Endocrine Pharm Flashcards
1
Q
what is the potency of hydrocortisone
A
- 1
2
Q
what is the potency of prednisone
A
- 3.5
3
Q
what do you use to replace glucocorticoids
A
- hydrocortisone
- prednisone
4
Q
what do you use to replace mineralocorticoids
A
- fludrocortisone
5
Q
which drugs are glucocorticoids antagonists
A
- mifepristone
6
Q
which drugs are somatostatin analogs used to inhibit ACTH and GH secretion
A
- pasireotide
7
Q
which drugs are glucocorticoid synthesis inhibitors
A
- ketoconazole
- aminoglutethimide
8
Q
why do you treat hyperprolactinemia with hypercortisolism
A
- hyperprolactinemia often goes hand in hand with hypercortisolism
9
Q
MOA of pasireotide
A
- inhibit release of GH from pituitary gland
10
Q
MOA of ketoconazole
A
- inhibit synthesis of cortisol
11
Q
MOA of aminoglutethimide
A
- inhibit synthesis of cortisol
12
Q
side effects of ketoconazole
A
- gynecomastia
- decrease libido
- impotence
13
Q
why does ketoconazole react with other drugs
what does this cause
A
- inhibits CYP3A4
- can’t metabolize the drug
- increased toxicities
14
Q
MOA of mifepristone
A
- binds GC receptor and inhibits cortisol binding
15
Q
mifepristone pregnancy category
why
A
- X
- induces abortion
16
Q
how do we treat primary hyperaldosteronism
what are they
A
- aldosterone antagonists
- spironolactone
- eplerenone
17
Q
treatments for secondary hypertension due to renovascular cause
A
- ACEi (-pril)
- ARBS (-artan)
18
Q
MOA of bisphosphonates
do we use them for mild or severe osteoporosis
A
- bind to bone
- cause osteoclasts to die by apoptosis
- mild
19
Q
examples of bisphosphonates
which are oral and which are IV
A
- alendronate (oral)
- risedonrate (oral)
- ibandronate (oral)
- zoledronate (IV)
20
Q
toxicities of bisphosphonates
how do we give to patient
A
- esophagitis (oral only)
- osteonecrosis of the jaw (more common in IV)
- on an empty stomach with lots of water
- patients should remain upright for an hour after ingestion
21
Q
MOA of raloxifine
do we use them for mild or severe osteoporosis
toxicities
A
- selective estrogen receptor modulator
- estrogen agonist in bone reversing osteoporosis
- mild
- VTE/stroke
22
Q
MOA of the parathyroid analogs
examples of these drugs
- do we use them for mild or severe osteoporosis
A
- in low intermittent doses stimulates osteoblasts
- teriparatide
- abaloparatide
- severe
23
Q
MOA of Denosumab
do we use them for mild or severe osteoporosis
A
- inhibits activation of osteoclasts by blocking RANKL
- severe
24
Q
treatment for hypothyroidism
which one is preferred and why
A
- levothyroxine/T4 - preferred dude to longer half life
- liothyronine/T3
25
what treatment for hyperthyroidism operates via the Wolff chaikoff effect
- potassium iodide
26
how does radioactive I^131 used in hyperthyroidism
- absorbed by thyroid gland
| - kills thyroid cells
27
MOA of methimazole
preferred during which phase of pregnancy
- thyroid peroxidase inhibitor
| - 2nd/3rd trimester
28
MOA of propylthiouracil
preferred during which phase of pregnancy
- thyroid peroxidase inhibitor
- 5' deiodinase inhibitor
- 1st trimester
29
major toxicity of methimazole and propylthiouracil
- agranulocytosis (neutropenia)
30
why do we use beta blockers in hyperthyroidism
- decrease cardiac output through the thyroid hormone up regulation of beta 1 receptors
31
long-acting insulin is used for
- basal glucose control
32
rapid/intermediate insulin is used for
- meals
33
what insulins are rapid acting
- aspart
- glulisine
- lispro
34
what insulins are short acting
- insulin (natural)
| - regular
35
what insulins are intermediate acting
- NPH
36
what insulins are long acting
- glargine
| - detimir
37
MOA of metformin
what type of drug is it
- inhibits gluconeogenesis in the liver
| - biguanide
38
toxicities of metformin
contraindicated in patients with
- lactic acidosis
- liver failure
- respiratory insufficiency
- alcoholism
- THINGS THAT PROMOTE ANAEROBIC CONDITIONS IN THE LIVER
39
MOA of the thiazolidinediones
examples of these drugs
- increases synthesis of glucose transporters
- Pioglitazone
- Rosiglitazone
- ALL END IN GLITAZONE
40
MOA of acarbose
- glucosidase inhibitor
| - blocks breakdown of saccharides in the intestines
41
MOA of miglitol
- glucosidase inhibitor
| - blocks breakdown of saccharides in the intestines
42
side effects of the glucosidase inhibitors
- GI upset (flatulence, diarrhea, abdominal pain)
43
what are the SGLT2 inhibitors
- end in -aglifozin
44
MOA of Canagliflozin
- SGLT2 inhibitor in PCT
| - decrease reabsorption of glucose
45
MOA of Dapagliflozin
- SGLT2 inhibitor in PCT
46
MOA of Empagliflozin
- SGLT2 inhibitor in PCT
47
toxicities of -agliflozin class
- increased urination
- hypotension
- UTIs
48
how does Canagliflozin promote UTIs
- excess glucose in urine promotes bacterial and fungal growth
49
MOA of sulfonylureas
- block K+ channels to depolarize cell
| - induce secretion of insulin from beta cell
50
what are the first gen sulfonyureas
- tolbutamide
| - chlorpropamide
51
what are the second gen sulfonyureas
- glyburide
- glipizide
- glimepiride
52
MOA of incretin modulators
- activate GLP-1 receptor on beta cells
- decrease glucagon release
- decrease gastric emptying
- increase glucose-dependent insulin release
53
examples of incretin modulators
- exenatide
| - liraglutide
54
MOA of DPP-4 inhibitors
- block enzyme that deactivates GLP-1
55
examples of DPP-4 inhibitors
- linagliptin
- saxagliptin
- sitagliptin
56
pharmacotherapy for type 2 diabetes always starts with
- metformin
57
MOA of desmopressin
used to treat
- ADH analog
| - central DI
58
examples of meglitinide analogs
- Repaglinide
- Nateglinide
- ALL END IN GLINIDE
59
MOA of amylin analogs
examples
- decrease glucagon release, gastric emptying, appetite
| - pramlintide
60
MOA of diuretics
used to treat which form of DI
examples
- induce volume depletion
- increase water reabsoprtion
- nephrogenic
- HCTZ (thiazide)
- amiloride (k+ sparing)
61
how are NSAIDs effective in treating DI
- effective in treating lithium induced DI
- reduces Li+ filtration by decreasing GFR
- prostaglandins vasodilate afferent arteriole. NSAIDS block prostaglandins
62
what two diabetes drugs cause hypoglycemia
- sulfonyureas
| - amylin analogs
