delayed carb absorption
AE:
- GI discomfort
- Dec. iron absorption -> anemia risk
- Long term -> liver dysfunction

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13
Q

Miglitol

A

Alpha-glucosidase inhibitors
Actions: Inhibit brush border enzymes -> delayed carb absorption
AE:
- GI discomfort
- Dec. iron absorption -> anemia risk
- Long term -> liver dysfunction

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14
Q

Dipeptidyl-peptidase-4 inhibitors (DDP-4)

A

Actions: Inc. incretin = inc. insulin secretion response
AE:
- Hypersensitivity reactions
- Rare: Pancreatitis

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15
Q

Sodium-glucose-2 transporter inhibitors (SGLT-2)

A

Actions: Block renal reabsorption of glucose -> glucose excreted in urine
AE:
- Female UTI
- Inc. urination -> dehydration, hypotension

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16
Q

Lugol solution

A

Class: Non-radioactive iodine
Uses: Hyperthyroidism
Actions: Inhibits T4/T3 synthesis and systemic release
AE: High doses can cause paradoxical response → hyperthyroid symptoms

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17
Q

Somatropin

A

Uses: Pediatric or adult GH deficiency
ROA: IM or subQ
Adverse effects: Hyperglycemia

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18
Q

Somatostatin

A

Uses: GH excess

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19
Q

Cabergoline

A

Class: Ergot alkaloid derivatives
- Dopamine agonists
Uses: Corrects amenorrhea, prolactin excess, and infertility
Actions: Activates dopamine receptors in anterior pituitary
- Inhibits prolactin secretion
AE: Headache, nausea, dizziness

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20
Q

Bromocriptine

A

Class: Ergot alkaloid derivatives
- Dopamine agonists
Uses: Corrects amenorrhea, prolactin excess, and infertility
Actions: Activates dopamine receptors in anterior pituitary
- Inhibits prolactin secretion
AE: Headache, nausea, dizziness

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21
Q

Tamoxifen

A

Class: SERMs
Actions:
- Inhbts. cell growth in breast tissue
- Protects against osteoporosis
- Improves lipid profile
AE:
- Inc. endometrial cancer risk
- Inc. hot flashes
- Inc. thromboembolism risk
Uses: Breast cancer prevention and treatment

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22
Q

Raloxifene

A

Class: SERMs
Actions:
- Inhbts. cell growth in breast tissue
- Protects against osteoporosis
- Improves lipid profile
AE:
- Inc. hot flashes
- Inc. thromboembolism risk
Uses:
- Osteo prevention
- Breast cancer prevention in high-risk patients

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23
Q

Combination oral contraceptives

A

Suppression of ovulation: high estrogen provides negative feedback to suppress FSH (follicle cannot mature, no ovulation occurs)
Also alters cervical mucus & endometrium

Excess estrogen: Nausea, breast tenderness, edema
Excess progestin: Inc. appetite, fatigue, depression

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24
Q

Progestin-only “minipills”

A

Cervical secretion changes

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25
Depot medroxyprogesterone acetate
Actions: Inhibition of FSH/LH secretion AE: Bone loss risk
26
Copper IUD
Actions: Local foreign body reaction and chemical changes that are toxic to sperm AE: Pelvic inflammatory disease if STI is present
27
Levonorgestrel IUD
Actions: Thickens cervical mucus, inhibits ovulation, alters endometrium AE: Pelvic inflammatory disease if STI is present
28
Mifepristone
Class: Antiprogestin Uses: Medical abortion Actions: Blocks progesterone receptors → de-implantation; cervical softening and dilation AE: - Abdominal pain - Vaginal bleeding - Bacterial infection (give antibiotic) Contraindications: Ectopic pregnancy, hemorrhagic disorders, anticoagulant use
29
Misoprostol
Class: Prostaglandin Uses: Medical abortion Actions: Directly stimulates uterine contractions AE: - Abdominal pain - Vaginal bleeding - Bacterial infection (give antibiotic) Contraindications: Ectopic pregnancy, hemorrhagic disorders, anticoagulant use
30
Clomiphene
Uses: Follicular maturation Actions: Blocks estrogen receptors in the hypothalamus/pituitary - Causes inc. in LH/FSH - Blocks negative feedback so that follicular maturation and ovulation can occur AE: - Hot flashes - Bloating - Breast engorgement - Ovarian hyperstimulation
31
Menotropin
Uses: Follicular maturation Actions: 50:50 mix of LH:FSH, direct action on ovary to induce follicular maturation - If ovaries can respond to LH/FSH, ovulation is ~100% AE: Ovarian hyperstimulation
32
Follitropin
Uses: Follicular maturation Actions: FSH that acts on ovary, stimulating follicles AE: Ovarian hyperstimulation
33
hCG and choriogonadotropin alpha
Uses: Ovulation Actions: Acts on ovary to induce ovulation by stimulating LH surge - IM - Administered AFTER clomiphene or menotropin/follitropins AE: Ovarian hyperstimulation or rupture of ovarian cysts
34
Terbutaline
Class: B2 agonist Actions: Agonizes B2 on uterine smooth muscle, dec. contractions AE: - Pulmonary edema - HypoTN - Hyperglycemia - Tachycardia
35
Nifedipine
Class: Ca2+ channel blocker Actions: Blocks Ca2+ from sarcoplasmic reticulum, dec. contractions AE: - Tachycardia - Facial flushing - Headache - Dizziness - Nausea
36
Indomethacin
Class: COX inhibitor Actions: Inhibits PG synthesis, dec. contractions and cervical ripening AE: - Nausea - Gastric irritation - Inc. postpartum bleeding
37
Oxytocin receptor blockers
Block uterine contractions by preventing initiation
38
Magnesium sulfate
Class: ACh inhibitor Uses: NOT A TOCOLYTIC - Neuroprotective effects to fetus Actions: Inhibits ACh at NMJ AE: - Adverse: HypoTN, flushing, headache, dizziness - Severe: Hypothermia, paralytic ileus, pulmonary edema
39
Hydroxyprogesterase caproate
Uses: Prevention of preterm labor for singleton pregnancy/history of preterm labor AE: - Injection site reactivity - Hives - Nausea/diarrhea
40
Dinoprostone
Class: Prostaglandin (PGE2) Actions: Cervical ripening via breakdown of collagenase AE: - Fetal distress - Tachysystole - Systemic absorption -> nausea/vomiting, diarrhea, fever ROA: Vaginal gel or pouches
41
Pitocin/Oxytocin
Effects: - Uterine stimulation: Inc. force, frequency and duration of contractions -> number of receptors inc. as labor progresses - Milk ejection - Water retention AE: - Shivering - Temp elevation
42
Misoprostol (Cytotec)
Class: Prostaglandin Uses: Postpartum hemorrhage Actions: Stimulates uterine contractions AE: - Nausea/vomiting, diarrhea (rare) - Shivering - Temp elevation
43
Caboprost tromethamine (Hemabate)
Class: Prostaglandin Uses: Postpartum hemorrhage Actions: Stimulates uterine contractions and INTENSE vasoconstriction Contraindications: - Pelvic inflammatory disease - Cardiac/pulmonary/renal disease - Caution in asthma, HTN, diabetes AE: - GI issues - HTN - Bronchoconstriction
44
Methylergonovine (Methergine)
Uses: Postpartum hemorrhage - Only in emergencies Actions: Stimulates uterine contractions and arteriole/venous constriction Contraindications/AE: - HTN - Nausea, vomiting - Headache
45
Tranexamic acid (TXA)
Class: Fibrinolysis inhibitor Uses: Menorrhagia Actions: Inhibits plasmin - Dec. fibrin mesh dissolving - Keeps clots in the body Contraindications/AE: - History of thrombosis
46
Levothyroxine
Class: T4 replacement Uses: Hypothyroidism - Takes 1 month to take full effect Contraindications/AE: - Hyperthyroidism ~Affected by~ - Food (dec. absorption) - CYP450 inducers induce metabolism - Dec. T4 -> T3 metabolism - Inc. thyroglobulin binding (binds T3 and T4 together) - Warfarin: Inc. blood-thinning effects - Catecholamines: Inc. sensitization of heart ROA: PO (on empty stomach) and IV
47
Liothyronine
Class: T3 replacement Uses: Hypothyroidism - Only when T4 can’t convert to T3 or myxedema coma
48
Methimazole
Class: Thionamides Uses: Hyperthyroidism Actions: Inhibits peroxidase to inhibit T4/T3 synthesis AE: - Cannot be used in 1st trimester pregnancy, crosses too much into placenta - Rare: agranulocytosis, hepatotoxicity, vasculitis - Overdose: hypothyroidism - Goiter bc no negative feedback to TSH → release more so enlarge gland
49
Propylthiouracil (PTU)
Class: Thionamides Uses: Hyperthyroidism and thyrotoxic crisis Actions: Inhibits peroxidase to inhibit T4/T3 synthesis peripherally AE: - Rare: agranulocytosis, hepatotoxicity, vasculitis - Overdose: hypothyroidism - Goiter bc no negative feedback to TSH → release more so enlarge gland
50
Spironolactone
Class: - K+ sparing diuretic - Aldosterone antagonist Actions: - Corrects HTN -> allows Na and water excretion - Conserves K+ because hyper-aldosterone caused hypokalemia AE: - Hyperkalemia - Gynecomastia - Menstrual irregularities
51
Hydrocortisone
Identical to cortisol Class: Glucocorticoid drug Uses: Primary adrenal insufficiency (Addison’s disease) Actions: Glucocorticoid and mineralcorticoid actions AE: None at physiologic dose ROA: PO, IV for stress dose
52
Dexmethasone
Class: Glucocorticoid drug Uses: Secondary and tertiary adrenal insufficiency Actions: - High glucocorticoid activity - Very little mineralocorticoid actions
53
Vasopressin
Uses: Diabetes insipidus and post-op abdominal distension Effects: Vasoconstriction, identical to ADH AE: All due to water intoxication/dec. osmolality - Early signs: Drowsiness, confusion, headache - Late signs: Seizures, coma High vasopressin doses -> hypertension, angina, MI
54
Desmopressin (DDAVP)
Uses: Diabetes insipidus Effects: Structurally analogous to ADH AE: All due to water intoxication/dec. osmolality - Early signs: Drowsiness, confusion, headache - Late signs: Seizures, coma ROA: PO, intranasal No vasoconstriciton Long duration
55
Prednisone
Class: Glucocorticoid drug Uses: General adrenocortical insufficiency Actions: - Glucocorticoid activity - Less mineralocorticoid activity - Longest acting (more potent)
56
Subdermal etonogestrel implant
Progestin only AE: Progestin side effects, irregular vaginal bleeding
57
Testosterone enanthate
Testosterone esters Cause hepatotoxicity AE: HEPATOTOXICITY, VIRILIZATION, prem epiphyseal plate closure, inc LDL, dec HDL, edema
58
Testosterone cypionate
Testosterone esters Cause hepatotoxicity AE: HEPATOTOXICITY, VIRILIZATION, prem epiphyseal plate closure, inc LDL, dec HDL, edema
59
Methyltestosterone
17-alpha-alkylated compounds Cause hepatotoxicity AE: HEPATOTOXICITY, VIRILIZATION, prem epiphyseal plate closure, inc LDL, dec HDL, edema 17-a abuse AE: HTN, suppressed LH/FSH, CAD/MI risk, aggressiveness
60
Sildenafil
Preferred Oral PDE5 inhibitors Actions: Inhibit PDE5 → cGMP accum → erection AE: Hypotension, CANNOT TAKE w/ alpha block Contraindications: MI, angina, hypotension, HF
61
Vardenafil
Prolonged QT Oral PDE5 inhibitors Actions: Inhibit PDE5 → cGMP accum → erection AE: Hypotension, CANNOT TAKE w/ alpha block Contraindications: MI, angina, hypotension, HF
62
Tadalafil
Long-acting Oral PDE5 inhibitors Actions: Inhibit PDE5 → cGMP accum → erection AE: Hypotension, CANNOT TAKE w/ alpha block Contraindications: MI, angina, hypotension, HF
63
Avanafil
Short-acting Oral PDE5 inhibitors Actions: Inhibit PDE5 → cGMP accum → erection AE: Hypotension, CANNOT TAKE w/ alpha block Contraindications: MI, angina, hypotension, HF
64
Finasteride
5-alpha reductase inhibitors Uses: BPH Action: inhibit T → DHT conversion + promote regression AE: dec libido, gynecomastia, dec PSA → eval for prostate cancer
65
Dutasteride
5-alpha reductase inhibitors Uses: BPH Action: inhibit T → DHT conversion + promote regression AE: dec libido, gynecomastia, dec PSA → eval for prostate cancer
66
Silodosin / Tamsulosin
Uses: BPH Relaxes smooth muscle in bladder neck + prostate Dec dynamic obst AE: abnormal ejaculation
67
Doxazosin / Terazosin
Uses: BPH Relaxes smooth muscle in bladder neck + prostate AE: hypotension, dizziness, nasal congestion

Pharmacology (15 decks)

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