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Pharmacology 2 > Endocrine III > Flashcards

Endocrine III Flashcards

1
Q

female hormone that inhibits the release of FSH and LH, helps with female maturation, and prepares the endometrial lining for implantation

A

estrogen

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2
Q

female hormone that inhibits the release of FSH and LH, and prepares and maintains the endometrial lining after implantation

A

progestin

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2
Q

what are 4 things that can occur with estrogen use?

A

decrease bone resorption
retain Na and water
increase HDL + TG
decrease LDL

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3
Q

what are 3 pathological things that can occur with progesterone use?

A

increase body temp
decrease HDL
increase LDL

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4
Q

what are 3 uses for estrogen?

A

contraceptive
HRT
female hypogonadism

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5
Q

what are 4 uses for progesterone?

A

contraceptive
HRT
endometriosis
adjunct for endometrial/breast cancer

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6
Q

what are anti-estrogens used for?

A

hormone-sensitive (ER+) breast cancer

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7
Q

how are most contraceptives metabolized?

A

by the liver

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8
Q

what should we monitor in patients who are taking contraceptives? (7)

A

chest pain
SOB
severe calf/thigh pain
severe headaches
dizziness
weakness/numbness
breast lumps

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9
Q

constant ratio of E and P in each tablet

A

monophasic

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9
Q

E to P ratio changes once during cycle

A

biphasic

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10
Q

E to P ratio changes twice

A

triphasic

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11
Q

tablets of one strength (color) x 21 days + 7 days of inactive tablets (different color), to make up the 28 day dosing cycle

A

monophasic OC

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12
Q

which types of OCs attempt to mimic the rising and falling pattern of estrogen and progesterone during the normal menstrual cycle?

A

biphasic and triphasic

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13
Q

what makes biphasic and triphasic different from monophasic?

A

bi and tri = same estrogen amount each day, but progesterone amount increases half-way through the cycle

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14
Q

tablets of one strength (color) for 7-10 days
tablets of another strength for the next 11-14 days
additional 7 days of inactive tablet, to make the full 28 day dosing cycle

A

biphasic

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15
Q

3 different doses (colors), one for each week, and a 4th dose of hormone-free (inactive tablets) during the last week

A

triphasic

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16
Q

4 doses of estrogen and two (middle) sequences of progesterone

A

quadri-phasic

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17
Q

what regimen of OC should we start with?

A

monophasic with 20mcg of estrogen and progesterone

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18
Q

how does the progesterone-only OC work?

A

inhibit LH surge (final signal for ovulation) = inhibits ovulation

thickened mucus in cervix prevents sperm passage from entering uterus

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19
Q

what does the mini-pill have?

A

low dose progesterone

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20
Q

how does the IUD work?

A

progesterone is released in small amounts, providing 5 years of continuous contraception

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21
Q

what is the IM version of the mini pill?

A

depo-provera (IM)

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22
Q

what do postcoital contraceptives contain?

A

only progesterone

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23
Q

what is plan B one-step? how should it be taken?

A

one dose levonorgestrel

within 72 hours of unprotected coitus

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24
Q

how many doses is next choice?

A

2 doses

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25
Q

what is ella? how should it be taken?

A

ulipristal acetate

within 120 hours of unprotected coitus

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26
Q

how does smoking affect the complications of OC?

A

increases embolic risk

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27
Q

what is important to remember about CYP3A4-inducing medications and OC?

A

CYP3A4 inducers increase the risk of unintended pregnancy for oral and implant contraceptives

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28
Q

progesterone antagonist that prevents implantation

A

mifepristone

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29
Q

progesterone antagonist that is used for abortion (unwanted pregnancy) via a single dose and is only intended for emergency postcoital contraception

A

mifepristone + misoprostol

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30
Q

aldosterone antagonist that includes only progesterone + an antihypertensive property

A

drospirenone

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31
Q

the conception drug that is considered an anti-estrogen drug

A

clomiphene

32
Q

clomiphene MOA

A

inhibits estrogen’s negative feedback, allowing increased secretion of FSH and LH

33
Q

what are 2 important things to tell a patient about clomiphene?

A

ovulation occurs 5-10 days after final dose

increases chance of multiple pregnancies to 10%

34
Q

what are the ADR of clomiphene? (2)

A

increase clotting factor synthesis

increased afterimages

35
Q

which patients should not take clomiphene?

A

patients with thromboembolic disease

36
Q

what could HRT be used to prevent, but comes with the risk of blood clots, heart attack, stroke, and cancer?

A

osteoporosis

37
Q

low bone mass and deterioration of bone tissue

A

osteoporosis

38
Q

osteoporosis bone fragility increases the susceptibility to fractures in which areas? (3)

A

hip
spine
wrist

38
Q

what is used as a diagnostic criteria to help predict future fracture risk?

A

bone mineral density (BMD)

38
Q

what is essential in helping treat a patient with osteoporosis?

A

calcium + vitamin D supplements

39
Q

what helps to decrease fall and fracture risk in patients with osteoporosis?

A

weight-bearing exercises

40
Q

-dronate

A

biphosphonates

41
Q

how do bisphosphonates treat osteoporosis? (4)

A

bind strongly to and accumulate in bone
inhibit bone reabsorption
increase BMD at spine and hip
decrease incidence of fractures

42
Q

why should bisphosphonates be taken on an empty stomach?

A

is very hydrophilic and has bioavailability less than 10% that decreases with food

43
Q

what happens to bisphosphonates in the body?

A

50% goes to bone
50% excreted by kidneys

44
Q

what are the ADR of alendronate, ibandronate, and risedronate?

A

esophageal reflux/heart burn

45
Q

how should bisphosphonates be taken? (2)

A

upright position
take with glass of water 30 mins before food

46
Q

when is the best time to take bisphosphonates?

A

first thing in the morning

47
Q

which bisphosphonate has a higher F, and is only a once yearly infusion?

A

zoledronate (IV)

48
Q

what are the ADR of zoledronate?

A

osteonecrosis of the jaw (usually after major dental sx)

49
Q

what are 2 ADR of bisphosphonates?

A

flu-like symptoms
kidney damage

50
Q

tissue specific estrogen agonist / antagonist

A

SERM (selective estrogen receptor modulator)

51
Q

-xifen

A

SERM
estrogen agonist/antagonist

52
Q

MOA of tamoxifen

A

estrogen agonist in bone, uterus, liver

estrogen antagonist in breast

53
Q

MOA of raloxifene?

A

estrogen agonist in bone

estrogen antagonist in breast and endometrial tissue

54
Q

SERM drugs approved for postmenopausal osteoporosis (2)

A

raloxifene
bazedoxifene/estrogen

55
Q

ADR of raloxifene as a estrogen agonist (2)

A

thromboembolic disease
afterimages

56
Q

why are SERMs an agonist in some tissues and antagonist in other tissues?

A

has a unique drug receptor conformation that interacts with co-activators and co-repressors in different tissues

57
Q

peptide that is composed of 32 amino acids, that binds to osteoclasts and inhibits bone resorption

A

calcitonin

58
Q

what is calcitonin used to treat? (3)

A

osteoporosis in women over 5 years postmenopausal

paget’s disease of bone

hypercalcemia

59
Q

how does calcitonin treat osteoporosis?

A

“calcitonin carries osteoporosis on it’s back”

increases spinal bone mass

60
Q

how does calcitonin treat hypercalcemia? (2)

A

decreases tubular reabsorption of calcium

promotes renal excretion of calcium, phosphate, sodium, magnesium, and potassium

61
Q

what are some ADR of calcitonin as a nasal spray? (6)

A

rhinitis
irritation of nasal mucosa
epistaxis
sinusitis
back pain/arthralgia
headache

62
Q

what are some ADR of calcitonin as an injection?

A

nausea
flushing

63
Q

what hormone regulates calcium and phosphate metabolism in the bone and kidney?

A

PTH (parathyroid hormone)

64
Q

synthetic PTH use to treat osteoporosis in women at high risk for fracture and for primary or hypogonadal osteoporosis in men at high risk of fracture

A

teriparatide

65
Q

teriparatide MOA (2)

A

stimulates osteoblast function

increase calcium absorption from GI tract and kidney

66
Q

why is there a black box warning for teriparatide?

A

osteosarcoma risk in rats

67
Q

post-partum depression medication that mimics the action of allopregnanolone - increasing the activity of GABAa receptors

A

zuranolone

68
Q

-nolone

A

PPD drug

69
Q

what are the ADR of zuranolone? (2)

A

drowsiness
dizziness

70
Q

medication approved for moderate to severe PPD, used IV

A

brexanolone

71
Q

medications used for labor and delivery (4)

A

oxytocin
PG E1
PG E2
misoprostol

72
Q

what are the risks with drugs for labor and delivery, especially oxytocin?

A

uterine rupture
uterine bleeding

73
Q

ADR of PGs E1 and E2?

A

N/V/D
cramping

74
Q

why is hyperprolactinemia an ADR of antipsychotics?

A

blocks inhibitory effect of dopamine on prolactin secretion since they are dopamine receptor antagonists

75
Q

3 dopamine receptor agonists used to treat hyperprolactinemia

A

bromocriptine
cabergoline
pergolide

76
Q

which of the 3 dopamine receptor agonists have the least ADRs?

A

cabergoline

77
Q

what are potential ADR with dopamine receptor agonists? (5)

A

psychosis/hallucinations
headache
n/v
postural hypotension
nasal congestion

Pharmacology 2 (22 decks)

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