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OPT 541 > Midterm 1 > Flashcards

Midterm 1 Flashcards

1
Q

Taladafil

A

ED. Inhibits PDEi so cGMP not broken down. It has the longest duration of action and not affected by food

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2
Q

Sildenafil

A

ED. Inhibits PDEi so cGMP not broken down. It can have vision effects as it blocks PDEi5 and can cross react with PEDI6 in retina

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3
Q

SE of PDEI5

A

Nasal congestion, flushing, HA, loss of blue/green discrimination (sildenafil), and dyspepsia. Caution: cardiovascular, organic nitrates, alpha adrenergic antagonists

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4
Q

Aledronate

A

bisphosphanate-decrease osteoclastic activity/formation and increase apoptosis. Weakest formula

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5
Q

Ibandronate

A

Bisphosphanate-decrease osteoclastic formation/activation and increases apoptosis. Available as IV and oral. oral=30 min before food. IV=every 3 months. Must sit up 60 min after taking

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6
Q

Zoldronic Acid

A

Bisphosphante-decrease osteoclastic formation/activation and increases apoptosis. Available as an IV. q1y

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7
Q

Pt. Ed. with bisphosphantes

A

Must sit up 30 min. after taking to decrease esphogitis and esphogal ulcers

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8
Q

Raloxifene

A

SERM. Used in postmenopausal osteoporosis. Increases estrogen. Increases serum total and LDL []. Antagonizes estrogen receptors in breast tissue!

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9
Q

Calcitonin

A

Used to treat osteoporosis. Administered intranasally. Not as effective as bisphosphanates. Released by thyroid!

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10
Q

Teriparatide

A

Used to treat high risk osteoporosis (aren’t responding to other treatment). subcutaneous q1d. Recombinant PTH.

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11
Q

diethylpropyl

A

Anorexiant used to treat obesity. Short term and risk of abuse. caution with MAOi.

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12
Q

Orlistat

A

lipase inhibitor to treat obesity. Can use for up to 4 years. Must take fat soluble vitamins 2 hours after

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13
Q

Prostaglandins

A

GPCR. Create PGF2alpha, lukeotriens, and thormboxane. Balanced by different actions of eicosanoids

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14
Q

Prostaglandins

A

GPCR. Create PGF2alpha, lukeotriens, and thormboxane. Balanced by different actions of eicosanoids

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15
Q

TXA1 VS PGI2

A

TXA1 (Thromboxane) from platelet cells cause cell aggregation and vasoconstriction. PGI2 (prostacyclin) inhibits platelet aggregation and cause vasodilation.

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16
Q

Misoprostal

A

Prostaglandin analogue used to protect the stomach lining

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17
Q

Asprin

A

Irreversible acetylates cyclooxygenase and so platelets must be regenerated. Salcilylates! Baby aspirin=81 mg. Analgesic and antipyretic. Increase lung ventilation. Will also decrease renal blood flow! (prostglandins needed for renal BV dilation) Can’t use for preoperative care! Can cause Reyes syndrome in kids (other salicylates as well) Can also have salicylate intoxication with overdose.

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18
Q

Ibuprofen

A

Irreversible acetylates cyclooxygenase but not leukotrienes. It is a propionic acid so no risk of reyes.

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19
Q

Indomethacin

A

Acetic acid NSAID. VERY POTENT!

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20
Q

Sulindac

A

Acetic acid NSAID with long half life!

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21
Q

Acetominophen

A

Inhibits prostaglandin synthesis in the CNS. Bad anti-inflam effect but good anti-pyretic and analgesic effect. Have liver toxicity

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22
Q

Treating RA

A

NSAIDS COX2, Acetominophen, DMARDS, low dose corticosteroids

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23
Q

Methotrexate

A

DMARDS. Used in cancer. Must take with leucovorin (folic acid). An immunosupprent. Used once a week

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24
Q

Hydroxycholoquine

A

DMARDS. Used in malaria. Causes ocular toxicity (bull’s eye retinopathy). Safe with prey.

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25
Q

Leucovorin

A

Used with methotrexate. Essentially a folic acid supplement!

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26
Q

Leflunomide

A

DMARD. Used if methotrexate or hydroxycholoquine doesn’t work.

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27
Q

omab

A

murine monoclonal ab (biologics)

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28
Q

ximab

A

chimeric (biologics)

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29
Q

zumab

A

humanized monoclonal ab (biologics)

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30
Q

umab

A

Human monoclonal ab (biologics)

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31
Q

cept

A

receptor-ab mediated fusion protein (biologics)

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32
Q

Prednisolone

A

Topical steroid. keton based. Potent so use with severe uveitis or allergic conjunctivitis. strong!

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33
Q

Treating acute gout

A

Indomethacin or other NSAIDS (not aspirin) or intrarticular administration of glucocortiocoids

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34
Q

Betamethason

A

Long acting steroid. used for respiratory syndrome in infants

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35
Q

Hydrocortisone

A

Shorting acting steroid. used with addisons disease.

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36
Q

Treatment of chronic gout

A
  1. Probenecid (uricosuric agent) 2. Allopurinal or febuxostat to inhibit synthesis of uric acid 3. colchicine-distrupts granulocytes motility to affected site. Used for recurrent attacks
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37
Q

Probenecid

A

chronic gout. uricosuric agent- increases excretion of uric acid

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38
Q

Allopurinal

A

chronic gout. Inhibit uric acid synthesis

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39
Q

febuxostat

A

chronic gout. inhibit uric acid synthesis

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40
Q

Colchicine

A

chronic gout. Stops motility of granulocytes to affected area.

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41
Q

Prednisolone

A

Topical steroid. keton based. Potent so use with severe uveitis or allergic conjunctivitis.

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42
Q

When are topical steroid CI

A
  1. Herpes simplex infectious epithelial keratitis 2. acute bacterial infection 3. significant epithelial compromise
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43
Q

How to treat a corneal ulcer?

A

Treat with AB until corneal integrity is good and then apply steroids.

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44
Q

Why taper steroids?

A

To allow adrenals to begin producing endogenous steroids again. Can have rebound effect. Taper by 50% once under control.

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45
Q

Ocular topical NSAIDS

A

Mostly used to treat periopertive care. Topical steroids used largely.

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46
Q

Corneal toxicity

A

Can occur if NSAIDS are used too often. Prescribe NSAIDS for less then a week.

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47
Q

Diphenhydramine

A

Used for allergies

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48
Q

Fexofenadine

A

Used for allergies

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49
Q

Loratidine

A

Used for allergies

50
Q

Ranitidine

A

Used for allergies

51
Q

Gonadorelin

A

Gonadotropin releasing hormone. Essential for release of FSH and LH from pituitary. Pulsatile release. Analogues of it (leuprolide) used to treat prostatic cancer, endometriosis, precocious puberty

52
Q

Leuprolide

A

Analog of GnRH. Suppresses production of gonadal hormones (LSH, LH). Used to treat prostatic cancer, endometriosis, precocious puberty.

53
Q

Mifepristone

A

A progesterone antagonist with partial agonist activity. Administered and then followed by misoprostol administered vaginally will cause an abortion.

54
Q

Cluster HA

A

No family history, M, Unilateral behind one eye, during sleep, constant and excruciating. 15-90 min.

55
Q

Tension HA

A

Family history. F. Occurs under stress. Bilateral band around head. Dull and persistent

56
Q

Common Migraine

A

AKA Migraine without aura. throbbing unilateral HA. Occurs with photpobia, phono phobia and nausea and vomiting.

57
Q

Classic Migraine

A

AKA Migraine with aura. Prodromes 20-40 minutes prior. Can cause sensory, visual, and or speech or motor disturbance.

58
Q

Biology of Migraines

A

Due to dilation of extra cranial and intracranial arteries. Aura due to decreased neural activity due to decreased blood flow to posterior cerebral hemisphere

59
Q

Meclizine

A

Antiemetic. Can use with migraines.

60
Q

Zolmitriptan

A

Seratonin agonist triptan. Treat Migraines. Nasal spray.

61
Q

Dihydroergotamine

A

Seratonin agaonist. Used for migraines. Like sumatriptan but administered intravenously. Nausea is a common adverse effect. Vasoconstrictor. Give during prodromal stage.

62
Q

Pathway for cortisol production

A

CRH (from HT)–>ACTH (ant pit)–>adrenal gland–>cholosterol–>progenenolone–>progesterone–>cortisol and other adrenal androgens. It is a GPCR and it is highest at 6 am

63
Q

Somatotropin

A

Growth Hormone. A large polypeptide released during sleep. Used for GH deficiencies. Has a short duration but cause IGF1 to be released from the liver which has a longer duration. It declines at 55.

64
Q

Octreotide (sandostatin)

A

A synthetic analogue of somatostatin. Used to treat acromegaly.

65
Q

Glyburide

A

insulin secretagogue (sulfonylureas). Oral. Promote insulin release, stop hepatic glucose production, increase peripheral insulin sensitivity. SE: weight gain, hyperinsulinemia, and hypoglycemia. Block K channel and cause more ca to enter the cell.

66
Q

Pegvisomant

A

An analogue of GH. Treats refractive acromegaly.

67
Q

Goserelin

A

An agonist at GnRH (gonadorelin) receptors. Results in decreased release of LH and FSH as not pulsatory. Treat prostate cancer, endometrious, and precocious puberty

68
Q

Bromocriptine

A

A dopamine agonist. Used to treat hyperprolactinemia as prolactin release is inhibited by dopamine. Prolactin decreases sex drive. Treat hyperprolactinemia.

69
Q

Posterior Pit. hormones

A

No RH. Released during partition or high osmolarity.

70
Q

Oxytocin

A

Used during labor to increased contractions. Also causes milk ejection.

71
Q

Insulin Lispro

A

Rapid acting insulin analog. 30-90 minute peak. Take 15 minutes before meal.

72
Q

Vasopressin

A

AKA anti-diuretic hormone. Released with high osmolarity. V1 receptor causes vasoconstriction. V2 causes increased

73
Q

Triiodiothyronine

A

Thyroid hormone T3. More active.

74
Q

Thyroxine

A

Thyroid hormone T4. Less active

75
Q

Hyperthyroidism (thyrotoxicosis)

A

tachycardia, few menstral periods, irritability, tremor, nervousness. Associated with graves, toxic adenoma, and goiter. Decreased TSH.

76
Q

Hypothyroidism

A

bradycardia, weight gain, depression, heavy menstral periods, fatigue, muscle pain, dry skin, infertility. Caused by autoimmune that destroys peroxidase or gland.

77
Q

Thyroid hormone synthesis

A

Ribosomes in thyroid follicles create thyroglobulin in ribosomes and then secrete into lumen. TSHR stimulate more iodine pumps and iodine taking into the cells. Iodine is oxidized by peroxidase and then bound to tyrosine parts of thryoglobulin. Condensation of 2 triiodotyrosines=T4. Condensation of a monoiodotyrosine with a diiodotryrsoine=T3. They are released into the blood and bind thyroxine-binding globulin. Thionamides effect the oxidation or condensation.

78
Q

Dutasteride

A

Antiandrogen. 5-alpha-reductase receptor antagonist. Decreases prostate size. Use for benign prostatic hypertrophy.

79
Q

Action of TH

A

Unbind thyroxine-binding globulin. Enter the cell and T4 converted to T3. Enter nucleus and bind receptors. Slow acting but long duration

80
Q

Levothyroxine

A

Synthetic T4. Treats hypotheyroidism.

81
Q

Graves ocular components

A

Dry eyes, proptosis, eye pain, optic neuropathy. Occurs as AB bind extra ocular muscles.

82
Q

Propylthiouracil (PTU)

A

Thioamide. Used to treat thyrotoxicosis. Inhibits condensation and conversion of T4 to T3. Used rarely as a short half life and toxic.

83
Q

Methimazole

A

Thioamide. Used for thyrotoxicosis. Inhibits condensation. More safe and used more often. tid.

84
Q

Thyroid Storm

A

Pt. presents with high levels of thyrotoxicosis. Can treat with high doses of drugs and more frequently.

85
Q

Type 1 diabetes

A

Occurs in early adulthood or puberty. Autoimmune disease kills beta cells of the pancreas. Require insulin injections. Prone to ketoacidosis (from breaking down fat)

86
Q

HBA1C

A

indicates how good glucose levels have been for the past 3 months

87
Q

Pancreatic Hormones

A

Insulin, glucacon, somatostatin

88
Q

Formation of insulin

A

Synthesized as proinsulin with a A,C,B chain. Cleaved to insulin and C-peptide. Check insulin levels by checking C-peptide as insulin immediately taken into the body once made.

89
Q

Increatin

A

Made by small intestines when lots of glucose in diet. Will cause beta cells to secrete insulin.

90
Q

SE of insulin

A

lipodystrophy (inj site), hypoglycemia (cause symp to kick in), confusion, vertigo, anxiety, tachycardia.

91
Q

Hydrochlorothiazide

A

Thiazide. Acts on distal tubule. Increase Na/Cl secretion. Used for HTN. Can result in hypokalemia.

92
Q

Nateglinide

A

Insulin secretagogue (glinide). oral. Promote insulin release, inhibit hepatic glucose creation, increase peripheral insulin sensitivity. Less hypoglycemia risk. use with metformin.

93
Q

Metformin

A

Insulin sensitizer (biguanide). Oral.Decrease hepatic glucose production and increase glucose uptake. Drug of choice for new type 2. Use with polycycstic ovary disease. SE: pregnancy chance, weight loss.

94
Q

Pioglitazone

A

Insulin sensitizer (thiazolidenediones/glitazone). Oral. Target the PPAR (peroxisome proliferative activated receptor) to increase GLUT4. increase insulin sensitivity in adipose, liver, and skeleton. Tier 2 as cardiac effects, heart attack, weight gain.

95
Q

Insluin secretagogues

A

Glipizide (sulfonyureas) and nateglinide (glinide)

96
Q

Insulin sensitizer

A

Metformin (bigunamide) and pioglitazone (thiazolidinediones/glitazones)

97
Q

Sitagliptin

A

Dipeptidyl Peptidase IV inhibitior. oral. DDPV inactivates increatin hormones and so this drug stops inactivation of increatin. This furthers increatin’s action and results in increase insulin release. (GLP1).

98
Q

Exenatide

A

Increatin mimetics. Increatin responsible for 60-70 percent of postprandial insulin secretion. An adjunct therapy. Take with a needle.

99
Q

SE of glucose lowering drugs

A

hypoglycemia (glinades and sulfonylureas), GI distrubance (biguanides and alpha glucocosidase inhibitors) Weight gain (sulfynolureas, glinades, thiazolendiones), Nausea (biguanides), Cardiovascular risks (thiazoldiediones). Can also have exudates, neovascularization, etc.

100
Q

Insulin glaragine

A

Long acting insulin analgoue. Subcutaneous action. Long acting insulin analgoue. Use with type 2 or with short acting in type 1.

101
Q

Where do the hormones from the adrenals come from?

A

Outer zona glomerulus-minteralcorticoids Middle zone fasicularis-glucocorticoids Inner zona reticularis-adrenal androgens

102
Q

Aldosterone

A

Secreated by adrenals. Controls the bodes water volume and concentration of ions. Resorbs bicarbonate, sodium, and water.

103
Q

Ketoconazole

A

Anti-fungal agent that can inhibit enzymes envolved in adrenocorticosteroid synthesis so can use to treat cushing’s syndrome

104
Q

spironolactone

A

An aldosterone antagonists. but also effects cortisone. Can be used to treat hirsuitism. Have SE of gynecomastia.

105
Q

Eplerenone

A

An aldosterone antagonist but also effects cortisone. It is antihypertensive. Better as no SE of gynecomastia.

106
Q

Estrogen uses

A
  1. postmenopausal (helps with osteoporosis, atrophy, and hot flashes-reestablishes HT feedback on no rep) 2. Birth control-higher dose and combine with progesterone.
107
Q

Tamoxifene

A

SERM. Antagonizes estrogen receptors in the breast. Used for breast cancer. Can cause tamoxifene retinopathy

108
Q

Clomiphene

A

SERM. Partial estrogen agonist. Used to cause ovulation and treat infertility

109
Q

Medroxyprogesterone

A

Oral progesterone. Used for contraception, dysmenorrhea, endometrios, infertility. If conception doesn’t occur progesterone [] falls and menestration occurs.

110
Q

Monophasic pills

A

Have a constant dose of estrogen and progesterone

111
Q

Triphasic pills

A

Have estrogen and an increasing dose of progesterone to mimic actual cycle.

112
Q

Progesterone

A

From adrenals. Used for contraceptive (less effected by first pass mech), dysmenorrhea, and endometirus, and infertility

113
Q

Plan B

A

A high dose of estrogen or estrogen and progestrin 72 hours after sex

114
Q

SE of Birth control

A

breast fullness, depression, blood clots, hypertension, HA, nausea, vomiting.

115
Q

Androgen effect

A

Normal maturation in M, sperm production, decrease resportion, increase synthesis of hemoglobin and muscle proteins

116
Q

5-alpha reductase

A

Converts testosterone to more potent dihydrotestosterone

117
Q

Aromatise

A

Converts testosterone to estrogen

118
Q

Furosemide

A

A loop diuretic. Acts on ascending to inhibit Na/K/Cl transport. It is most efficacious diuretic.

119
Q

Alprostadil

A

Prostaglandin. Used for ED. Keep ductus arteries open. Intrapenile injection or intraurethal suppository.

120
Q

Phentermine

A

Anorexiant. Similar to diethylproprion

121
Q

Eplernone

A

Aldosterone antagonist. K sparing diuretics. Binds aldosterone receptor so don’t get response to aldosterone. Used with other diuretics. Less endocrine effects then spironolactone.

122
Q

Levonorgestreal

A

Progestin (synthetic progesterine) Used with contraception.

OPT 541 (3 decks)

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