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Exam 4 Endocrine Pharmacology Flashcards

1
Q

Ovine corticorelin (Acthrel)

A

CRH analog. helps release ACTH. Used for dx Cushings

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2
Q

Corticotropin (Acthar)

A

porcine ACTH. used for adrenal insuff dx (by stim adrenals), symptoms of MS (by immunosupp) and infantile spasms

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3
Q

Cosyntropin (Cortrosyn)

A

synthetic ACTH. used for adrenal insuff dx (by stim adrenals)

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4
Q

hydrocortisone, cortisone, prednisone, prednisolone, methylprednisolone, mometasone furoate (topical)

A

short acting and low potency glucocorticoids

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5
Q

traimcinolone (+nystatin)

A

intermediate acting and potency glucocorticoid

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6
Q

betamethasone, dexamethasone, clobetasol prop (topical)

A

long-acting with high potency glucocorticoid

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7
Q

dexamethasone sod phos, fluorometholone, medrysone, prenisolone acetate, difluprednate

A

opthalmic GC for allergic conjunctivitis, post-op inflammation

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8
Q

fludrocortisone

A

only MINERALCORTICOID. for hypoaldosteronism or adrenal insuff.

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9
Q

adrenal insuff use MOA

A

replacement addisons disease

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10
Q

anti-inflammatory general MOA

A

inhibits and decreases PLA2 expression

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11
Q

anti-inflamm for asthma MOA

A

decrease COX2 exp

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12
Q

anti-inflamm for arthritis MOA

A

decrease leuk count

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13
Q

anti-inflamm for GI

A

decrease leuk function

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14
Q

anti-inflamm for post sx

A

decrease macrophage function

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15
Q

uses of GC *5 As

A

adrenal insuff, anti-inflamm, allergies, auto-immune and anti-neoplastic

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16
Q

SE of GC general

A

cushings like

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17
Q

SE of GC adrenicortical insuff d/t

A

adrenal suppression

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18
Q

SE of GC hyperglycemia d/t

A

decrease glucose uptake and increased glycogen

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19
Q

SE of GC muscle wasting d/t

A

increase GNG

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20
Q

SE of GC hyperNa, edema, HTN, hypoK, alkalosis d/t

A

increase NA, decrease K and decrease H reabs.

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21
Q

SE of GC ammenorrhea/hirsutism d/t

A

decrease LH (and thus estrogen)

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22
Q

SE of GC stunted growth d/t

A

decrease GH

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23
Q

SE of GC peptic ulcers d/t

A

decrease PLA2 and COX2

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24
Q

SE of GC immunosupp/infection d/t

A

decrease leuk, decreased PLA2 and COX

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25
SE of GC myopathy d/t
decrease K reabs
26
SE of GC osteoporosis d/t
inhibits osteoblast and decrease Ca from gut which leads to increase PTH (pulling Ca from bone)
27
SE of GC cataracts d/t
oxidative stress induced by GCs depletes GSH
28
GC contraindicated in
DM, hypothyroid, ulcers, inf (esp TB), preg, COPD
29
GC interactions with
P450 inducers, NSAIDs, K depleting diuretics and vaccines
30
pasireotide (signifor LAR)
anticorticosteriod which inhibits release of ACTH via SST5. used for cushings or acromegaly (extra GH) when sx fails. analog of SST and is selective for SST2 and 5.
31
metyrapone (metopirone)
anticorticosteroid that inhibits 11beta-hydroxylase (synthesis inhibitor). inhibits cortisol and aldosterone synthesis. used to dx HPA axis or tx tumors. if give should see low cortisol causing increase in CRH/ACTH release and increase in 11-deoxycortisol so hypo/pit okay!
32
mitotane (lysodren)
anticorticoid binds mitochondria proteins to cause atrophy in zona fasc and reticularis of adrenal cortex (synthesis inhibitor). only effects GC. used for adrenal tumor.
33
mifepristone (korlym) aka mifeprex
anticorticosteroid antagonizes progesterone and GC receptors at higher conc (receptor antag-tx excess cortisol) used for abortion, cushings from ectopic ACTH.
34
spironolactone
anticorticosteroid that antagonizes MC receptors (excess aldosterone). used for primary or secondary aldosteronism, edema, hypoK, HTN and HF.
35
androgen general MOA
activation of nuclear androgen receptor. used for breast tumors, anabolics, anemia, osteoporosis, reverse male aging.
36
goserelin, nafarelin, triptorelin, histrelin, leuprolide
GnRH analogs, receptors agonists (antiandrogen). long-acting analogs suppress FSH/LH. for prostate CA or BPH in males and for breast CA, endomet...in women.
37
degarelix (firmagon)
GnRH antagonist (antiandrogen)
38
abiraterone acetate (zytiga)
testosterone and estrogen synthesis inhibitors (antiandrogen). inhibits CYP17 to inhibit synthesis of test/estrogen. used for AR + prostate tumors.
39
finasteride and dutasteride
DHT synthesis inhibitors (antiandrogen). inhibits 5alpha reductase (esp type2). used for BPH, alopecia and hirsutism in women. dutasteride-type 1 and 2.
40
flutamide, bicalutamide, nilutamide, enzalutamide and spironolactone
androgen receptor antagonists (antiandrogen). competitive antagonism of androgen receptors. uses for prostate CA and XS androgen in women.
41
gonadotropins
FSH and LH
42
Menotropins, hMG
FSH and LH like drug for infertility
43
Urofollitropin, hFSH | Follitropin alfa, r-hFSH
FSH like drugs for infertility
44
Lutropin alfa, r-hLH:LH | hCG
LH/LH like drugs for infertility
45
ganirelix acetate, cetrorelix
long acting analogs suppress FSH/LH. these are antagonists!
46
hypogonadotropic hypogonadism
lutropin alfa with follitropin alfa one day then hCG day later
47
controlled ovarian hyperstimulation
urofollitropin on day 2/3 of cycle then GnRH antagonist from day 7/8, then give hCG
48
infertility d/t anovulation/irregular
clomiphene (estrogen antagonist) for 5 days
49
estrogen drugs
activate estrogen receptors. for OC, replacement, menses issues, osteoporosis, acne
50
tamoxifen and toremifene (SERM)
selective estrogen receptor modulator. antagonizes E2 induced proliferation of breast CA cells. used for breast CA or prophylaxis for recurrence. reloxifene-works in same way but doesn't stimulate uterine growth.
51
bazedoxifene + conj estrogens (SERM)
estrogen effect on bone, antagonism of estrogen effect on uterine cells. uses to prevent menopause and related osteoporosis.
52
ospemifene
estrogen agonist effect in vag endometrium, not breast. for dispareunia
53
fulvestrant (faslodex)
estrogen receptor antagonist. antagonizes and degrades ERs. for breast CA.
54
clomiphene (clomid)
estrogen receptor antagonist. blocks estrogen inhibition of GnRH at hypothalamus. used for induction of ovulation.
55
danazol
antagonizes progestin and GC receptors and activates androgren receptors. inhibits many steroid enzymes. used for endometriosis.
56
anastrozole, letrozole, exemestane
estrogen synthesis inhibitors. reversible or irrev inhibition of aromatase. used for breast CA in post menopausal women.
57
progestin MOA general
activation of receptor, replace with smaller periodic doses, large dose causes long term supp. used for replacement, contraception, menses issues, endomet.
58
ullipristal
progestin receptor antagonist. antagonizes progestin receptor. for post-coital contraception.
59
mifepristone
progestin and GR antagonist. antagonizes progestin receptors ad GC receptors. for post-coital contraception.
60
korlym
anti-progetin that can be used for hyperglycemia.
61
hormonal contraception MOA
estrogen and progestin activate negative feedback to prevent GnRH, FSH and LH secretion. progestins-delay ovum transport, thicken mucus.
62
estrogens and LDL/HDL
decrease LDL and increase HDL. progestin works opposite.
63
progestin BC: desogestrel, norgestimate, ethynodiol, norgestrel, norethindrone, drospirinone, dienogest.
same dose or increasing during cycle.
64
norgestimate, norgestrel, levonorgestrel, drospirenone
monophasic
65
desogestriel (mircette)
biphasic
66
norgestimate, norethindrone
triphasic
67
dienogest + estradiol (natazia)
four-phasic
68
emergency contraception P or E+P
plan B (levonorgestrel), next choice. MOA feedback inhibition prevents GnRH, LH, FSH which prevents or delays ovulation and implantation
69
emergency contraception P agonist/antagonist
Ulipristal-comp antagonist of progestin receptor which prevents or delays ovulation/implant. Mifepristone-comp antagonist of progestin receptor, stimulation of uterine contraction

PCOL (9 decks)

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