Endocrine Pharmacology Flashcards
Hormone that uses Dopamine as part of the negative feedback mechanism
Prolactin
Hormones secreted by the anterior Pituitary
Growth hormone, TSH, ACTH, FSH, LH, and Prolactin
A performance enhancing drug for growth hormone deficiency. For Turner, Noonan and Prader-Willi diseases.
Somatropin - increases release of IGF-1 in the liver and cartilage.
Somatostatin analog for acromegaly, pituitary adenoma, carcinoids and variceal bleeding. It suppresses IGF-1 secretion
Octreotide
A gonadotropin analog for controlled ovarian hyperstimulation and infertility due to hypogonadism in men.
Follitropin Alfa - activates FSH receptors. Mimics effects of endogenous FSH
A gonadotropin analog - that activated LH receptors, for controlled ovarian hyper-stimulation and hypogonadism
Choriogonadotropin alfa
GnRH analog, mimic GnRH secretion also used for endometriosis, precocious puberty and prostate cancer. May cause hot flashes, osteoporosis and temporary exacerbation of precocious puberty or prostate cancer
Euprolide - increased LH and FSH secretion with intermittent secretion
GnRH antagonist for prostate cancer. It does not cause tumor flare-up when used for treatment of advanced prostate cancer
Ganirelix - blocks GnRH receptors
Dopamine agonist for hyperprolactinemia, acromegaly and pituitary adenoma
Bromocriptine - inhibits prolactin release. Slightly inhibits GH release
For labor induction, labor augmentation and control of postpartum hemorrhage. Contraindicated to fetal distress, prematurity and abnormal presentation
Oxytocin
ADH agonist for central Diabetes insipidus, hemophilia A and also for primary nocturnal enuresis
Desmopressin
ADH antagonist for SIADH and hyponatremia. May cause central pontine myelinolysis due to rapid correction of hyponatremia
Conivaptan
Iodide ion is converted to iodine by what enzyme?
Thyroid peroxidase
Step in the synthesis of TH were tyrosine residues in thyroglobulin are iodinated to form monoiodotyrosine or diiodotyrosine
Iodine organification
Autoimmune disorder where B lymphocytes produce an antibody that activates the TSH receptor causing thyrotoxicosis. These B lymphocytes are not susceptible to negative feedback
Graves disease
Expected thyroid profile of patient with Graves disease
High T3, high T4 and low TSH
Which is more potent? T3 or T4?
T3 is 10 times more potent than T4. T4 is converted to T3 in target cells
Thyroid hormone drug used for hypothyroidism and myxedema coma
Levothyroxine
A medical emergency, representing the end state of untreated hypothyroidism. Treated with IV loading dose of Levothyroxine
Myxedema coma
A thioamide drug for hyperthyroidism and thyroid storm. Drug of choice for pregnant hyperthyroid patients with slow onset of actions
Propylthiouracil - inhibits thyroid peroxidase reactions
A thioamide drug for hyperthyroidism. Drug of choice for nonpregnant hyperthyroid patients. Prenatal exposure causes aplasia cutis congenita
Methimazole
Used for hyperthyroidism by emitting beta rays causing destruction of thyroid parenchyma. Preferred treatment for most patients
Radioactive iodine131
Drug for hyperthyroidism, thyroid storm and used also for radiation prophylaxis. It prevents radiation induced thyroid damage and causes fetal goiter during prenatal exposure
Potassium iodide - SIMD: Lugol’s solution
Condition that results from Ingestion of iodine causing hypothyroidism
Wolf-Chaikoff effect
Condition due to ingestion of iodine causes hyperthyroidism
Jod-Basedow phenomenon
A beta blocker drug used for hyperthyroidism and thyroid storm by inhibiting conversion of T4 to T3 in the periphery.
Propanolol
Condition characterized by sudden acute exacerbation of all the symptoms of thyrotoxicosis, presenting as a life threatening syndrome.
Thyroid storm
Drugs that inhibits conversion of T4 to T3 in the periphery
Propylthiouracil
Propranolol
Hydrocortisone
Low potency hydrocortisone
Desonide
Slow-acting, low potency glucocorticoid for acute adrenal insufficiency, insect bites and thyroid storm
Hydrocortisone
A mineralocorticoid drug for chronic adrenal insufficiency, CAH and adrenal replacement therapy
Fludrocortisone - may cause salt and fluid retention and hypokalemia
Condition associated with adrenal insufficiency
Addison’s disease
Condition associated with adrenal excess
Conn’s disease
Syndrome caused by any condition that produces elevated glucocorticoid levels
Cushing syndrome
Most common cause of Cushing syndrome
Iatrogenic Cushing syndrome due to exogenous steroid intake
Glucocorticoid synthesis inhibitor drug used for breast cancer and Cushing syndrome by inhibiting Desmolase, blocking conversion of cholesterol to pregnenolone
Aminoglutethimide
Azole antifungal used for adrenal carcinoma. Hirsutism and cushing syndrome. May cause hepatotoxicity. Potent CYP450 inhibitor
Ketoconazole
Drug of choice for pregnant patients with Cushing syndrome
Metyrapone
Drug used for primary hypogonadism, postmenopausal hormonal replacement therapy and contraception. May cause breakthrough bleeding and increases risk of Endometrial Cancer and Breast cancer
Ethinyl estradiol
A synthetic estrogen used for atrophic vaginitis, HRT and metastatic prostate cancer. May cause infertility, ectopic pregnancy, clear cell vaginal adenocarcinoma in daughters of mother who took DES
Diethylstilbestrol
Also known as emergency contraception that prevents pregnancy if administered within 72 hours after unprotected intercourse
Postcoital contraceptives - progestin alone, estrogen alone or combination
Combined oral contraceptive also for hypogonadism, acne, hirsutism and endometriosis. But may cause breakthrough bleeding, thromboembolism and breast cancer
Estradiol + norethindrone
Mixed estrogen agonists that have estrogen agonists effects in some tissues and act as partial agonists or antagonists in other tissues
Selective Estrogen Receptor Modulators (SERMs)
SERM for hormone responsive breast cancer. May cause endometrial hyperplasia, hot flushes and endometrial cancer
Tamoxifen
SERMs for breast cancer prevention and osteoporosis but no estrogenic effects on endometrial tissue
Raloxifene - increases bone mineral density.
SERMs used for induction of ovulation. May cause hot flushes, ovarian enlargement and multiple pragnancies. Increased risk of low-grade ovarian cancer with ling term use
Clomiphene
Antiandrogen used fir endometriosis, fibrocystic disease and hemophilia. Contraindicated during pregnancy and breast-feeding
Danazol
Drug for medical abortion, Cushing syndrome. Combination with misoprostol results in abortion of 95% of early pregnancies.
Mifeprostone (RU -486)
Androgen drug for male hypogonadism, delayed puberty and wasting syndrome. Contraindicated in pregnant women and patients with prostate cancer
Testosterone - activates androgen receptors.
Androgen antagonist for prostate cancer and surgical castration by competetitive antagonist at androgen receptor
Flutamide
An androgen antagonist, orphan drug status for hirsutism, component of combined oral contraceptives, decreases sexual drive in men.
Cyproterone
An androgen synthesis inhibitor for benign prostatic hypereplasia, male pattern baldness and hirsutism. May cause impotence, gynecomastia and depression.
Finasteride - inhibits 5a-reductase enzyme that converts testosterone to dihydrotestosterone
Chronic disorder of carbohydrate, fat and protein metabolism due to a relative or absolute deficiency in insulin secretory response
Diabetes Mellitus
In patient with DM type II C peptide value would be? Increase or decrease?
Increase while in DM type I it is decreased
Glucose transporter for brain
GLUT 1 and GLUT 3
Rapid acting insulin
Lispro, Aspart and Glulisine
Short acting Insulin
Regular insulin
Long acting insulin
Ultralente, Glargine, Detemir, and Lantus
Intermediate acting insulin
NPH and Lente
Pancreatic hormone for diabetes mellitus, and diabetic emergencies. All preparations contain zinc
Insulin - beta blockers may mask sign of hypoglycemia
Refers to a condition when the evening dose of intermediate insulin is high, hypoglycemia develops around 3:00am. As a result, counter regulatory hormones are produced, resulting in pre-breakfast hyperglycemia.
Somogyl effect - treatment would be decreasing dose of insulin
Period in DM type I when exogenous insulin requirements decrease due to an increase in the endogenous production of insulin. Transient phase followed by total lack of endogenous insulin production.
Honeymoon Period
Most physiologic strategy because it copies the body’s normal production of insulin as closely as possible.
Basal bolus - long-acting insulin (basal) + short acting insulin with every meal (bolus)
Drugs that stimulate release of endogenous insulin by promoting closure of potassium channels in pancreatic B-cell membrane it depolarizes the cell and trigger insulin release
Insulin secretagogues - not effective in patients who lack functional pancreatic B-cells
First generation sulfonylurea for DMTypeII. May cause hypoglycemia, weight gain and disulfiram reaction. Requires islet cell function
Chlorpropamide - increases insulin secretion from pancreatic cells by closing ATP sensitive K+ channels
Second generation sulfonylurea for DMtype II. Causes less hypoglycemia, weight gain and cholestatic jaundice. Contraindicated in patients with hepatic impairment and renal insufficiency
Glipizide - Glimepiride, Glibenclamide and Gliclazide
A meglitinide drug for DM type II with least hypoglycemia and upper respiratory tract infections. Can be used in patients with sulfa allergies
Repaglinide
Drugs that reduces postprandial and fasting glucose levels by activating AMP-stimulated protein kinase leading to inhibition hepatic and renal gluconeogenesis.
Biguanides - stimulates glucose uptake and glycolysis in peripheral tissues. Slows glucose absorption from GI tract and reduces plasma glucagon levels. Reduce the risk of diabetes in high risk patients.
First line drug for DM type II and Diabetes prevention, and PCOS
Metformin - causes GI disturbances, weight loss and lactic acidosis.
Drug of choice for Obese diabetic patients.
Metformin - contraindicated in patients with renal disease, alcoholism, hepatic disease or conditions predisposing to tissue anoxia
Drugs that increases target tissue sensitivity to insulin by activating the peroxisome proliferator-activated receptor-gamma nuclear receptor. Increases glucose uptake in muscle and adipose tissue. Inhibit gluconeogenesis and both fasting and postprandial hyperglycemia
Thiazolidinediones
Thiazolidinedione drug fro DM type II and diabetes prevention. Contraindicated in pregnancy, chronic liver disease and congestive heart failure
Pioglitazone - Rosiglitazone, Troglitazone
Drugs that inhibits a-glucosidase enzyme. Slowed absorption causes reduction of postprandial hyperglycemia. It reduces risk of diabetes in high risk patients.
Alpha glucosidase inhibitors
Alpha glucosidase inhibitor drug for DM type II that causes Gi didturbances
Acarbose
DPP-4 inhibitor drug, Incretin modulator for DM type II. Administered orally as monotherapy or in combination with metformin
Sitagliptin
Antiobesity drug for obesity and Dm type II. May cause weight loss, flatulence and steatorrhea. Rebound weight gain upon discontinuation
Orlistat - inhibits Gi and pancreatic lipases. Reduces absorption of fats.
Anti obesity drug withdrawn due to increased risk of suicides, depression and other serious psychiatric problems
Rimonabant
Pancreatic hormone for severe hypoglycemia, beta-blocker overdose and radiology of the bowels
Glucagon - activates glucagon receptors
Synthesis and secretion of PTH is primarily regulated by the?
Serum concentration of free ionized calcium
A recombinant parathyroid hormone for osteoporosis. By acting on the PTH receptors to produce a net increase in bone formation
Teriparatide -must be administered in low intermittent doses to stimulate bone formation.
Inactive vitamin D drug for vitamin D deficiency
Ergocalciferol - commonly added to dairy products and other food products
Active vitamin D for secondary hyperparathyroidism in CKD
Calcitriol - active vitamin D is required in CKD, liver disease and hypoparathyroidism
A peptide hormone secreted by parafollicular C cells in the thyroid gland. It decreases serum calcium and phosphate by inhibiting bone resorption and inhibiting renal excretion.
Calcitonin
Drug administered as nasal spray for Paget’s disease of bone, hypercalcemia, osteoporosis and tumor marker for thyroid cancer
Calcitonin
