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Pharmacology > Hypothal and Pituitary Hormones, Drugs acting on the uterus, gonadal hormones, > Flashcards

Hypothal and Pituitary Hormones, Drugs acting on the uterus, gonadal hormones, Flashcards

1
Q

Mifepristone is classified as what type of drug

A

Anti progestin (only one we cover)

its works as part of a Two person team with Misoprostol (a PGE1 analogue) for medical abortion

MIFE and MISO!

but when combined==> INC RISK OF GI AE. *DIARRHEA*

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2
Q

whats the treatment for Chronic (Addison’s disease)-Primary adrenal Insufficiency

  • hyperpigmentation (due to: increased ACTH)
  • hyponatremia (hypervolemic type)
  • hypotension
  • no H+ secretion–>metabolic acidosis (normal anion gap)
  • High H+ in serum–> low bicarb
  • no K+ secretion–> hyperkalemia

-

A

Daily hydrocortisone-short acting (increase dose during stress) +

mineralocorticoid (fludrocortisone)

***DO NOT administer glucocorticoids lacking salt- retaining effects or long acting ones either like (Triamcinolone or Dexamethasone)

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3
Q

name the Androgen Receptor Antagonists

what the relationship between Bicalutamide, nilutamide & Flutamide?

A

Flutamide

  • Bicalutamide*
  • Nilutamide*

Cyproterone

Spironolactone

**Bicalutamide and Nilutamide are similar to flutamide butlower risk of hepatotoxicity

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4
Q

whats the treatment for a Prolactinoma

A
  • dopamine agonists (eg., ergot alkaloids such as bromocriptine, cabergoline)
  • transsphenoidal resection.
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5
Q

Can Methylprednisolone be given via Aerosol or topical admin?

A

NO! just oral, IM and iV

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6
Q

what effect does a Pituitary prolactinoma have on GnRH?

A

it causes GnRH to ↓ —-> hypogonadism, amenorrhea, galactorrhea & osteoporosis

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7
Q

what are expected lab values during Acute adrenal insufficiency, or Addisonian crisis?

A

Laboratory findings may include hyponatremia, hyperkalemia, metabolic acidosis, azotemia as a consequence of aldosterone deficiency; and hypoglycemia, and eosinophilia as a consequence of cortisol deficiency.

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8
Q

how do you administer growth hormone

A

subcutaneously bc since its a protein it will be broken down too quickly if its given orally

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9
Q

list all the ways Triamcinolone can be administered

A

Aerosol, IM, topical and Oral

not IV

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10
Q

What adverse effects are commonly associated with mineralocorticoids?

A

Hypokalemia

metabolic alkalosis

increased plasma volume

hypertension

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11
Q

whats the most common cause of Primary adrenal insufficiency (Addison disease) in the US and worldwide

A

The most common cause in the United States is autoimmune destruction of the adrenal glands.

The most common cause worldwide is tuberculous adrenalitis.

***In primary adrenal insufficiency, the glands themselves are destroyed so that the patient becomes deficient in cortisol and aldosterone.

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12
Q

List the SERMs

TR-TC

A

Tamoxifen

Raloxifene

Toremifene

Clomiphene

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13
Q

List the Competitive GnRH ANTAGONISTS (2)

-relix

A

Cetrorelix

Ganirelix

*prevents LG surge during controlled ovarian hyperstimulation

SUBCUTANEOUS injection

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14
Q

list the Mineralocortocoids

A

• Aldosterone
Most important mineralocorticoid in humans

• Fludrocortisone

Synthetic corticosteroid. Most commonly prescribed salt-retaining hormone

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15
Q

list the synthetic GCs

A
  • Prednisone
  • Methylprednisolone
  • Dexamethasone
  • Beclomethasone
  • Triamcinolone
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16
Q

a 1000-fold increase in estriol is an indicator of…

A

fetal well being.

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17
Q

list the synthetic GCs that can be given via the aerosol route

A

Beclomethasone

Triamcinolone

18
Q

list the corticosteroid synthesis inhibitors

A

Ketoconazole

Aminoglutethimide

Metyrapone

19
Q

list Long-acting glucocorticoids

A

Dexamethasone

20
Q

Elevated ACTH with low cortisol is diagnostic of _________________

Low ACTH and low cortisol suggest__________

fill in the blank with

primary adrenal insufficiency or

secondary adrenal insufficiency.

A

primary adrenal insufficiency, particularly in patients who are severely stressed or in shock.

secondary adrenal insufficiency.

21
Q

is primary or secondary adrenal insufficiency being described below

patients are deficient in cortisol because of a lack of ACTH from the pituitary, but aldosterone production is maintained by the renin- angiotensin system. Therefore, volume depletion and hyperkalemia are not present and the patient will not manifest the typical hyperpigmentation.

A

secondary

22
Q

List the estrogens

MC DEEE

A

Mestranol

Conjugated estrogen

Diethylstilbestrol

Ethinyl estradiol,

Estrone

Estriol

23
Q

characteristic abnormalities of serum electrolytes in adrenal insufficiency are:

A

low sodium

high potassium

low bicarbonate

high BUN.

24
Q

What signaling pathway does GH use to mediate its effects via cell surface receptors

A

Mediates effects via cell surface receptors that activate JAK/STAT signaling cascades

25
Q

what is the name of the anti androgen drug that inhibits 5α-reductase

and what are its main clinical uses

A

Finasteride

Benign prostatic hyperplasia (BPH)

male- pattern hair loss

26
Q

In secondary adrenal insufficiency are mineralocorticoids and cortisol levels deficient as in primary (addisons)?

A

nah, In secondary adrenal insufficiency, the renin-angiotensin system usually is able to maintain near-normal levels of aldosterone so that the patient is deficient only in cortisol.

27
Q

what are the 3 ways Cortisol (Hydrocortisone) evokes its antiimflamm effects

A

matory Effects

  1. Inhibition of phospholipase A2 (through induction & activation of annexin I) which blocks arachidonic acid release (major precursor of prostaglandins).
  2. Cyclooxygenase-2 synthesis is reduced (through inhibition of NF-B)

.3. Induction of MAPK phosphatase I (inhibits MAPK activated proinflammatory signaling pathways)

28
Q

List GCs that can be given via IV/IM route

A

Dexamethasone

Hydrocortisone

Methylprednisolone

Prednisolone

29
Q

List the Short -medium acting GCs

“P-M-H”

A

Prednisone

Methylprednisolone

Hydrocortisone

30
Q

List all the Androgens

D(a)MN, SO FO!

(damn, so fo-ward!)

A

Danazol

(a)

Methyltestosterone,

Nandrolone,

Stanozolol

Oxandrolone

Fluoxymesterone,

Oxymetholone

31
Q

list the gonadotropin analogues

A

Follitropin

Urofollitropin

hCG

Menotropins

32
Q

what is Secondary adrenal insufficiency and whats the most common cause of it

A

Secondary adrenal insufficiency is adrenal failure caused by a lack of ACTH stimulation from the pituitary gland.

It can be caused by an autoimmune, infiltrative, metastatic disease of the pituitary.

The most common reason, however, is chronic exogenous administration of corticosteroids, which can suppress the entire hypothalamic-pituitary-adrenal axis.

33
Q

List all the Progestrins

@ PM NNN & DD

[@ night, Nani and D get together]

A

Progesterone

Medroxyprogesterone

Norgestrel

Norgestimate

Norethindrone

Desogestrel

Drospirenone

34
Q

what are the physiological effects of Growth Hormone (aka: somatotropin)

A
  • Stimulation of longitudinal growth of bones
  • Increased bone mineral density
  • Increased muscle mass (in GH deficient people)
  • Increased GFR
  • Stimulation of preadipocyte differentiation into adipocytes
  • Anti-insulin actions (decreased glucose utilization & increased lipolysis)–> eventually leads to diabetes
  • Development & increased function of immune system
35
Q

Dopamine antagonists (eg., antipsychotics) can cause ____________ due to hyperprolactinemia

A

galactorrhea

36
Q

LIst Intermediate- acting glucocorticoids

A

Triamcinolone

just one in this category!

37
Q
A
38
Q

what are the two ways Beclomethasone can be admin

A

aerosol and topical

not IV or IM

39
Q

list the corticosteroid antagonists

A

Mifepristone

Spironolactone

40
Q

List GCs that can be given via Topical route

A

Beclomethasone

Dexamethasone

Hydrocortisone

Triamcinolone

41
Q

List the aromatase inhibitors

LAE

Lance aux epines

A

Letrozole

Anastrozole

Exemestane

Pharmacology (14 decks)

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