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systemic pharm > hormones > Flashcards

hormones Flashcards

1
Q

4 types of hormone therapies

A

Thyroid Disease
Menopausal Hormone Therapy
Contraception
Selective Estrogen Receptor Modulators (SERMs)

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2
Q

what does the thyroid gland do?

A

The thyroid gland, albeit non-essential for life, governs tissue metabolism

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3
Q

how is normal growth and maturation made possible?

A

Normal growth and maturation is made possible by maintaining an optimal level of tissue metabolism

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4
Q

what are T3 and T4? What do they stand for? Which is most active?

A

Triiodothyronine (T3; most active) and thyroxine (T4) are two major thyroid hormones

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5
Q

what 3 things does hypothyroidism cause?

A

Hypothyroidism causes bradycardia, poor cold resistance, and mental/physical slowing

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6
Q

what 5 things does hyperthyroidism cause?

A

Hyperthyroidism causes tachycardia, body wasting, tremor, nervousness, and heat flashes

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7
Q

2 drugs for hypothyroidism?

A

Levothyroxine [Synthroid®, Levoxyl®]

Liothyronine [Cytomel®]

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8
Q

2 drugs of hyperthyroidism?

A

Propylthiouracil (PTU)

Methimazole [Tapazole®]

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9
Q

whats the number 2 highest selling drug in america?

A

levothyroxine sodium

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10
Q

indication for levothyroxine

A

INDICATION
Hypothyroidism
DOSING [50-200ug]
1 tab qd

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11
Q

moa of levothyroxine soidum?

A

CLINICAL PHARMACOLOGY
Thyroid hormone replacement
Mechanism of Action
Synthetic T4 (tetra-iodothyronine)

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12
Q

adverse effects of levothyroxine sodium

A

ADVERSE EFFECTS
Common: Weight loss, diaphoresis, headache, alopecia
CV: Hypertension
CNS: Pseudotumor cerebri (children), hallucination [ψ]
OCULAR: Ptosis, diplopia, EOM paresis

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13
Q

levothyroxine sodium drug interactions

A

DRUG INTERACTIONS

Sympathomimetics (Additive)

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14
Q

what 3 things characterize menopause?

A

Menopause is characterized by reduced libido, vasomotor instability (hot flashes) and vaginal atrophy

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15
Q

estrogen dosing for menopause compared to contraception

A

Estrogen dosing for menopause is significantly lower and therefore safer than for contraception

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16
Q

what the most potent estrogen produced and secreted by the ovary?

A

estradiol

17
Q

what is a metabolite of estradiol w/ 1/3 potency, which is the primary circulating estrogen after menopause

A

estrone

18
Q

because estrogens have a chloesterol back bone, what are they able to do?

A

Having a cholesterol backbone, estrogens dissociate from their globulin or albumin binding sites and readily cross cell membranes to bind to nuclear receptors where they affect gene transcription and translation

19
Q

3 menopausal therapies

A

Estrone [Menest®]
Estradiol
Mestranol [Necon®]

20
Q

estrone indication

A

INDICATION
Menopause, Breast Cancer, Prostate Cancer, Osteoporosis prevention
DOSING [0.3-2.5mg]
1 tab PO qd

21
Q

CLINICAL PHARMACOLOGY
Hormone Replacement Therapy (HRT)
Mechanism of Action
Binds to estrogen receptors, developing and maintaining female sex characteristics and reproductive systems

A

moa of estrone

22
Q

ADVERSE EFFECTS
Common: Headache/migraine, elevated BP, weight changes, fluid retention, contact lens intolerance, vision changes
SEVERE ADVERSE EFFECTS
BLACK BOX: Endometrial Cancer, Stroke, DVT, MI, Invasive Breast Cancer

A

adverse effects of estrone

23
Q

estrone drug interactions

A

DRUG INTERACTIONS
Azole Antifungals (Impaired metabolism)
Adverse effects of systemic steroids may be increased
Anti-hyperlipidemic effects of Omega-3 FA’s may be antagonized

24
Q

CONTRAINDICATIONS
Hypertension
Smoker
Migraine [with aura] > [without aura]

A

estrone contraindications

25
Q

contraception drug

A

Drospirenone/Ethinyl Estradiol [Yaz®]

26
Q

ways contraceptive agents are grouped

A

monophasic, biphasic, triphasic, and four phasic vs progestin only

27
Q

indication for yaz

A

INDICATION
Contraception, Acne Vulgaris, Dysmenorrhea, Endometriosis, PCOS
DOSING [3 mg/20 ug]
1 tab PO qd

28
Q

moa for yaz

A

CLINICAL PHARMACOLOGY
Hormone Therapy
Mechanism of Action
Suppresses LH and FSH, inhibiting ovulation; alters cervical mucus and endometrium

29
Q

yaz adverse effects

A 
ADVERSE EFFECTS
 Common: Headache, weight changes, BP elevated, increased cholesterol, contact lens intolerance
SEVERE ADVERSE EFFECTS
 MI, stroke, ocular lesions
BLACK BOX
 Smoking and CV Events
30
Q

yaz drug interactions

A 
DRUG INTERACTIONS
 Impaired metabolism of Cyclosporine
 NSAIDs (Additive hyperkalemia)
 Tetracyclines, Penicillins, Cephalosporins, Macrolides, Quinolones (Decreased efficacy)
 Ascorbic Acid (Decreased metabolism)
31
Q

yaz contraindications

A

CONTRAINDICATIONS
Hypertension
Smoker
Migraine w/ aura > w/o aura

32
Q

selectivity property of SERMs refers to what?

A

their ability to inhibit or stimulate estrogen receptors depending on the tissue

33
Q

uses of SERMs include what?

A

Uses include management of breast cancer, osteoporosis, menopause and anovulation

34
Q

3 types of SERMS

A

Tamoxifen [Soltamox®]
Clomiphene [Serophene®, Clomid®]
Raloxifene [Evista®]

35
Q

INDICATION for tamoxifen

A

INDICATION
Metastatic Breast Cancer
DOSING [10/20 mg]
1-2 tabs qd-bid

36
Q

moa of tamoxifen

A

CLINICAL PHARMACOLOGY
SERM
Mechanism of Action
Binds to estrogen receptors, producing estrogenic and anti-estrogenic effects

37
Q

adverse effects of tamoxifen

A 
ADVERSE EFFECTS
 Common: Dizziness, headache, VA changes
SEVERE ADVERSE EFFECTS
 Thromboembolism, stroke
 Pancytopenia
 Retinopathy, cataracts
38
Q

drug interactions of tamoxifen

A

TAMOXIFEN
DRUG INTERACTIONS
May increase Cyclosporine, Systemic Steroid, Oxycodone levels
Chlorpheniramine, Macrolides (Inhibit hepatic production of active metabolite)

systemic pharm (16 decks)

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