Endocrine II

Question 1

a glucocorticoid receptor antagonist that has anti-progestin activity as an oral contraceptive

Answer 1

mifepristone

Question 2

how do glucocorticoids decrease inflammation/stop the production of prostaglandins?

Answer 2

to allow lipocortin to stop the conversion of phospholipase A2 to phospholipids, no longer creating PGs

Question 3

which 2 corticosteroids are good for children and why?

Answer 3

fluticasone
budesonide

have a high first-pass effect

Question 4

what are the ADR of corticosteroids?

Answer 4

Cushing’s syndrome
Osteoporosis
Retarded growth
Thin skin - bruising
Immunosuppression
Cataracts + glaucoma
Oedema
Suppression of HPA axis
Teratogenic
Emotional disturbance
Rise in BP
Obesity
Increased hair growth
Diabetes mellitus
Striae

Question 5

what are the ADR of long term use of inhaled corticosteroids? (3)

Answer 5

candidiasis
dry mouth
dysphonia

Question 6

why is there an increase risk of infection/immunosuppression in a patient who is taking a corticosteroid?

Answer 6

prevents accumulation of neutrophils and monocytes at sites of inflammation

Question 7

why is osteoporosis possible in a patient taking a corticosteroid?

Answer 7

corticosteroids suppress calcium absorption

Question 8

why would taking a corticosteroid decrease normal adrenal release of cortisol in stressful situations like major surgery, acute infection, or trauma?

Answer 8

because the body will think we have enough cortisol to handle the stress

Question 9

what should we do for a patient that is taking a corticosteroid, who is experiencing or about to experience a stressor?

Answer 9

increase dose 2-3x the usual maintenance dose

Question 10

what should we do to the increased corticosteroid dose once the stressor is over?

Answer 10

decrease dose over several days to previous maintenance level

Question 11

why should we avoid cold turkey in corticosteroids?

Answer 11

cold turkey can lead to adrenal crisis

Question 12

what is a short acting corticosteroid, it’s dosing, administration route, and its duration of action?

Answer 12

hydrocortisone
20mg
IV/IM
8-12 hrs

Question 13

what are the 4 medium acting corticosteroids?

Answer 13

prednisone
prednisolone
methylprednisolone
triamcinolone

Question 14

what is the prednisone dosing, administration route, and its duration of action?

Answer 14

5mg
PO
18-36 hrs

Question 15

what is the prednisolone dosing, administration route, and its duration of action?

Answer 15

5mg
IV
18-36 hrs

Question 16

what is the methylprednisolone dosing, administration route, and its duration of action?

Answer 16

4mg
IV/IM
18-36 hrs

Question 17

what is the triamcinolone dosing, administration route, and its duration of action?

Answer 17

4mg
topical
18-36 hrs

Question 18

what are the 2 long acting corticosteroids?

Answer 18

dexamethasone
betamethasone

Question 19

what is the dexamethasone dosing, administration route, and its duration of action?

Answer 19

0.75mg
PO
36-54 hrs

Question 20

what is the betamethasone dosing, administration route, and its duration of action?

Answer 20

0.6-0.75 mg
PO
36-54 hrs

Question 21

which corticosteroid has the best sodium-retaining potency?

Answer 21

hydrocortisone

Question 22

which corticosteroids have the best anti-inflammatory potency? (2)

Answer 22

dexamethasone
betamethasone

Question 23

what are 4 androgens that are used to replace or augment endogenous androgen in hypogonadal men?

Answer 23

testosterone
methyltestosterone
fluoxymesterone
danazol

Question 24

what is an antiandrogen that is known as a synthesis inhibitor?

Answer 24

cyproterone

Question 25

what is cyproterone used for? (2)

Answer 25

hirsutism in women

male to female gender transition

Question 26

what are androgen receptor antagonists used for?

Answer 26

treat prostate cancer

Question 27

what are 5alpha-reductase inhibitors used for?

Answer 27

“5 alpha reductace inhibitors like to reduce the prostate”

prostate enlargement

Question 28

what hormone is responsible for the enlargement of the prostate?

Answer 28

DHT

Question 29

what drug class will we use to prevent the conversion of testosterone to DHT, to treat benign prostate hypertrophy?

Answer 29

5alpha-reductace inhibitor

Question 30

-steride

Answer 30

5alpha-reductase inhibitors

Question 31

which type of 5alpha-reductase inhibitor drug works everywhere/is non-selective?
what’s the name of the drug?

Answer 31

type 1 - dutasteride

Question 32

which type of 5alpha-reductase inhibitor drug works in the prostate/is selective? what’s the name of the drug?

Answer 32

type 2 - finasteride

Question 33

-sin

Answer 33

alpha 1 receptor antagonists

Question 34

which drug class prevents the narrowing of the lumen of the urethra / relaxes the smooth muscle of prostatic urethra to treat BPH?

Answer 34

alpha 1 receptor antagonists

Question 35

which of the drug classes used to treat BPH has a slower onset? what is it?

Answer 35

5alpha-reductase inhibitors
6 months

Question 36

-fil

Answer 36

PDE5 inhibitors

Question 37

how do PDE5 inhibitors help with erectile dysfunction?

Answer 37

inhibits PDE5 from turning cGMP into GMP

encourages more cGMP (vasodilation) for longer lasting erections

Question 38

what are 4 ADR of PDE5 inhibitors?

Answer 38

since PDE5 inhibitors dilate vessels, they cause:
headache
flushing
dizziness
rhinitis

Question 39

what 2 drugs are CI in patients using a PDE5 inhibitor, due to drug-drug interactions?

Answer 39

nitrates
antihypertensives

Question 40

why do PDE5 inhibitors have a lot of drug interactions?

Answer 40

they are CYP3A4 substrates (metabolized by liver)