Endocrine Pharm Flashcards
Somatropin
Genetically engineered analog of GH
Acts by stimulating the production of IGF-1
Mechanism is through CAMP upregulation
Sermorelin
Synthetic GHRH
Stimulates Gs subunit upregulating CAMP
Causes release of GH
Mecasermin
Recombinant form of IGF-1
Pegvisoment
GH Antagonist
Blocks the binding of GH to GH receptors
Prevents synthesis and release of IGF-1
Bromocriptine
Dopamine agonist
Acts at the D2 receptor to inhibit the secretion of prolactin and GH in cells that express the receptor
Cabergoline
Dopamine agonist
Acts at the D2 receptor to inhibit the secretion of prolactin and GH in cells that express the receptor
Octreotide
Synthetic analog of SST
Longer half life than SST
Stimulates the Gi subunit decreasing the synthesis and release of GH
Pasireotide
SST Analog
Can also inhibit secretion of ACTH
Approved for treatment of Cushings Disease
Thyroglobulin
Proloid
Thyroid Hormone
Potency of each preperation varies
Sodium Levothyroxin
Synthroid
Drug of choice for Myxedema
Sodium Lyothyronine
T3
Short acting, rapid onset
Lugol’s Solution
Potassium and Iodide in high concentration in solution
High concentration of Iodide inhibits thyroid hormone secretion
I131
Radioactive Iodine
Drug of choice for destroying toxic adenoma
Prednisone
Oral corticosteroid
Can block the intestinal absorption of Calcium
Can be used in hypercalcemia
Bisphosphonates
Bind to hydroxyapetite to prevent the resorption of bone
Used in Paget’s disease and Osteoporosis/penia
Teriparitide
Human PTH
Stimulates new bone growth
Reduces vertebral fracture risk 65%
Raloxifine
SERM
Similar to hormone replacement but without increased risk of breast cancer
Increases estrogen
Methimazole
Inhibitor of thyroid peroxidase
PTU
Drug of choice for treatment of thyrotoxicosis is pregnant women
Inhibitor of TPO
Mercaptomidazole
DO NOT USE IN PREGNANCY
Inhibitor of TPO
Beclomethasone
Corticosteroid
Rapidly metabolized by the lungs
Can be taken by inhalation
Fluticasone
Corticosteroid
Taken orally
Undergoes significant first pass metabolism
Mifepristone
Glucocorticoid antagonist
Approved for hyperglycemia in Cushing’s syndrome patients
Also used for early term abortions
Spironolactone
Aldosterone inhibitor
Used for hypertension and CHF
Eplerenone
Selective mineralocorticoid recepter antagonist
Less side effects than spironolactone
Dexamethasone
Long acting glucocorticoid
Feedback inhibition on CRH prevents release of ACTH
Does not enter the CNS
Metyrapone
Inhibits 11B-hydroxylation
Prevents biosynthesis of glucocorticoids
Aminoglutethimide
Inhibits cholesterol to progenelone step of adrenal steroid biosynthesis
Ketoconazole
Antifungal antibiotic that inhibits 11B Hydroxylase
Insulin
Not active orally
Injected Subcutaneosly
Used to replace insulin not made by B cells
Insulin lispro
Synthetic insulin
Absorbed more rapidly
Doesn’t dimerize upon injection
Can be injected just prior to eating
NPH Insulin
Intermediate acting Insulin
Forms protamine zinc insulin
Insulin is released slowly from the complex
Insulin Glargine
Ultra long acting synthetic insulin
Precipitates upon injection and slowly dissolves over time
Does not produce peak concentration
Insulin Detemir
Newer peakless long acting insulin
Injected twice a day
Precipitates upon injection and dissolves over time
Tolbutamide
First generation Sulfonylurea
Inhibit K+ efflux causing depolarization of B cells and the release of insulin
Can cause hypoglycemia
Glyburide
Second generation sulfonylurea
Inhibit K+ efflux causing depolarization of B cells and the release of insulin
Can cause hypoglycemia
Glipizide
Second generation sulfonylurea
Inhibit K+ efflux causing depolarization of B cells and the release of insulin
Can cause hypoglycemia
Metformin
Inhibits gluconeogenesis in the liver
Almost never causes hypoglycemia
Can cause lactic acidosis
Acarbose
Alpha glucosidase inhibitor slows breakdown of carbs in the intestines
If hypoglycemia occurs patient should take glucose tablets
Pioglitazone
Decreases insulin resistance
May reduce risks of heart attack and stroke
Increases synthesis and translocation of glucose transporters
Repaglinide
Same mechanism of action as sulfonylureas
Sitagliptin
Inhibits DPP4 which normally breaks down GLP-1
Elevated levels of GLP-1 stimulate insulin release
Canagliflozin
SGLT2 Inhibitor
Taken orally
Reduces reuptake of glucose in the kidney
Can cause mycotic infections and UTI
Testosterone enanthate
IM 2x/month or transdermal preps
Synthetic testosterone replacement
Testoderm
Testosterone coated film taped to the thin skin of the scrotum
Androderm
Skin permeation enhancers added to the film
Patch can be placed anywhere
Permeation enhancers cause some skin irritation
Androgel
Androderm in the form of a gel
Rubbed onto skin
Danazol
Orally active androgens
Used in chronic angioedema
Stimulates hepatic synthesis of esterase inhibitor
Stanozolol
Orally active androgens
Used in chronic angioedema
Stimulates hepatic synthesis of esterase inhibitor
Flutamide
Androgen receptor antagonist
Limited efficacy due to increase in LH secretion that counteracts the effects
Used with GnRH analogues to treat metastatic prostate cancer
Leuprolide
GHRH agonist that stimulates receptors interrupting normal pulsatile release
This downregulates production of FSH and LH
Bicalutamide
Androgen receptor antagonist
Limited efficacy due to increase in LH secretion that counteracts the effects
Used with GnRH analogues to treat metastatic prostate cancer
Cyproterone Acetate
Weak antagonist of the androgen receptor
Used to treat hirsutism is women
Finasteride
Blocks type II 5a Reductase (prostate)
Prevents conversion of T to DHT
Approved for male pattern baldness
Dutasteride
Blocks 5a reductase
Prevents conversion of T to DHT
Sildenafil
PDE5 inhibitor
Prevents breakdown of cGMP
Nerves must be functional for erection to be achieved
Alprostadil
PGE1 agonist
Causes increase in cAMP
Doesn’t require functional neurons
Injected into the penis
Papaverine
Nonselective PDE inhibitor
Prevents breakdown of CAMP and CGMP
Injected into the penis
Phenotolamine
A adrenergic receptor agonis
Constricts arterioles promoting erection
Injected into the penis