exam 5 estrogen progestin gi and such Flashcards
Estrogen that is absorbed slowly, prolonged duration when esterified and IM injection
RT for primary hypOgonadism
post men RT
most potent
inc first pass
Estradiol
Estrogen-
Insoluble in H2O
monthly OC
estradiol cyionate
Estrogen-
has dec first pass
OC
ethinyl estradiol
Estrogen receptor ANTagonist
tx of hormone responsive MT breast cancer
Fulvestrant
Non-steroidal estrogen modulator
used for estrogen dependent breast cancer
anti-estrogen on breast
pro-estrogen on lipids bones and uterus
tamoxifen
non-steroidal ER modulator
- used for prevention of osteoporosis/dec risk of breas cancer in postmen
- lowers cholesterol, not in hdl
raloxifene
Third gen progestin
- OC
- Ovarian suppression
- Lowest androgenic activity
Desogestrol
Endometrial protection in ERT, 2ndry amenorrhea, suppress dysmenorrhea, endometriosis, vaginal bleeding disorders
medroxyprogesterone
2nd class progestin OC ovarian suppression varying androgenic activity
norethindrone
Norethindrone derivative, 1st trimester abortion, inc uterine contraction with misoprostol
antag, dec prostaglandin dehyrogenase
inc contraction of uterine sm
ae vaginal bleeding and abd pain
Mifepristone
weak bases that react with HCl to form salt and water to inc pH to 4.2-4.7.
- protect Gi mucosa thru stimulation of prostaglandin production
- neutralize gastric activity; prolonged if taken with food
Antacids
Aluminum Hydroxide
Magnesium Hydroxide
Mg faster than Al
side effect of Al=constipation
Mg= diarrhea
Suppress 24hr gastric secretion
cimetidine
H2R antagonist
administered as inactive prodrug, protonated, blocks H+/K+ atpase. stops parietal cells
-give 1hr before meal on empty stomach
rapid first pass
PPI
Omeprazole
=DOC for gastrinoma and hyper H+
prevent traveler’s diarrhea, direct anti microbial activity against h.pylori
can cause tongue and stool blackening
CI: renal insufficiency
Bismuth subsalicylate
mucosal protective agent
PG E1 analog
- Inc mucosal blood flow
- Buffer H+
- stimulates mucus and bicarb secretion
Use PO for prevention of EtOh and NSAID assoc ulcers
Misoprostol
mucosal protective agent
sucrose salt
-prevent bleeding from stress related gastritis
sucralfate
mucosal protective agent
agonists on enteric neurons 5ht-4 receptors in atch release
-anti nausea and anti-emetic effect
metoclopramide
=prokinetic
- fecal softener
- stool surfactant agent
- allow water and lipids to penetrate stool to soften it
Laxative
-Docusate
osmotic
inc fecal fluidity and stool liquidity
Laxative
magnesium oxide
for IBS
- serotonin 5-HT3 R antag
- PO for severe IBS in women w/ diarrhea as predominate symptom
alonestron
produces IBD remission in 50-60% pts and maintained up to 80%
SE: bone marrow suppression, liver toxicity, hypersens rxn’s
requires LFT and blood chem tests
Azathioprine
for IBD
-anti TNF therapy for mod to severe crohns and uc in acute/chronic pts
AE: infection due to suppression of th1
infliximab
for IBD
-induce and maintain remission in crohns
-inc dose=inc SE
enhanced by FOLATE supplements
methotrexate
for IBD
first line of drug for mild to mod UC
produces and maintains remission
sulfasalazine
antiemietic
-selective serotonin 5-ht3 antagonist
-useful in comiting from vagal stim and chemo
DOC cuz no blocking of DA receptors
Ondansetron
antiemetic
- block NK1 receptor
- used in combo with cortico and 5HT3-R antag as prophylaxis
Aprepitant
antiemetic
-prevent postsurgical nausea vomiting
droperidol
antiemetic
-DA D2 receptor antagonist
migraine assoc vomitting
promethasize
binds Fe, fails to compete with biological chelated iron
deferoxamine
bdendate chelator react with metals reactivates cellular sulfhydryl-containing enzymes-arsenic, mercrury, and lead chelator
dimercaprol
chelator of divalent/trivalent cations in vitro
- coadminister calcium to prevent depeltion
- metals capable of binding edta and displacing ca are chellators
EDTA-edetate calcium disodium
produces lead diiuresis similar to edta, PO with few SE for tx of children with blood lead concentrations >45 ug/L
Succimer
immune stimulant, may inc macrophage activity and enhance NKC
echinacea
contains ephedrine (sympathomimetic)
- 16x risk of hemorrhagic stroke in women taking phenylpropanolamine as appetite suppressant
- dietary supplement to promote wt loss and inc energy
ephedra
tx for nausea a/w motion/morning sickness.
use with anticoags is problematic since prolongs bleeding time
ginger
promoted as being physically, mentally, and sexually invigorating
- anti stress properties
- may also inhibit platelet aggregation
ginseng
herbal remedy for dementia nd circulator disorders
- can inc acetylcholine activity and affect serotonin and norepinephrine
- relax vascular smooth muscle and prevent platelet activation
- anti-oxidant activity
Ginko balboa
anxiolytic, sedative, and sleep aid
-enhance Gaba-ergic activity. similar to benzodiazepines
Kava
Tx of benign prostatic hyperplasia.
improve UT symptoms similar to finasteride.
-inhibit testosterone 5-a reductase, anti-androgenic and anti-estrogenic effects
saw palmetto
enhance production of cyp3a enzymes which metabolize a host of toxins and drugs
st. johns wort
