Endocrine Pharmacology

Question 1

What cell type secretes prolactin and where is it secreted from?

Answer 1

Secreted by lactotrophs in anterior pituitary

Question 2

under what condition is prolactin inhibited?

Answer 2

under high dopamine level

Question 3

What does hyperprolactinemia lead to?

Answer 3

leads to hypogonadotrophic hypogonadism

Question 4

What drugs have an effect on dopamine levels and therefore on prolactin ?

Answer 4

Antipsychotics 
Antiemetics 
Antidepressants 
Opiates
H2 receptor antagonists

Question 5

what symptoms may a female with hyperprolactinemia present with?

Answer 5

Amenorrhea (no period – due to hypogonadism from hyperprolactinemia)
Galactorrhea (spontaneous milk flow from breast)

Question 6

what is the most common functioning pituitary tumour? How can it be identified?

Answer 6

Prolactinoma

Using MRI scan

Question 7

What is the first line treatment recommended for a prolactinoma? give an example

Answer 7

Dopamine agonists e.g. cabergoline

Question 8

What is ADH also known as?

Answer 8

Vasopressin

Question 9

Where is vasopressin/ADH secreted from?

Answer 9

secreted from posterior pituitary

Question 10

What condition occurs when ADH is no longer secreted?

Answer 10

Cranial Diabetes insipidus

Question 11

What condition occurs when the body is longer responsive to ADH?

Answer 11

Kidney Diabetes insipidus

Question 12

what are the 2 types of ADH receptors, where are they found and how dot hey respond to ADH?

Answer 12

V1 receptors: on vascular smooth muscle, cause vasoconstriction
V2 receptors: in DCT and collecting tubule of kidneys, increases the number of aquaporin channels to reabsorb water

Question 13

What is desmopressin and what effects does it have?

Answer 13

oral form of vasopressin

Has no vasoconstrictor effects so just increases water reabsorption and a has longer half life

Question 14

What is acromegaly? what causes it?

Answer 14

Hormonal disorder that is caused by pituitary adenoma that leads to excessive growth hormone secretion which stimulates IGF-1

Question 15

What treatment is there for acromegaly?

Answer 15

Somatostatin analogue
Dopamine agonist
GH receptor antagonist

Question 16

side effect of somatostatin analogue?

Answer 16

Gallstones

Question 17

side effect of GH receptor antagonist ?

Answer 17

Liver injury

Question 18

What treatment is given for hypothyroidism and what from does the thyroxine circulate in?

Answer 18

levothyroxine

Mostly as T4

Question 19

What are thionamides and how what is their mechanism of action?

Answer 19

Antithyroid drugs
They reduces thyroid hormone synthesis by:
Inhibiting iodide oxidation (to iodine)
Inhibiting iodination of tyrosine (to form MIT/DIT)
Inhibiting coupling of iodotyrosines (to form T3/4)

Question 20

Name two examples of thionamides, what are their side effects?

Answer 20

Carbimazole - causes low WBC count, concerns about use during pregnancy
Propylthiouracil (PTU) - risk of liver damage

Question 21

List 3 other treatment options for hyperthyroidism

Answer 21

Beta-blockers – propranolol, reduces sympathetic action, doesn’t affect hormonal levels
Potassium iodide – saturates gland and stops hormones being released
Radioactive iodine

Question 22

Which diabetes drugs increase insulin levels? give examples

Answer 22

Sulphonylureas e.g. Gliclazide
GLP-1 agonists e.g. Exenatide, liraglutide
DPP-4 inhibitors e.g. Sitagliptin, linagliptin
Insulin

Question 23

Which diabetes drugs increase insulin sensitivity? give examples

Answer 23

Biguanides e.g. Metformin

Thiazolidinediones e.g. Pioglitazone

Question 24

Which diabetes drug increases glucose in urine? give examples

Answer 24

SGLT2 inhibitors e.g. Dapagliflozin, canagliflozin

Question 25

What effect does metformin have?

Answer 25

Reduced hepatic gluconeogenesis

Question 26

What effect do sulphonylureas have?

Answer 26

Bind to receptor on beta cells, inhibit K+ ATP channels and permit increased insulin secretion
Increased circulating insulin

Question 27

What is PPARγ? What effect do thiazolidinediones have on it?

Answer 27

PPARγ is a nuclear receptor expressed in adipose tissue, muscle, liver.
They are PPARγ agonists and increase transcription of insulin sensitising genes

Question 28

What effect doe SGLT2 inhibitors have?

Answer 28

Inhibit SGLT2 transporters which normally reabsorbs glucose in proximal convoluted tubule
Lowers glucose without causing hypoglycaemia

Question 29

What is the synthetic version of cortisol?

Answer 29

Hydrocortisone

Question 30

Apart from hydrocortisone, give 3 examples of glucocorticoid preparations

Answer 30

Prednisolone
Dexamethasone
Betamethasone

Question 31

Aldosterone is a type of ______?

Answer 31

Mineralocorticoid

Question 32

why can aldosterone not be given orally?

Answer 32

It is metabolised in the liver

Question 33

Give an example of a synthetic mineralocorticoid

Answer 33

Fludrocortisone

Question 34

What effect does aldosterone have?

Answer 34

Main action on Na/K pump –> sodium and water reabsorption, loss/excretion of potassium

Question 35

Give an example of a mineralocorticoid receptor antagonist, what effect does it have?

Answer 35

Spironolactone - block aldosterone receptor

Question 36

give examples of 2 bisphosphonates used to treat osteoporosis? What effect do they have?

Answer 36

Alendronate
zolendronate
Binds to bone and inhibits osteoclast activity