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Pharmacology > Exam 5 > Flashcards

Exam 5 Flashcards

1
Q

Levothyroxine
Liothyronine
Liotrix
Triiodothyronine

A

Hypothyroid drugs
M: activation of T3 receptors
C: hypothyroidism, myxedema
T: tachycardia, heat intolerance, tremors arrhythmias. insomnia, a fib and osteoporosis in geriatric population.

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2
Q

Methimazole

Propylthiouracil

A

Hyperthyroid drugs
M: block thyroid peroxidase, inhibiting the oxidation of iodide and the organification of iodine > inhibition of thyroid hormone synthesis. Propylthiouracil also blocks 5’-deiodinase, which decreases peripheral conversion of T4 to T3.
C: hyperthyroidsism. PTU blocks Perpheral conversion (and more protein bound) so used in Pregnancy
T: skin rash, agranulocytosis, aplastic anemia, hepatotoxicity (PTU). Methimazole-altered taste/smell. do not use in pregnancy.

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3
Q

ethinyl estradiol
mestranol
dethylstilbestrol (DES)

A

first two steroidal synthetic, DES non-steroidal synthetic
M: bind estrogen receptors
C: hypogonadism or ovarian failure, menstrual abnormalities, HRT in postmenopausal women, use in men with androgen dependent prostate cancer.
T: increase risk of endometrial cancer, bleeding in postmenopausal women, clear cell adenocarcinoma of vagina in females exposed to DES in utero, increase risk of thrombi. contraindicated in ER + breast cancer, history of DVTs

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4
Q

medroxyprogesterone (MPA)
norethindrone
norgestrel

A

Progestins
MPA=depo-provera shot
M: bind progesterone receptors, decrease growth and increase vascularization of endometrium.
C: used in oral contraceptives and in the treatment of endometrial cancer and abnormal uterine bleeding.
T: breakthrough bleeding, impaired glucose tolerance, changes in lipid metabolism. 19-nor can cause acne and hirsutism

nor=19 nor testosterone derivative

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5
Q

Clomiphene

A

M: partial agonist of estrogen receptors in hypothalamus. prevents normal feedback inhibition and increase release of LH and FSH from pituitary, which stimulates ovulation.
C: usted to treat infertility due to lack of ovulation
T: may cause hot flashes, ovarian enlargement, multiple simultaneous pregnancies, and visual disturbances.

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6
Q

Tomoxifen

A

Selective estrogen receptor modulators
M: agonist to bone, partial agonist to endometrium, antagonist to breast/HPG axis
C: ER + breast CA
T: hot flashes, endometrial CA, nausea, vomiting, thromboembolic events

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7
Q

Raloxifene

A

Selective estrogen receptor modulators
M: agonist to bone, antagonist to breast/uterus/HPG axis
C: CA, post menopausal osteoporosis
T:hot flashes, nausea, vomiting, thromboembolic events

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8
Q

danazol

A

M: synthetic androgen that acts as partial agonist at androgen receptors
C: endometriosis, breast fibrocystic disease, and hereditary angioedema
T: weight gain, edema, acne, hirsutism, masculinization, decrease HDL, hepatotoxicity

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9
Q

anastrozole
letrozole
exemestane

A

M: aromatase inhibitors
C: postmenopausal women with breast cancer
T: go disturbances, hot flashes, lethargy

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10
Q

Mifepristone (RU486)

Ulipristal

A

M: competitive inhibitor of progestins at progesterone receptors leading to uterine contractions and shedding of uterus lining
C: termination of pregnancy (less than 7 weeks), administered with misoprostol (PGE1)
T: heavy bleeding, GI effects, abdominal pain

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11
Q

Lispro
Aspart
Glulisine

A

Rapid-acting insulin
M: duration of 3-5 hrs
C: DM1, DM2, GDM postprandial glucose control
T: hypoglycemia, rare hypersensitivity rxns

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12
Q

regular insulin

A

M: bind insulin receptor, increase liver glucose stored as glycogen, increase glycogen and protein synthesis in muscles, increase K+ uptake, and increase TG storage in adipose tissue. duration 4-12 hours
C: DM1, DM2, GDM, DKA (IV), hyperkalemia (+glucose), stress hyperglycemia

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13
Q

NPH

A

M: duration 10-20 hours
C: DM1, DM2, GDM

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14
Q

Glargine

Detemir

A

M: duration 12-20 for G, 22-24 for D
C: DM1, DM2, GDM (basal glucose control)

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15
Q

Metformin

A

Biguanides
M: unknown, causes increase in peripheral glucose utilization and decrease in hepatic glucose output (increase glycolysis, decrease gluconeogenesis)
C: 1st line agent in type 2 DM, does not produce hypoglycemia, and can be used in patients without islet function
T: GI upset, lactic acidosis (do not use in renal failure), B12 deficiency in long term use.

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16
Q 
Tolbutamide
Chlorpropamide 
Glyburide
Glimepiride
Glipizide
A

Sulfonylureas
M: close K+ channel in Beta-cell membrane, so cell depolarizes triggering insulin release via Ca influx
C: stimulate release of endogenous insulin in DM2, require some islet function so useless in DM1
T: hypoglycemia (especially in renal failure), weight gain.

Tol and Chl are first generation, can have disulfiram like effects (ETOH)

17
Q

Acarbose

Miglitol

A

glucosidase inhibitors
M: inhibit intestinal brush border alpha glucosidases. delayed sugar hydrolysis and glucose absorption. decrease postprandial hyperglycemia.
C: used as mono therapy in DM2 or in combo with other agents
T: GI disturbances, contraindicated for patients with GI diseases

18
Q

Pioglitazone

Rosiglitazone

A

Thiazolidinediones
M: increase insulin sensitivity in peripheral tissue by activating PPAR gamma nuclear transcription regulator.
C: used as mono therapy in DM2 or combo therapy.
T: hepatotoxicity, heart failure, weight gain, edema, bone fractures

19
Q

Pramlintide

A

M: amylin analog, decrease gastric emptying, decrease glucagon. must be injected
C: DM1, DM2
T: hypoglycemia, nausea, diarrhea, delayed drug absorption

20
Q

Exenatide

Liraglutide

A

M: GLP-1 analogs. increase insulin, decrease glucagon release. inhibit gastric emptying. must be injected
C: DM2
T: pancreatitis, nausea, vomiting. diarrhea, hypoglycemia

21
Q

Linagliptin
Sitagliptin
Saxagliptin

A

M: DPP-4 inhibitors. inhibit incretin degradation, increase insulin, decrease glucagon release. oral drug.
C: DM2
T: respiratory and urinary infections, pancreatitis, HA

22
Q

Benzoyl Peroxide

A

M: causes release of oxygen species from neutrophils
C: tx acne. does not lead to resistances; combo with erythromycin and clindamycin

23
Q 
Tretinoin
Adapalene
Tazaroten
Alitretinoin
Isotretinoin
Bexarotene
Acitretin
A

Retinoids
M: bind RAR and effect gene transcription. useful in many skin conditions by promoting desquamation, collagen synthesis, loosen corneocytes, reduce follicular obstruction, ect.
C: acne, psoriasis, skin aging, skin cancer.
Tretinoin: photochemically unstable, do not use with benzoyl peroxide
Adapalene: tx acne
Tazaroten: psoriasis and mild to mod. acne. teratogen.
alitretinoin: aids related Kaposi’s sarcoma
Isotretinoin: significant teratogen
Bexarotene: cutaneous T-cell lymphoma
Acitretin: psoriasis, severe teratogen. do not combine with ETOH
T: in general, photosensitivity and skin irritancy

24
Q

Calcipotriene

A

Vitamin D analog
M: binds vit D receptor which complexes with RXR alpha receptor to regulate gnu transcription.
T: hypercalciuria and hypercalcemia; less with topical use

25
Q

Tacrolimus

Pimecrolimus

A

M: topical calineurin inhibitos
C: atopic dermatitis, psoriasis, pruritis

26
Q

Chlorpheniramine
Dephenhydramine
Dimenhydrinate

A

1st Gen Antihistamines
M: reversible inhibitions of H1 receptors
C: allergy, motion sickness, sleep aid
T: sedation, anti-muscarinic, anti alpha adrenergic effects

27
Q 
Pyrilamine
Hydroxyzine
Meclizine
Promethazine
Cyproheptadine
A

1st generation antihistamines
Py: low to moderate sedation, little antimuscarinic, not used for motion sickness
Hy: marked sedation and antimuscarinic. antiemetic, sedative, anxiolytic, and skin allergies
Mec: little antimuscarinic, less sedating. motion sickness and vertigo
Pro: local anesthetic, antiemetic. significant side effects (all).
Cyp: serotonin syndrome (anti serotonin activity) weight gain.

28
Q

Loratadine
Fexofenadine
Desloratadine
Certirizine

A

M: reversible inhibition of H1 receptors. less lipophilic so reduced sedation
C: allergies
T: do not mix fexo with antacids. less sedation. minimal side effects.

29
Q

Cromolyn

Nedoromil

A

M: inhibit degranulation of mast cells
C: nasal sprays and eye drops to tx allergies; used against asthma as well.

30
Q

omalizumab

A

M: monoclonal antibody that binds IgE
C: uticaria and asthma

Pharmacology (4 decks)

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