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DEMS > Endocrinology Pharmacology > Flashcards

Endocrinology Pharmacology Flashcards

1
Q

Ending for Somatostatin analogs

A

reotide

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2
Q

Calcitonin mechanism

A

inhibit osteoclast bone resporption avaliable SC or nasal spra

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3
Q

Plant Sterols and Stanols - uses

A

inhibits 50% of cholesterol absorption to decrease TG and LDL, not HDL.
Dyslipidemia

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4
Q

Calcitonin ADRs

A

N, hand swelling, urticaria cramps

Rhinitis, epistaxis

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5
Q

Bromocriptine - Class

A

DA Agonist

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6
Q

Kinetics Octreotide vs. Lanreotide

A

Octreotide: SC every 6-12 hours or IM 1x month
Lanreotide: SX 1x month

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7
Q

ADRs of thionamids

A

Pruritic rash, gastric intolerance, arthralgia
Agranulocytosis
PTU _ hepatotoxicity - rare!

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8
Q

Phenoxybenxamine

A

irreverisble alpha antagonist

used for HTN control in pheochromocytoma

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9
Q

Demeclocycline - mechanism

A

Inhibits ADH on distal tubule

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10
Q

ADRs of Vitamin D

A

toxicity Hypercalcemia and hypercalciuria

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11
Q

Sclerostin

A

also romosozumab that blacks osteoblast differential and stimu
increase formation and resportion. still in trial

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12
Q

what causes SIADH?

A

Tumors, pulmonary dz, CNS trauma, infection.

SSRIs, halperidol, TCADs

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13
Q

Coenzyme Q10

A

Antioxidant used for hypertension.
Statins, BB, and diuretics can lower level of this in the body.
Must take with fatty meal

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14
Q

Dihydrotachysterol

A

1,25 (OH)2 Vitamin D3

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15
Q

Mecasermin - uses

A

use if growth hormone insensitive - Laron Dwarfism

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16
Q

Metoprolol

A

selective Beta blocker to control tachycardia

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17
Q

Action of bisphosphonate

A

Pyrophosphate analog that incorporated into hydroxyapettie of bone to promote osteoclast apoptosis and inhibit osteoclast fxn

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18
Q

Chlorpropamide - use

A

central diabetes insipidus pts that are DDAVP intolerant

risk of hypoglycemia

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19
Q

Treatments for Central Diabetes Insipidus

A

ADH Analog - Desmopressin (DDAVP)

Chlorporpamide

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20
Q

Somatropin - ADRS

A

Safe in kids

Insulin resistance, glucose intolerance, slight risk of pseudotumor cerebri

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21
Q

Somatropin uses

A

Replacement therapy for GH deficient kids - SC or 3x/week IM
Poor growth with turner’s, prader willi, renal insufficiency
wasting or cachexia in AIDS
Controversial for adults with GH deficiency
Controversial for kids with idiopathic short stature

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22
Q

Uses of calcitonin

A

treatmeny.t of osteoporosis - NOT prevention!

Useful if back pain

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23
Q

Ergocalciferol

A

D2

Less efficient than D3

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24
Q

Mechanism of thionamides

A

blocks thyroid peroxidase

PTU also inhibits 5’deiodinase to decrease peripheral conversion

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25
Q

Somatropin Kinetics

A

IM

T1/2 is 25 minutes but lasts for 36 hours

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26
Q

Treatment of SIADH

A

Demeclocycline

V2 Antagonists

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27
Q

Mechanism of Desmopressin

A

ADH analog that has V1- Vasocontrictive effects on Gq and antidiruetic effect V2 (Gs)

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28
Q

when should Thionamides be used

A

mild hyperthyroidism, small glands, or young patients

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29
Q

Teriparatide uses

A

treatment of sever osteoprosis

not recommended for greater than2 years

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30
Q

Somatostatin analog - Uses

A

Growth Hormone excess - Acromegaly and Gigantism
Meds following surgery
Octeotride is used to control bleeding of esophageal varices and GI hemorrhage

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31
Q

Use of calcium gluconate

A

severe hypocalcemia (IV

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32
Q

Iodide and thionamide tx

A

iodide can delay the effect of thionamide tx, so start after the effects take place.

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33
Q

Metyrosine

A

Competitive inhibitor of Catecholamine synthesis

inhibits tyrosine hydroxylase

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34
Q

Recommended dietary intake of calcium

A

Adolescent 1300 mg
29-50 and men 50-70: 1000 mg
Men >70 and women >50: 1200 mg

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35
Q

Calcium and loop diuretics

A

increase calcium excretion.

used for hypercalcemia

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36
Q

Strength of GCC anti-inflammatory

A

DEX> Triamcinolone>Pred>cortisol

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37
Q

Trilostane

A

inhbits 3Beta hydroxysteroid dehydrogenase - inhibits progesterone formation
late

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38
Q

Iodide - SSKI and Lugol’s mechanism

A

high doses of iodine inhbiits thyroid hormone synthesis with rapid action

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39
Q

Sterols and Stanols - ADRs and DDIs

A

GI - nausea, vomiting, constipation, diarrhea,
takes 2-3 weeks to be effective, and only effective as long as you take it.
DDI: Zetia

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40
Q

Conivaptan - class

A

V2 Receptor antagonist

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41
Q

Liotrix

A

4:1 T4/T3 combination

rarely required or recommended.

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42
Q

Mecasermin - class

A

Recombinant IGF-1

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43
Q

Contraindications with Fish Oil

A

Limit to 12oz per week with pregnancy
increases risk of bleeding
DDIs: antihypertensives, antigcoagulatns, contraceptives, orlistat
Ginger, Garlic, Ginkgo, and Ginseng

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44
Q

Metyrapone

A

Inhibits 11B hydroxylase to inhibit cortisol formation.

Late

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45
Q

131 iodine tx vs surgery

A

80% of iodine are hypothyroid

50-60% post surgery are hypothyroid

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46
Q

Treatment for hyperprolactinomas

A

Cabergoline and bromocriptine - DA agonists

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47
Q

Treatments of nephrogenic diabetes insipidus

A

Thiazide diuretics

NSAIDS

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48
Q

Calcitriol

A

1,25 (OH)2 Vitamin D3

for pts with decrease VD synthesis - CRF and Vit D dependent rickets

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49
Q

Uses of Desmopressin

A

Central Diabetes Incipidus due to inadeqate ADH secretion.

Nocturnal emesis

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50
Q

Denosumab

A

RANKL antibody that prevents stimuation of osteoclast acitivt
give SC q 6 months

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51
Q

Bisphosphonate action

A

1-10% oral absoprtion

not recommended for low GFR

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52
Q

Mifepristone

A

Glucocorticoid Receptor antagonists at high doses.

used to control hyperglycemia secondary to elevated cortisol

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53
Q

Prednisone ratio of GCC: MCC

A

4:0.3 -

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54
Q

Which calcium do you take iwth meals?

A

calcium carbonate

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55
Q

Teriparatide

A

PTH analog
Anabolid tx for osteoporosis
synthetic PTH administered intermittently (SC QD) to increase osteoblastic activity.

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56
Q

Cholecalciferol

A

D3

preferred replacement agent due to modest cost and efficacy

57
Q

Kinetics of Pegvisomant

A

SC 1x day

58
Q

Niacin - uses

A

lower LDL and TG, increase HDL, but no decrease in all cause mortality.

59
Q

11Beta-HSD1

A

Activation of cortisone to cortisol in LIVER

inactive in fetus

60
Q

131 iodine

A

radioactive iodine used for hyperthyrodism.
Preferred in pts >21
CI in pregnancy
80% progress to hypothyroidism

61
Q

Kinetics Tolvaptan vs. Convivaptan

A

Tolvaptan is Oral and Convivaptan is IV

62
Q

Adverse effects of Levothyroxine

A

Caution for pts with heart disease
Hyperthyroid:
Kids: restless, insomnia, accelerated bone maturation
Adults: anxiety, heart palpitations, exacerbate cardiac symptoms.
DDI: will increase adrenergic effects or decongestants.

63
Q

Ending for bisphosphonates

A

dronate

64
Q

Aldosterone ratio of GCC: MCC

A

0.3:3000

65
Q

HTN supplement uses

A

Garlic

CoEnzyme 10

66
Q

Raloxifine uses

A

second line for osteoporosis and for increased risk of invasive breast cancer
tx and prevention

67
Q

Fludrocortisone ratio of GCC: MCC

A

10:125-500

68
Q

Garlic - uses

A

Allicin is active ingredient to inhibit hepatic cholesterol synthesis for HTN and dyslipidemia treatment
Need 4g per day -
odorless product does NOT have allicin

69
Q

Tolvaptan - class

A

V2 Receptor antagonist

70
Q

risks of somatropin in athelets

A

acromegaly, arthropathy, viceromegaly due to higher than physiology GH levels

71
Q

Raloxifine ADRs

A

hot flashes, leg cramps, thromboembolic disorders

72
Q

Raloxifine

A

Selective estrogen receptor modulator
to decrease osteoclast avitiy and increase OPG
works in bone and liver, but antagonist in uterus and breast

73
Q

Pharmacologic use of glucocorticoids

A

use those without MCC acitvity

74
Q

Kinetics - Desmopressin

A

Nasal 1-2x/day
Oral 2-3x/day
T1/2 is 2 hours

75
Q

Somatropin - class

A

Recombinant GH

76
Q

Propylthiouracil -class

A

Thionamide

77
Q

Miacalcin

A

Nasal calcitonin

78
Q

Mitotane

A

Inhibits Cholesterol Oxidase early in Glucocorticoid synthesis.
for cushings

79
Q

Bitter Orange uses

A

created in response to ephedra ban
contains 1-6% synephrine. used for weight loss
not recommended due to potential for death.

80
Q

PTU absorption vs. Methimazole

A

PTU is 50-80% and methimazole is 100%

81
Q

Vanadium - uses and ADRs

A

T2D
DDI: anticoagulants and antiplatelets
Risk of kidney toxicity

82
Q

Physiologic replacement of glucocorticoids

A

need both GCC and MCC acitivty

83
Q

Calcium - uses

A

people with low calcium, gain more weight.

but calcium supplementation does not make make up for fat intake.

84
Q

Desmopressin - class

A

ADH analog

85
Q

Ketoconazole

A

Inhibits 17,20 demolase that inhibits formation of pregenenolone.
to inhibit early glucocorticoid synthesis

86
Q

Ephedra - use

A

moderate weight loss

stimulated nervous system

87
Q

Hydrochlorothiazide

A

thiazide diuretic to decrease Ca excretion. used for hypercalciuria

88
Q

Mecasermin - ADRS

A

hypoglycemia

take with carbs to avoid

89
Q

Treatment of pheochromocytoma before surgery?

A

1) phenoxybenzamine
2) meoprolol
3) Nefedipine
4) Metyrosine

90
Q

Pegvisomant - mechanism

A

mutated GH that competitively inhibits GH receptor

91
Q

Orlistat

A

FDA approved for long term weight loss.
Take MVitamin 2 hours before or after dose.
ADR: liver damage/failure

92
Q

Garlic ADRs

A

discontinue 2-3 weeks prior to surgery.
Ginger, Ginko and Vitamin E
Anticoagulant and Antiplatelet drugs

93
Q

Cabergoline - class

A

DA agonist - used for GH excess and Hyperprolacinemia

94
Q

Dexamethosone ratio of GCC: MCC

A

30: 0 no mineralcorticoid

95
Q

Treatment of thyroid storm

A

1) propanolol to block t4-T3 conversion
2) sodium iodide or KI (oral)
3) PTU to block synthesis
4) hydrocortisone to protect against shock

96
Q

V2 Receptor atagonist - mechanism

A

inhibits antidiuretic effect of ADH

97
Q

Liothyronine

A

Synthetic T3
Shorter T1/2 1 day
Used in T3 suppression test…

98
Q

Chlorpropamide - class

A

1st generation sulfonylurea

99
Q

Management of CAH in kids vs. adults

A

kids: hydrocortisone

Adults; pred or dexa

100
Q

Somatostatin analog - mechanism

A

Inhibits GH release via Gi protein receptor to decrease cAMP.
Also decreases Insulin and glucagon, intereferes with TRH, and decreases GI motilit

101
Q

Chromium - uses and mechanism

A

Reduction of blood glucose, HbA1C and FFA and reduces oxidative stress with mixed data.
several salt forms exist
risk of renal and liver dysfunction

102
Q

when should levothyroxine be taken?

A

on an empty stomach with water for best absoprtion - impaired by metal ions, cipro, dietary fiber, and soy

103
Q

Denosumab

A

high risk of fractures or unresponsive to bisphosphonates

Tx NOT prevention

104
Q

Triamcinolone ratio of GCC: MCC

A

5:0 - no mineralcorticoid activity

105
Q

Lanreotide - classy

A

somatostatin analog - inhibits GH

106
Q

Somatostatin Analogs - ADRs

A

transient hyperglycemia

107
Q

Iodomethacin - mechanism

A

a NSAID that inhibits PG synthesis
To increase ADH activity in nephrogenic DI
used in combo with hydrochlorothiazide

108
Q

Teriparatide ADRs

A

nausea, HA, dizzy, sever muscle pain

109
Q

Fish oil - indication and mechanism

A

Hypertriglyceridemia

decreases hepatic secretion of VLDL and increases VLDL clearance.

110
Q

What supplements are taken for weight loss

A

Calcium
Ephedra
Bitter orange
Alli/Orlistat

111
Q

Chlorpropamide - mechanism

A

mechanism of sulonylurea K block potentiates ADH action

112
Q

What are the medicine treatments for GH excess

A

1) Somatostatin Analogs
2) DA agonists
3) GH receptor antagonist

113
Q

Diabetes supplement meds

A

Chromium

Vanadium

114
Q

Methimazole - class

A

Thionamide

115
Q

Nefdipine

A

Ca channel blocker

116
Q

ADRs with Desmopression

A

GI upset, Headache, allergy

Nasal irritation with nasal administration

117
Q

Use of Iodide

A

Rarely used alone
KI and NaI are used in thyroid storm
KI is protective against radioative iodide uptake

118
Q

What alternative meds are used to treat dyslipidemia?

A

Fish Oil
Fiber
Niacin
Plant sterols and stanols

119
Q

Thyroid USP

A

porcine thyroid extract

NOT recommended due to unexpected toxicity and antigenicity

120
Q

Drugs that cause central diabetes insipidus

A

Lithium

Demeclocycline

121
Q

Hydrocortisone - ratio of GCC: MCC

A

1:1

122
Q

DA agonists - uses

A

Second line: Cabergoline for GH excess, oral intake

First line for Hyperprolactinoma - Cabergoline is perferred due to less side effects. But Bromocriptine for pregnancy

123
Q

DA agonist - mechanism

A

Binds to D2 receptor to decrease GH secretion and prolactin secretion. Also reduces size of prolactinoma

124
Q

What is a good steroid to give fetus?

A

Betamethosone - poor substrate to 11B-HSD2 - less deactivation

125
Q

ADRs with bisphosphonates

A

Esophagitis!
Atypical femur fractures
Osteonecrosis of jaw

126
Q

Bisphosphonate uses

A

First line therapy for osteoporosis
and hypercalcemia of malignancy
Prevention and treatment

127
Q

Calcifediol

A

25 OH Vitamin D3

doesn’t require liver hydroxylation, useful in liver Dz

128
Q

PTU vs. Methimazole pregnancy

A

PTU is preferred due to higher binding and decreased crossing placenta

129
Q

AD agonists Side Effects

A

N/V, Head ache, postural hypertension

130
Q

Pegvisomant - class

A

GH receptor antagonist

131
Q

Recommended vitamin D intake

A

<70 is 600 IU

>70 is 800 IU

132
Q

Hydrochlorothiazide - uses

A

Nephrogenic DI - due to inadequate ADH action - paradoxically reduces polyuria.

133
Q

11Beta - HSD2

A

Inactivating from Cortisol to cortisone in Kidney

active in fetus

134
Q

Coenzyme Q10

A

Anticoagulants

Increase T4/T8 ratio

135
Q

Ephedra = ADRS

A

dizziness, N/D, papitations, HTN, MI, arrhythmias, suddent death.
Benefits do not outweigh the risks

136
Q

Niacin Side effects

A

Flushing, increased uric acid, increased blood glucose, headache.
Hepatotoxicity

137
Q

Doing of T4 across the continuum

A

Infants: require more T4
Adults: start at 50-100 ug and titrate up
Elderly: low dose to prevent subclinical cardiac disease
pregnancy: increase dose due to high TBG

138
Q

Octreotide - class

A

Somatostatin analog - inhibits GH

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