Endocrine Pharmacology Flashcards
1
Q
GH receptor antagonist
A
Pegvisomant
2
Q
Somatostatin analog used for variceal bleeding
A
Octreotide
3
Q
SSx of ovarian hyperstimulation syndrome (3)
A
Ovarian enlargement
Ascites
Hypotension
4
Q
Drug class used in infertility due to hypogonadism in men
A
FSH analogs: Follitropin alfa, Menotropins, Urofollitropin, Follitropin beta
5
Q
Leuprolide dosing in controlled ovarian hyperstimulation
A
Intermittent
6
Q
Leuprolide causes temporary exacerbation of these diseases (2)
A
Precocious puberty
Prostate cancer
7
Q
Oxytocin receptor blocker
A
Atosiban
8
Q
Only nonsteroidal hormone that can act in nuclear receptors
A
Thyroid hormones
9
Q
Levothyroxine dose must be (decreased/increased) in oatients with cardiovascular disease
A
Decreased
10
Q
Intravenous loading dose of levothyroxin in myxedema coma
A
300-400 mcg
11
Q
Drug of choice for pregnant hyperthyroid patients
A
Propylthiouracil
12
Q
Prodrug of methimazole
A
Carbimazole
13
Q
Teratogenic effect of methimazole
A
Aplasia cutis congenita
14
Q
Antithyroid agents’ onset of action
A
3-4 weeks
15
Q
Antithyroid medication that can cause fulminant hepatitis
A
Propylthiouracil
16
Q
Antithyroid medication that can cause cholestatic jaundice
A
Methimazole
17
Q
Permanent hypothyroidism is a side effect of this drug used for hyperthyroidism
A
131-I (radioactive iodine)
18
Q
Between PTU and SSKI, which one should be administered first in thyroid storm
A
PTU
19
Q
Teratogenic effect of SSKI
A
Fetal goiter
20
Q
Three antithyroid drugs that inhibit peripheral conversion of T4
A
Hydrocortisone
Propranolol
Propylthiouracil
21
Q
Three drugs that can cause hyperthyroidism
A
Amiodarone
Clofibrate
Methadone
22
Q
Most common side effect of clomiphene
A
Hot flushes
23
Q
Amiodarone, when given for less than two weeks, causes hypothyroidism. What do you call this phenomenon?
A
Wolff-Chaikoff effect
24
Q
These antithyroid drugs block uptake of iodide by the thyroid gland through competitive inhibition of the iodide transport mechanism.
A
Anion inhibitors: Perchlorate, pertechnetate, thiocyanate
25
Enzyme that converts cholesterol to pregnenolone
Desmolase
26
Enzyme that converts testosterone to its active form
5 alpha reductase
27
Corticosteroid with the highest salt-retaining activity
Fludrocortisone
28
Corticosteroid with the highest anti-inflammatory properties
Betamethasone
29
Glucocorticoids (2) used to hasten fetal lung maturation
Betamethasone
| Dexamethasone
30
Drug of choice for acute adrenal insufficiency
Hydrocortisone
31
Strategies (3) to minimize steroid side effects
Local application
Alternate-day regimen
Dose-tapering
32
Side effect of fludrocortisone on the bone
Osteoporosis
33
Most common cause of Cushing's syndrome
Iatrogenic
34
ACTH-secreting pituitary adenoma is also known as
Cushing's disease
35
Glucocorticoid synthesis inhibitor that acts on desmolase
Aminogluthetimide
36
Azole antifungal that acts as a glucocorticoid synthesis inhibitor
Ketoconazole
37
Glucocorticoid synthesis inhibitor used in diagnostic testing for adrenal insufficiency
Metyrapone
38
Drug of choice for pregnant patients with Cushing's syndrome
Metyrapone
39
Metyrapone inhibits this step of steroid synthesis to interfere with cortisol and corticosterone synthesis
11-hydroxylation
40
When given alone, ethinyl estradiol increases the risk of:
Endometrial cancer
41
Teratogenic effect of diethylstilbestrol
Clear cell vaginal adenocarcinoma
| Penile carcinoma
42
Effect of estrogen and progestin on blood cholesterol levels, respectively
Estrogen: Increased triglycerides
Progestin: Decreased HDL
43
Type of oral contraceptive that closely mimics hormonal changes in the menstrual cycle
Biphasic/Triphasic
44
Type of oral contraceptives for lactating women
Progestin-only pills
45
Progestin used as an appetite stimulant
Megestrol
46
Effect of combined oral contraceptives on lifetime risk of breast cancer
No effect
47
Component of combined oral contraceptives that is highly antiandrogenic
Drospirenone
48
Intramuscular preparations of medroxyprogesterone acetate are given how frequently?
Every 3 months
49
Emergency contraception with levonorgestrel must be taken within how many hours after unprotected intercourse?
72
50
Full estrogen receptor antagonist used in hormone receptor positive metastatic breast cancer
Fluvstrant
51
Tamoxifen exerts its antagonist and agonist activity on these organs, respectively
Estrogen antagonist: Breast and CNS
| Estrogen agonist: Uterus, liver bone
52
Effect of raloxifene on the uterus
Estrogen antagonist
53
This selective estrogen receptor modulator reduces the incidence of breast cancer in women who are at high risk
Raloxifene
54
Indication for clomiphene
Induction of ovulation
55
Effect of clomiphene on gonadotropins?
Increased FSH and LH secretion
56
With long term use, this SERM increases the risk of low-grade ovarian cancer
Clomiphene
57
This estrogen synthesis inhibitor acts by inhibiting aromatase and is effective against breast cancers that have become resistant to tamoxifen
Anastrazole
58
Indications (4) of danazol, an ovarian inhibitor
Endometriosis
Fibrocystic disease
Hemophilia
Angioneurotic edema
59
Pharmacologic antagonist of glucocorticoid and progesterone receptors used in medical abortion and Cushing's syndrome
Mifepristone
60
Mifepristone, when combined with misoprostol, results in abortion in how many % of early pregnancies?
95%
61
Sepsis due to Clostridium sordelli is a side effect of this progesterone antagonist
Mifepristone
62
Side effects (2) common to all androgens
Virilization in females
| Paradoxical femininization in males
63
This drug is used to treat male hypogonadism, delayed puberty, and wasting syndromes and is contraindicated in pregnant women and patients with prostate cancer
Testosterone
64
Oxandrolone can cause this malignancy
Hepatocellular carcinoma
65
This drug is given to patients following surgical castration
Nilutamide
66
Leuprolide must be co-administered with this androgen antagonist to prevent acute flare up of prostate cancer
Flutamide
67
This androgen antagonist decreases sex drive in men
Cyproterenone
68
Drugs used to treat male pattern baldness inhibit this enzyme
5 alpha reductase
69
Glucose transporter that needs insulin to uptake glucose
GLUT 4
70
Three rapid acting insulin preparations
Aspart
Glulisine
Lispro
71
All preparations of insulin contain this trace mineral
Zinc
72
Human regular insulin peaks in the blood at
30 minutes to 3 hours
73
Duration of action of rapid acting insulin
3-4 hours
74
Three population groups prone to developing hypoglycemia with insulin use
Advanced renal disease
| Children
75
In Somogyi effect, hypoglycemia develops at around 3 AM with subsequent pre-breakfast hyperglycemia. What is the treatment for this?
Decrease evening dose of insulin
76
Blood sugar pattern in waning of insulin dose
Hyperglycemia both at 3 AM and 7 AM (treated by increasing evening insulin dose)
77
Mild pre-breakfast hyperglycemia in dawn phenomenon is attributed to this hormone
Growth hormone
78
Most physiologic strategy for insulin therapy
Basal bolus
79
Insulin secretagogues increase insulin secretion from pancreatic beta cells by closing this channel
ATP-sensitive K+ channel
80
Insulin secretagogues that cause disulfiram reaction
1st generation sulfonylureas
81
Three 1st generation sulfonylureas
Chlorporpamide, Tolbutamide, Tolazamide
82
This 2nd generation sulfonylurea can cause cholestatic jaundice
Glibenclamide
83
Insulin secretagogue that may be used in patients with chronic kidney disease. This drug also has the least incidence of hypoglycemia.
Nateglinide
84
Biguanides activate this enzyme to inhibit hepatic and renal gluconeogenesis
AMP-stimulated protein kinase
85
Drug of choice for obese diabetics
Metformin
86
Thiazolidinediones bind to this receptor
PPAR gamma
87
Thiazolidinedione that reduces mortality and macrovascular events
Pioglitazone
88
Hypoglycemia from acarbose can be treated with
Oral glucose
89
Acarbose, miglitol, and voglibise inhibit this enzyme
Alpha glucosidase
90
Amylin analog that has an anorectic effect.
Pramlintide
91
Aside from hypoglycemia, GLP-1 agonists such as exenatide and liraglutide have this side effect
Acute pancreatitis
92
Sitagliptin, saxagliptin, and linagliptin inhibit the enzyme dipeptidyl peptidase 4 (DPP-4) which degrades:
GLP-1 and other incretins
93
This bile acid binder lowers glucose through an unknown mechanism
Colesevelam
94
Mechanism of action of Orlistat
Inhibits gastrointestinal and pancreatic lipases
95
Sibutramine, an antiobesity drug removed from the market due to increased macrovascular risk, acts by
Inhibiting norepinephrine and serotonin reuptake
96
Rimonabant, a cannabinoid-1 receptor blocker, was removed from the market due to
Increased risk of suicides, depression, and serious psychiatric problems
97
Net effect of parathyroid hormone on phosphate levels
Decreased
98
Indications of ergocalciferol
Vitamin D deficiency: Osteomalacia, Rickets
99
Active vitamin D used to treat hypocalcemia in hypoparathyroidism
Calcitriol
100
Skin disease that can be treated with calcipotriene
Psoriasis
101
Side effects of calcitriol (3)
Hypercalcemia
Hypercalciuria
Hyperphosphatemia
102
This endocrine drug is a tumor marker for thyroid cancer. It is also administered as a nasal spray to treat Paget's disease of the bone, hypercalcemia, and osteoporosis.
Calcitonin
103
Alendronate, a bisphosphonate used for osteoporosis, can cause osteonecrosis of:
the jaw
104
Contraindications of alendronate
Esophageal motility disorders
Peptic ulcers
Renal impairment
105
Phosphate binding resin used in hyperphosphatemia from CKD
Sevelamer
106
Calcium carbonate, the calcium supplement preparation that has the highest elemental calcium content, is how many % calcium
40%
