Exam 2 - more endocrine

Question 1

2 drugs to treat hyperthroidism

Answer 1

1. sodium levothyroxine (T4, Synthroid/Levoxyl)

2. sodium liothyronine (T3, Cytomel)

Question 2

MOA for sodium levothyroxine

Answer 2

alters DNA transcription/protein synthesis
promotes GNG
promotes glycogen stores
Increases BMR

Question 3

3 drugs for hypothroidism

Answer 3

1. propylthiouracil PTU
2. Iodides
3. methimazole (Tapazole)

Question 4

2 oral side effects of Tapazole

Answer 4

1. taste alteration

2. salivary gland swelling

Question 5

3 side effects of PTU

Answer 5

1. skin rash
2. nausea
3. agranulocytosis

Question 6

MOA for PTU

Answer 6

Blocks iodination (synthesis of T3/T4) reaction in thyroid gland

Question 7

MOA for Tapazole

Answer 7

Blocks iodines ability to combine with Tyrosine to form T3/T4

Question 8

5 side effects of Tapazole

Answer 8

1. hematologic disorders
2. fever
3. rash
4. vasculitis
5. arthralgia

Question 9

What diabetes medication helps to improve glycemic control in type 1 and type 2?

Answer 9

Long acting Lantus Solostar

Question 10

Side effect of Lantus Solostar

Answer 10

mouth numbness

Question 11

5 classes of type 2 diabetes medications

Answer 11

1. sulfonylureas
2. biguanides
3. alpha-glucosidase inhibitors
4. thiazolidinesdiones (TZDs)
5. Incretins

Question 12

example of a biguanides

Answer 12

metformin

Question 13

5 effects of metformin

Answer 13

1. inhibits absorption of glucose from gut
2. decreases hepatic glucose production
3. increase insulin activity
4. increase peripheral glucose uptake and utilization
5. reduces LDL cholesterol and triglycerides

Question 14

2 side effects of metformin

Answer 14

1. lactic acidosis

2. GI effects

Question 15

4 drugs from the 1st generation of sulfonylureas?

Answer 15

1. tolbutamide
2. tolazamide
3. acetohyxamide
4. chlorpropramide

Question 16

2 drugs from the 2nd more potent generation of sulfonylureas

Answer 16

1. glipizide

2. glyburide

Question 17

3 effects of sulfonylureas

Answer 17

1. promote insulin release from beta cells
2. increase insulin release in pancreas in presence of glucose
3. enhance effect of insulin to stimulate glucose uptake in muscle and fat cells

Question 18

Major drug interaction associated with sulfonylureas

Answer 18

Aspirin - may enhance hypoglycemic response

Question 19

2 drugs from the alpha glucosidase inhibitor class

Answer 19

1. acarbose

2. miglitol

Question 20

MOA for alpha glucosidase inhibitors

Answer 20

Inhibits enzyme that degrades carbs so no monsaccharides are absorbed

Question 21

2 drugs in the TZD class

Answer 21

1. pioglitazone

2. rosiglitazone

Question 22

TZDs: ____ blood glucose by improving target cell response to insulin _____ increasing pancreatic insulin secretion. “____” insulin receptors = reduces insulin resistance. Activity depends on presence of ____ ____. Decrease ___ glucose output. Increase insulin-stimulated glucose uptake in ___ ____. Decreases _____ in adipocytes.

Answer 22

Lower
WITHOUT
Reset
insulin activity
hepatic
skeletal muscle
lipolysis

Question 23

How do incretins work?

Answer 23

Mimic hormones produced by the body to stimulate the release of insulin

Question 24

3 types of estrogen replacement drugs (HRT)

Answer 24

1. conjugated equine estrogens (Premarin)
2. estrified estrogens
3. Estradiol preps

Question 25

Long term findings of HRT drugs?

Answer 25

decrease in cholesterol but increase in blood clots and no reduction of heart disease and may increase risk of stroke. (Increase risk of breast cancer and women with an intact uterus -> risk for endometrial cancer(

Question 26

Combination HRT drug

Answer 26

Prempro (adding progesterone reduces risk for endometrial cancer)

Question 27

2 progesterone replacement drugs

Answer 27

1. norethindrone (OC) | 2. Provera

Question 28

What is Provera used for?

Answer 28

tx of abnormal uterine bleeding, secondary amenorrhea, endometrial cancer

Question 29

EVISTA: activates ____ receptors in bone FDA approved for prevention of _____ in postmenopausal women. Does not activate estrogen receptors in the ____, thus helps prevent cancer. Only medicine proven to reduce both risk of ___ fractures and risk of ___ ___ in postmenopausal women. _____ action on bone. Absence of ____ bleeding and _____ and ____ stimulation.

Answer 29

``` estrogen osteoporosis breast spinal breast cancer anti-resorptive vaginal endometrial breast ```

Question 30

2 side effects of Evista

Answer 30

hot flashes and leg cramps

Question 31

3 oral bisphosphonates (poor bioavailability)

Answer 31

1. Fosamax 2. Actonel 3. Boniva

Question 32

4 IV bisphosphonates

Answer 32

1. Didronel 2. Aredia 3. Zometa 4. Skelid

Question 33

1 IV prevention bisphosphonate

Answer 33

Reclast

Question 34

3 side effects of bisphosphonates

Answer 34

1. erosive esophagitis 2. headache 3. GI distress

Question 35

Bisphosphonates: approved to treat _____ in postmenopausal women, increase bone ____ density, inhibits ____ activity, and inhibits formation, growth, and dissolution of bone ____ ____/

Answer 35

osteoporosis mineral osteoclastic hydroxyapatite crystals

Question 36

_____ increase plasma Ca and maintains levels

Answer 36

PTH

Question 37

Hormone form of Vit D

Answer 37

calcitriol - produced by kidneys in response to PTH