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Pharm > Endocrine/Reproductive > Flashcards

Endocrine/Reproductive Flashcards

0
Q

Octreotide

A

Somatostatin analog
Tx: acromegaly, Upper GI bleeding (varices), hyperinsulinism
Side Effects: Injection site reaction, gallbladder sludge, n/v, glucose intolerance, carcinoid tumors (diarrhea)
IM

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1
Q

Somatropin

A 
Recombinant human GH
Tx: GH deficiency, short stature
C/I: Active malignancy, ICU pts
Side Effects: ICP, SCFE, scoliosis, DM, soft tissue deposition
SQ daily
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2
Q

Pegvisomant

A

Pegylated recombinant GH (GHR antagonist)
Tx: acromegaly
Adverse Fx: Local reaction, hepatitis, tumor growth
SQ
Cross-reacts with GH; use IGF-1 to monitor effects

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3
Q

Bromocriptine

A

Prototype Dopamine agonist
Tx: hyperprolactinemia
Adverse Effects: n/v, orthostasis (with first dose), blunts antipsychotics
PO daily

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4
Q

Cabergoline

A

Dopamine agonist
Tx: hyperprolactinemia, acromegaly (mixed adenomas)
Higher affinity with longer-half life than bromocriptine
PO weekly
Fewer adverse effects than bromocriptine
High doses (for Parkinson’s) linked to valvular disease

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5
Q

hCG

A

Dx pregnancy
Tumor marker for germ cell tumors
Tx: Stimulate ovulation in fertility treatment and IVF, cryptorchidism

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6
Q

FSH

A

Dx: Precocious puberty or delayed puberty
Tx: Follicle/sperm stimulation in fertility treatment and IVF
Adverse Effects: Multiple gestations, OHSS

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7
Q

Leuprolide

A

GnRH agonist
Tx: Central precocious puberty, hormone-dependent cancers, endometrious/uterine fibroids, and fertility treatment (short-term therapy)
IM

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8
Q

ACTH

A

Tx: infantile spasms

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9
Q

Cosyntropin

A

ACTH fragment
Screen for adrenal insufficiency
IM or IV push

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10
Q

Dexamethasone

A

Potent, long-acting glucocorticoid with no mineralocorticoid activity
Hormone replacement therapy
Tx: stress, inflammation and cerebral edema, chemo adjunct, immunosuppression

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11
Q

Fludrocortisone

A

Potent mineralocorticoid

Hormone replacement therapy

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12
Q

Fluticasone

A

Potent glucocorticoid
Tx: asthma, allergic rhinitis
Inhalant/nasal spray (limit systemic side effects)

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13
Q

Hydrocortisone

A

Short-acting glucocorticoid (mineralocorticoid at higher doses)
Hormone replacement
Tx: inflammation
Topical prep available

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14
Q

Methylprednisolone

A

Intermediate-acting glucocorticoid
Hormone replacement therapy
Tx: inflammation

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15
Q

Prednisone

A 
Intermediate-acting glucocorticoid
Requires liver metabolism into active prednisolone 
Hormone replacement therapy
Tx: inflammation
Used with pregnancy
PO
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16
Q

Prednisolone

A

Intermediate-acting glucocorticoid
Tx: inflammation
Used instead of prednisone with hepatic failure

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17
Q

Triamcinolone

A

Potent, intermediate-acting glucocorticoid (no MR activity)
Tx: asthma, inflammation, psoriasis
PO, IM, topical

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18
Q

Spironolactone

A

MR antagonist
Tx: HTN and CHF
Weak androgen receptor antagonist
Tx: hirsutism

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19
Q

Glyburide

A

Sulfonylurea
Inhibit ATP sensitive K channel (enhances physiological response)
C/I: sulfa allergy, hepatic disease, low GFR
Adverse Effects: hypoglycemia (esp. in elderly), weight gain
1-2 times daily PO, cheap

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19
Q

Glipizide

A

Sulfonylurea
Inhibit ATP sensitive K channel (enhances physiological response)
C/I: sulfa allergy, hepatic disease, low GFR
Adverse Effects: hypoglycemia (esp. in elderly), weight gain
1-2 times daily PO, cheap

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20
Q

Glimepiride

A

Sulfonylurea
Inhibit ATP sensitive K channel (enhances physiological response)
C/I: sulfa allergy, hepatic disease, low GFR
Adverse Effects: hypoglycemia (esp. in elderly), weight gain
1-2 times daily PO, cheap

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21
Q

Repaglinide

A

Meglitinide
Inhibit ATP-sensitive K channel
Most active post-prandially (skip a meal, skip dose)
C/I: hepatic or renal dysfunction, increases cipro and clarithromycin concentration
Side Effects: Hypoglycemia (less than SUs), weight gain

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22
Q

Metformin

A

Biguanide
Improves insulin sensitivity in liver
C/I: renal or liver dysfunction (risk of lactic acidosis)
Side Effects: B12 deficiency, GI effects (titrate dose up)
No hypoglycemia or weight loss
1st line for T2DM
1-3x daily

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23
Q

Pioglitazone

A

Thiazolidinediones (TZDs)
Activates PPARgamma - Regulates FA metabolism and improve insulin sensitivity
Long time (weeks to months) for maximum response
C/I: CHF/edema, hepatic disease, retinopathy, drug interactions (phenyotin, warfarin and amiodarone)
Side Effects: hepatotoxic, weight gain, edema, increase CV risk
1-2x daily

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24
Q

Acarbose

A 
Alpha-glucosidase inhibitor
Reduce carbohydrate absorbtion
Taken with meals
Variable response
GI side effects
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25
Q

Sitagliptin

A

DPPIV Inhibitor
Increases endogenous incretin levels
C/I: acute pancreatitis, heart failure, renal dysfunction
Side Effects: Hypersensitivity (angioedema and urticaria), nasopharyngitis
Daily dosage, costly

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26
Q

Saxagliptin

A

DPPIV Inhibitor
Increases endogenous incretin levels
C/I: acute pancreatitis, heart failure, renal dysfunction
Side Effects: Hypersensitivity (angioedema and urticaria), nasopharyngitis
Daily dosage, costly

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27
Q

Canagliflozin

A

SGLT-2 Inhibitor
Lowers renal glucose reabsorption - osmotic diuresis
C/I: renal dysfunction, elderly, diuretics, hypovolemia, bladder cancer
Side Effects: GU infection, polyuria, volume depletion, LDL increase
Improves blood pressure
Daily dosing, costly

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28
Q

Liraglutide

A

GLP-1 analog
Stimulates insulin release;decreases gastric emptying; suppress appetite
C/I: acute pancreatitis, medullary thyroid cancer
Side Effects: GI, tachycardia, acute pancreatitis

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29
Q

Exenatide

A

GLP-1 analog
Stimulates insulin release;decreases gastric emptying; suppress appetite
C/I: acute pancreatitis, medullary thyroid cancer, GFR < 30
Side Effects: GI, tachycardia, acute pancreatitis

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30
Q

Pramlintide

A

Amylin agonist
Decreases glucagon secretion; slows gastric emptying; satiety
Frequent injections (before meals)

31
Q

Lispro

A

Rapid-acting bolus insulin - post-prandial hyperglycemia
PK suited to carbohydrate absorption
Costly

32
Q

Aspart

A

Rapid-acting bolus insulin - post-prandial hyperglycemia
PK suited to carbohydrate absorption
Costly

33
Q

Glulisine

A

Rapid-acting bolus insulin - post-prandial hyperglycemia
PK suited to carbohydrate absorption
Costly

34
Q

Insulin

A

Short-acting bolus insulin
Low immunogenicity, cheap
Must taken 30 minutes before meal; PK don’t overlap w/ CHO absorb.
Delayed post-prandial hyperglycemia

35
Q

NPH

A

Intermediate acting, basal insulin

Inexpensive; can be mixed with bolus insulin

36
Q

Mixed insulin (70 aspart protamine suspension/30 aspart; 70 NPH/30 insulin)

A

Twice daily at breakfast and dinner

Mimic physiologic insulin

37
Q

Glargline

A

Long-acting basal insulin
Once daily dose; ~ body’s basal secretion
Less hypoglycemia
More costly; Cannot be mixed
Acidic - forms microprecipitates –> slow release
Acidity causes injection site irritation

38
Q

Determir

A 
Long-acting basal insulin
Once daily dose; ~ body's basal secretion
Albumin-bound --> slow release
Less hypoglycemia
More costly
Cannot be mixed
39
Q

Iodine

A

Blocks thyroid hormone release (Wolff-Chaikoff effect) and decreases gland vascularity
Tx thyroid storm (MUST give thionamide first)

40
Q

Methimazole

A

Thionamide - TPO inhibitor; does not inhibit deiodinase
1st line tx for hyperthyroidism
Teratogenic during 1st trimester
Side Effects: Rash, LFTs, lupus-like syndrome, agranulocytosis
Once daily dosing

41
Q

Propylthiouracil (PTU)

A

Thionamide - TPO inhibitor; Type I 5’-deiodinase inhibitor
2nd line tx for hyperthyroidism
Drug of choice in pregnancy - doesn’t penetrate placenta
Hepatotoxic
Side Effects: Rash, LFTs, lupus-like syndrome, agranulocytosis
Twice daily dosing

42
Q

Radioactive Sodium Iodide

A

Ablates thyroid gland
C/I: children and pregnant women
Few side effects - doesn’t concentrate in other parts of body
Requires lifetime thyroid hormone replacement therapy

43
Q

Levothyroxine

A

T4 hormone replacement

7 day half-life - Takes 6-8 weeks for steady state concentration

44
Q

Liothyronine

A

T3
7 hour half-life
4x more potent than T4
Side effects: tachycardia and jitteriness (due to rapid onset)

45
Q

Beta blockers

A

Tx symptoms of hyperthyroidism
Atenolol has advantages of single-day dosing
Propanolol can also inhibit Type I 5’-deiodinase (SLOW effect; contributes little)

46
Q

Thyrotropin Alfa

A

Recombinant TSH
Monitor recurrence of thyroid cancer - “reveals” thyroid cells
Increases radioablation efficacy - stimulates thyroid uptake of I

47
Q

Dessicated Procine Thyroid Extract

A

“Natural” thyroid hormone derived from dsesicated porcine thyroid glands

48
Q

Thryolar

A

Synthetitc combination of T4 and T3

49
Q

Lithium

A

Tx hyperthyroidism; MOA unknown

In vitro, decreases colloid droplet formation within thyroid cells - decreased pinocytosis and proteolytic digestion

50
Q

Dexamethasone

A

Anti-inflammatory
Blocks T4 to T3 conversion
Tx: thyroid storm

51
Q

Abiraterone

A

17alpha-hydroxylase inhibitor
Decreases androgen (adrenal and gonadal) production
Tx castration-resistant prostrate cancer
Used in combination with glucocorticoid (inhibits production)
Pregnant women and children should avoid

52
Q

Degarelix

A

GnRH receptor antagonist
Suppresses gonadotropin release; immediate action
Tx prostate cancer

53
Q

Danazol

A

Weak synthetic androgen
Suppresses FSH/LH release
Tx endometriosis and fibrocystic breast disease

54
Q

Finasteride

A

5alpha-reductase inhibitor; Type II (urogenital tract)
Prevents conversion of T to DHT
Tx BPH and androgenic alopecia (some Type I inhibition)
Larger dose for BPH; often in combo with alpha-1 adrenergic blockers
Avoid in pregnant women (danger to male fetus)

55
Q

Dutasteride

A

5alpha reductase inhibitor (both type)
Tx BPH and androgenic alopecia
Avoid contact with pregnant women

56
Q

Bicalutamide

A

Androgen receptor antagonist
No cross-specificity
Treat prostate cancer
Does not inhibit HPA (used in conjunction with leuprolide)
Receptor eventually develops acquired resistance –> agonist effects

57
Q

Fluoxymestrone

A 
Potent synthetic androgen
HRT for hypogonadism in males
17alpha-alkylated (slow metabolism, PO)
Liver toxicity
Reduced estrogenic activity; not a good substrate for aromatase
58
Q

Methyltestosterone

A

Synthetic androgen
HRT for hypogonadism in males
17-alkylated (slow metabolism; PO)
Liver toxicity, edema, virilization, gynecomstic, polycythemia, prostate

59
Q

Nandrolone

A

Synthetic androgen

Anabolic steroid abused by athletes

60
Q

Testosterone and ester derivatives

A

HRT for hypogonadism and delayed puberty in males
Transdermal patch, gel and buccal capsule for T
Esters delivered by IM injection (slowly absorbed, more sustained)

61
Q

Estradiol and esterifid/conjugated derivatives

A

HRT in women
Tx abnormal uterine bleeding, and atrophic vaginitis
Also used in OCP

62
Q

Drospirenone

A

Synthetic progestin
Spironolactone derivative (can lower BP)
Used in OCP

63
Q

Hydroxyprogesterone caproate

A

Synthetic progesterone

Tx amenorrhea, metorrhagic and induction of secretory endometrium

64
Q

Norethindrone

A

Synthetic potent progestin

HRt, amenorrhea and OCP

65
Q

Norgestrel and Norgestimate

A

3rd generation progestins

OCP, emergency contraception

66
Q

Medroxyprogesterone acetate (MPA)

A

Synthetic progestin
HRT, endometrial hyperplasia, prostate cancer and sex offenders
Progestin-only OCp

67
Q

Progesterone

A

HRT, amennorrhea

68
Q

Estradiol/Norethindrone

A

Combination of E and P for HRT in postmenopausal women

69
Q

Estrogen/Medroxyprogesterone

A

E and P combo

HRT

70
Q

Estrogen/Methyltestosterone

A

Estrogen and T

HRT in postmenopausal women

71
Q

Tamoxifen

A

SERM
Mixed function estrogen receptor agonist/antagonist
Tx breast cancer (chemotherapy and chemoprevention)
Thromoboembolic risk
Stimulates GU growth
Doesn’t prevent hot flashes

72
Q

Raloxifene

A

SERM
Primary indication in osteoporosis prevention and PM HRT
Chemoprevention in breast cancer

73
Q

Clomiphene

A

Anti-estrogen
Induce ovulation in female infertility
Stimulates gonadotropin release in male infertility

74
Q

Mifepristone

A

Anti-progestin
Abortion pill
Must be used in combination with misoprostol

75
Q

Fulvestrant

A

Anti-estrogen

Tx breast cancer in PM women

76
Q

Anastrozole

A

Aromatase inhibitor
Tx locally advanced or metastatic breast cancer (postmenopausal only)
Can cause joint pain

Pharm (6 decks)

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