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Pharmacology > Exam 7: Endo/MSK > Flashcards

Exam 7: Endo/MSK Flashcards

1
Q

Somatropin

A

synthetic growth hormone

SQ/IM, give at night, start ASAP, stop w/growth plate closure

assessed w/x-ray monthly (or just wt/ht?)

prolonged tx leads to diabetes mellitus (antagonizes insulin)

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2
Q

Ocreotide

A

tx for acromegaly

natural GH inhibiting hormone -> suppress the release of GH from pituitary

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3
Q

Pegvisomant

A

tx for acromegaly/gigantism

GH receptor antagonist

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4
Q

Vasopressin

A

tx DI

identical to endogenous ADH

shorter duration of action (2-8), IM/SC, potent vasoconstrictor -> used in cardiac arrest

ADRs: water intoxication, excessive vasoconstriction, tachypnea

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5
Q

Desmopressin

A

tx DI -> drug of choice

synthetic form of vasopressin (ADH)

longer duration of action (8 - 20), less potent vasoconstrictor, INH/PO/SC/IV

less significant ADRs but same

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6
Q

Levothyroxine

A

synthetic T4 (much of the drug converts to T3, so don’t need that as well)

narrow thera range and takes long time to reach (1 month, 7 day half-life), in morning w/o food (30-60 min b4)

increases metabolic rate and oxygen demand/consumption (careful w/cardiac & HTN ->MI)

IV for myxedema coma

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7
Q

Liothyronine

A

synthetic T3

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8
Q

Methimazole

A

thionamide

inhibits the synthesis/release of T3/4 (doesn’t destroy existing, so can take 3-12 weeks to stabilize)

can lead to hypothyroidism, agranulocytosis (sore throat/fever, monitor WBCs -> high risk for infx)

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9
Q

Propylthiouracil (PTU)

A

thionamide

safer in pregnancy

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10
Q

Propanolol

A

for decreasing HR for Graves

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11
Q

Hydrocortisone

A

tx of Addisons/adrenal insufficiency

PO - chronic and IV - acute

may need to increase if known time of stress (hospitalization, etc.)

never stop abruptly - acut insufficiency s/s (N/V, profound fatigue, confusion, coma, fluid deficit, renal injury, and hypotension (hypoNa and hyperK)

synthetic steroid, drug of choice, both gluco & mineral

ADR: HTN, high BGL, impaired wound healing, leukocytosis, impaired immunity, osteoporosis– Cushing’s syndrome!

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12
Q

Fludrocortisone

A

the only mineralcorticoid available -> add if needed

for sodium loss and hypotension (K+ wasting) -> watch for fluid overload

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13
Q

Dexamethasone

A

tx inflammation from cerebral edema -> used often w/neuro surgery
also tx allergic reactions

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14
Q

Prednisone

A

inexpensive glucocorticoid and frequently prescribed

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15
Q

Ketoconazole

A

antifungal, but tx for Cushings -> inhibits synthesis of adrenal steroid hormones

not first choice -> treat underlying first, discontinue corticosteroids, adrenalectomy

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16
Q

Calcium/Vit D

A

decrease bone resorption (stop clast breakdown)

1000 mg/day for premenopausal
12-1500 mg/day postmenopausal

excess - hypercalcemia, kidney stones

17
Q

Estrogen Replacement Therapy

A

decrease bone resorption (stop clast breakdown)

benefits don’t outweigh risks of cancer (not up to date, but on slides)

18
Q

Raloxifene

A

Estrogen Receptor Modulators (SERM)

decrease bone resorption (stop clast breakdown)

binds to selective estrogen receptors (only bone receptors) and produce positive estrogen effects on bone

Black box: DVT/PE

19
Q

Alendronate/Ibandronate

A

Biphosphonates (fosamax), PO/IV

decrease bone resorption (stop clast breakdown)

ADR: esophagitis/ulcer, atypical femur fractures, jaw necrosis, ocular issues

take on empty stomach, low bioavailability
full glass of water
must stay upright for 30 min after admin

20
Q

Calcitonin

A

decrease bone resorption (stop clast breakdown)

SC/INH

lowers serum calcium level by moving calcium to bone, endogenous is secreted by thyroid

21
Q

Teriparatide

A

(Forteo)
promote bone formation - increases bone deposition by blasts

form of endogenous parathyroid hormone, daily prefilled SQ

ADRs: arthralgias, back pain, leg cramps, ortho hypo

Black box: osteosarcoma

22
Q

Denosumab

A

monoclonal antibody that decreases formation and function of clasts

decreases bone resorption, SQ

ADRs: Back pain/pain in extremities, Hypocalcemia, Serious infections, Dermatologic reactions, dermatitis, eczema, Osteonecrosis of the jaw

23
Q

NSAIDs

A

starting at diagnosis and PRN for rapid relief

“prostaglandin inhibitors” -> reduce vasodilation, capillary permeability, fever, and pain
inhibit the COX enzymes - COX 1 = protects stomach lining, renal function, and platelet aggregation; COX 2 = triggers inflammation, pain, fever, maintains renal function

2nd gen like celecoxib select for only COX 2 and protect stomach/renal more but inc risk for MI/CVA

renal impairment, PUD (GI upset/bleed), bleeding tendency, peripheral edema

24
Q

Glucocorticoids

A

rapid relief and can slow disease progression
short courses due to ADR

25
Q

Methotrexate

A

DMARD

start at diagnosis and continue indefinitely - not rapid relief, but slows progression

reduce joint destruction, slow disease progression, onset typically weeks to months

sometimes used for cancer

labs: AST, ALT (hepatotoxic), BUN/creatinine (nephrotoxic) & CBC (bone marrow suppression)

26
Q

Sulfasalazine

A

DMARD

tx IBD and RA

ADRs: GI, derm, **cannot give to pt w/sulfa allergy, hepatotoxic, bone marrow suppression

27
Q

Hydroxychloroquine

A

DMARD

antimalarial agent - MOA w/RA is unknown
combo w/methotrexate

ADR: retinal damage

28
Q

Adalimumab/Etanercept

A

TNF blockers

blocks inflammatory mediators -> worried about serious systemic infx (sepsis/fungal)

ADRs: systemic infx, hypersensitivity, hepatotoxic, heme (aplastic, neutro and thrombocytopenia)

29
Q

Allopurinol

A

inhibits uric acid formation -> preferred agent

prophylactic

30
Q

Naproxen/indomethacin

A

NSAIDs for gout

??

31
Q

Probenecid

A

increases uric acid excretion

don’t use 2-3 weeks after acute attack

32
Q

Prednisone

A

when NSAIDs not tolerated or contraindicated

33
Q

Colchicine

A

anti-inflammatory

MOA: inhibits migration of leukocytes to inflamed site

not used as much bc NSAIDS more effective

ADRs: GI

34
Q

Baclofen

A

CNS depressant - acts in spinal cord, no direct effect on skeletal muscles (spasticity)

PO or intrathecal

ADRs: drowsiness, fatigue, hypo-ventilate, dizzy, avoid alcohol, can have withdrawal -> hallucinations, ideations

35
Q

Diazepam/tizanidine

A

central acting (CNS) skeletal muscle relaxant -> reduces tonic motor activity from the brainstem

works on both spasms and spasticity

do not drive car

ADR: CNS depressant, anticholinergic, dysrhythmias, serotonin syndrome

36
Q

Dantrolene

A

directly on skeletal muscles (spasticity)

ADR: muscle weakness, hepatotoxic, drowsy

37
Q

Cyclobenzaprine

A

central acting (CNS) skeletal muscle relaxant -> reduces tonic motor activity from the brainstem

only works on spasms, not spasticity

ADR: CNS depressant, anticholinergic, dysrhythmias, serotonin syndrome

Pharmacology (12 decks)

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