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OBGYN pharmacology > MOA > Flashcards

MOA Flashcards

1
Q

USED IN T1DM AND T2DM to regulate postprandial glucose

A

pramlintide

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2
Q

rapidly contracts the uterine smooth muscle through activation of serotonin and alpha adrenergic receptors to

deliver the placenta AFTER LABOR IS OVER!!!!

(will abort the baby if given during labor)

A

ergonovine maleate

methylergonovine maleate

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3
Q

when giving glucocorticoids what type of dose do you start with

A

high dose then taper down to lowest effective dose

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4
Q

repaglinide, nateglinide (meglitinides)

A

NOT a sulfa drug, these that close the K channel, depolarize the membrane, and cause insulin to be exocytosed

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5
Q

rhPTH (1-84)

A

recombinant PTH that binds to receptor to stimulate the RANK ligand to cause

OSTEOCLASTIC and BLASTIC activity

used in tx of hypOparathyroidism

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6
Q

tolbutamide, chlorpropamide, tolazamide

A

1st gen sulfonylureas that close the K channel, depolarize the membrane, and cause insulin to be exocytosed

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7
Q

calcitonin

A

inhibits bone resporption of Ca and phos by osteoclasts

antagonizes the actions of PTH

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8
Q

acarbose and miglitol

A

alpha glucosidase inhibitors that delay CHO digestion and decrease intestinal glucose absorption

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9
Q

androgen receptor antagonists

reduce male sex accessory organ function

A

flutamide

bicalutamide

nilutamide

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10
Q

inhibits bone resporption of Ca and phos by osteoclasts

antagonizes the actions of PTH

A

calcitonin

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11
Q

DPP-4 inhibitors that inhibit the the enzyme that degrades GLP-1 (increasing insulin secretion)

A

“gliptins”

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12
Q

hMG

A

used for FSH properties

** develops the ovarian follicles and stimulates estrogen **

** stimulates spermatogenesis **

(also has LH but FYI)

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13
Q

in ART

what are females given to ensure the transfer of the embryo

A

progesterone

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14
Q

iodide

A

rapidly decreases the synthesis and release of T3 and T4 for a short term effect

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15
Q

short term (1-2 week) tx with glucocorticoids does what to the HPA axis

A

not likely to cause the life threatening adrenal insufficiency problems

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16
Q

exemestane

A

irreversible inhibitor of aromatase (enzyme in the final step in estrogen synthesis)

DOC for breast CA tx of POST menopausal women

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17
Q

nifedipine

A

stops uterus smooth muscle contractions (CCB)

prevents early labor

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18
Q

works on OT receptors in the uterus to

induce labor (DOC)

prevent hemorrhage

stimulate milk let down reflex

A

oxytocin

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19
Q

spironolactone

A

mineralocorticoid receptor antagonist

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20
Q

“gliflozin”

A

SGLT-2 inhibitors that inhibit the Na-glucose co-transporter in the kideny

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21
Q

bromocriptine

A

dopamine agonist-

leads to suppression of hepatic glucose production

decreases postmeal plasma glucose levels

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22
Q

suppress testosterone synthesis and spermatogeneis

A

long acting GnRH analogues and antagonists antiandrogen MOA

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23
Q

SGLT-2 inhibitors that inhibit the Na-glucose co-transporter in the kideny

A

“gliflozin”

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24
Q

cholecalciferol (skin)

ergocalciferol (diet)

calcitriol (active)

A

(vitamin D)

increases GI Ca and phos absorption

must be adequate for optimal absorption of Ca

decreses renal excretion of Ca and Phos

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25
Q

equal anti inflammatory and salt retaining effects

A

hydrocortisone

cortisone

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26
Q

lots of SALT RETAINING effects

NO

anti-inflammatory effects

A

aldosterone

fludrocortisone

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27
Q

what do you do to decrease the suppression on the adrenal gland caused by glucocorticoids

A

give on alternate days

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28
Q

estradiol, estrone, estriol endocervical gland effects

A

cervical mucus

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29
Q

LH agonist

binds to the LH receptor

** stimulates progesterone to make the corpus luteum **

** stimulates testosterone production in the testes **

A

hCG

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30
Q

chronic tx with glucocorticoids does what to the HPA axis

A

suppresses it to the point where it can cause life threatening adrenal insufficiency

this can last for months

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31
Q

inhibit LH secretion

inhibiting the creation of steroids by the testes

A

estrogen antiandrogen MOA

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32
Q

gradually inhibits the synthesis of T4

A

propylthiouracil and methimazole

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33
Q

mifepristone

A

receptor antagonist of

both

glucocorticoids

and

progesterone

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34
Q

metformin

A

(1) decreases gluconeogenesis, glycogenolysis, and CHO intestinal absorption (2) increases insulin sensitivity

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35
Q

1st- hCG (for up to a year)

2nd- add hMG (for a few months)

A

male fertility tx

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36
Q

beta blocker that inhibits the peripheral conversion of T4 to T3

A

propanalol

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37
Q

emergency only use to stop early labor by short term cervicouterine relaxation

A

nitroglycerin

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38
Q

anti-fibrinolytic that inhibits the activation of plasminogen

reduces death due to postpartum hemorrhage

“along with standard uterotonic therapy”

A

tranexamic acid

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39
Q

indomethacin

A

inhibits COX to reduce prostaglandin synthesis

and delay early labor

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40
Q

radioactive iodine 131

A

in small amounts it is diagnostic but in large amounts it is curative

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41
Q

progesterone effects on uterus

A

converts endometrium to secretory state

needed to maintain pregnancy

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42
Q

progesterone thermogenic effects

A

increases body temp

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43
Q

antiestrogen that is

antagonist in the breast AND the uterus

agonist in the bone and liver

A

raloxifene

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44
Q

diazoxide

A

raises blood sugar by inhibiting insulin secretion or decreasing glucose utilization

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45
Q

“glitazone”

A

thiazolidinediones that increase insulin sensitivity by binding to PPARy receptor

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46
Q

thiazolidinediones that increase insulin sensitivity by binding to PPARy receptor

A

“glitazone”

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47
Q

bile acid sequestrant that lowers A1C somehow

A

colesevelam

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48
Q

tamoxifen

A

antiestrogen that is

agonist in uterus and bone

antagonist in breast

(used for estrogen dependent breast CA in pre and post menopausal women)

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49
Q

“glutides” and exenatide

A

GLP-1 agonists (act like GLP-1 to increase release of insulin and decrease release of glucagon

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50
Q

cetrorelix

ganirelix

A

GnRH antagonist

LD: suppresses LH

HD: suppresses FSH

goal is to suppress endogenous LH and FSH

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51
Q

propylthiouracil

A

gradually blocks the conversion of T4 to T3

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52
Q

anastrozole

letrozole

A

nonsteroidal

inhibitor of aromatase

(final step in estrogen synthesis)

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53
Q

long acting GnRH analogues and antagonists ART MOA

A

suppress LH and FSH for

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54
Q

inhibits PTH secretion

alters the physical chemical properties of the bone mineral

A

calcium

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55
Q

19- nortestosterones

norethindrone

norgestrel

levonorgestrel

norgestimate

A

derived from testosterone and have both progestin and androgenic activity

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56
Q

progesterone

medroxyprogesterone

megestrol acetate

A

progesterone derivatives

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57
Q

liothyronine sodium

A

synthetic T3- shorter half life and duration of action than T4

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58
Q

cortisone MOA

A

must be converted to hydrocortisone in the liver to be active

less potent than hydrocortisone

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59
Q

propanalol

A

beta blocker that inhibits the peripheral conversion of T4 to T3

How well did you know this?
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60
Q

propylthiouracil and methimazole

A

gradually inhibits the synthesis of T4

How well did you know this?
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3
4
5
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61
Q

alpha glucosidase inhibitors that delay CHO digestion and decrease intestinal glucose absorption

A

acarbose and miglitol

How well did you know this?
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62
Q

hCG

A

LH agonist

binds to the LH receptor

** stimulates progesterone to make the corpus luteum **

** stimulates testosterone production in the testes **

63
Q

in small amounts it is diagnostic but in large amounts it is curative

A

radioactive iodine 131

64
Q

nitroglycerin

A

emergency only use to stop early labor by short term cervicouterine relaxation

65
Q

a steroid

irreversible inhibitor of aromatase

(final step in estrogen synthesis)

A

exemestane

66
Q

NOT a sulfa drug, these that close the K channel, depolarize the membrane, and cause insulin to be exocytosed

A

repaglinide, nateglinide (meglitinides)

67
Q

1st gen sulfonylureas that close the K channel, depolarize the membrane, and cause insulin to be exocytosed

A

tolbutamide, chlorpropamide, tolazamide

68
Q

antiestrogen that is

antagonist in the hypothalamus

agonist everywhere else

A

clomiphene

69
Q

estradiol, estrone, estriol ovary effects

A

prepare follicle cells for ovulation (with FSH)

70
Q

what are females given to ensure the embryo transfer

A

progesterone

71
Q

progesterone derivatives

A

derivatives of progestin:

progesterone

medroxyprogesterone

megestrol acetate

72
Q

antibody that binds to and inhibits the RANK ligand causing

OSTEOCLAST INHIBITION

used in osteoporosis

A

denosumab

73
Q

oxytocin

A

works on OT receptors in the uterus to

induce labor (DOC)

prevent hemorrhage

stimulate milk let down reflex

74
Q

synthetic T3- shorter half life and duration of action than T4

A

liothyronine sodium

75
Q

ergonovine maleate

methylergonovine maleate

A

rapidly contracts the uterine smooth muscle through activation of serotonin and alpha adrenergic receptors to

deliver the placenta AFTER LABOR IS OVER!!!!

(will abort the baby if given during labor)

76
Q

alpha glucosidase inhibitors that delay CHO digestion and decrease intestinal glucose absorption

A

acarbose and miglitol

77
Q

estradiol, estrone, estriol pubertal effects

A

female secondary sex characteristics

close the epiphysis

78
Q

danazol

A

weak progestin, androgen, and glucocorticoid

decreases function of the ovaries

79
Q

female fertility tx

(fertilization)

A

1st- hMG (for 9-12 days)

2nd- hCG (1 dose)

**in sequence**

80
Q

male fertility tx

A

1st- hCG (for up to a year)

2nd- add hMG (for a few months)

81
Q

used for FSH properties

** develops the ovarian follicles and stimulates estrogen **

** stimulates spermatogenesis **

A

hMG

82
Q

testosterone, methyltestosterone virilizing effects

A

spermatogenesis

sexual development

83
Q

rapidly decreases the synthesis and release of T3 and T4 for a short term effect

A

iodide

84
Q

lowers dopamine levels which leads to suppression of hepatic glucose production

A

bromocriptine

85
Q

long acting GnRH agonist

initially causes an LH surge

BUT THE ULTIMATE EFFECT IS

INHIBITION OF GONADOTROPIN RELEASE

(goal is to reduce androgens)

A

leuprolide

goserelin

86
Q

mifepristone

A

antiprogestin that blocks progestin binding to the progesterone receptor

87
Q

relaxes the uterus

stops premature labor

A

mag sulfate

88
Q

estrogen antiandrogen MOA

A

inhibit LH secretion

inhibiting the creation of steroids by the testes

89
Q

antiestrogen that is

agonist in uterus and bone

antagonist in breast

(used for estrogen dependent breast CA in premenopausal women)

A

tamoxifen

90
Q

“dronates”

A

PCP bond analogs of pyrophosphate that

INCORPORATE INTO BONE

inhibit osteoclasts

DOC for osteoporosis

91
Q

synthetic T4- takes 4-6 weeks to reach steady state

A

levothyroxine sodium

92
Q

estradiol, estrone, estriol vaginal epithelium effects

A

stimulate proliferation

93
Q

mitotane

A

inhibitor of corticosteroid synthesis

adrenocorticolytic

causes adrenocorticol atrophy

(destroys the gland)

94
Q

estrogens

long acting GnRH analoges and antagonists

androgen receptor antagonists

5-alpha reductase inhibitors

A

antiandrogens

(list of groups)

95
Q

GLP-1 agonists (act like GLP-1 to increase release of insulin and decrease release of glucagon

A

“glutides” and exenatide

96
Q

repeated applications with glucocorticoids causes a ___ effect

A

depot effect

(increases absorption)

97
Q

denosumab

A

antibody that binds to and inhibits the RANK ligand causing

OSTEOCLAST INHIBITION

used in osteoporosis

98
Q
A
99
Q

estradiol, estrone, estriol metabolic effects

A

makes liver proteins (that bind to hormones)

increases HDL and reduces LDL

Na and H20 retention

100
Q

progesterone’s effect on early labor

A

it PROPHYLACTICALLY prevents

not an acute tx

101
Q

“paratides”

teraparatide, abaloparatide

A

PTH analogs that intermittently stimulate the PTH receptor to cause

OSTEOBLASTIC activity

used in osteoporosis

only anabolic osteoporosis drug

102
Q

calcium

A

inhibits PTH secretion

alters the physical chemical properties of the bone mineral

103
Q

glyburide, glipizide, glimepride

A

2nd gen sulfonylureas that close the K channel, depolarize the membrane, and cause insulin to be exocytosed

104
Q

finasteride

dutasteride

A

5 alpha reducatse inhibitors

stop the conversion of testosterone to DHT

decreases DHT and PSA

increases total testosterone (so might make more estrogen)

105
Q

GnRH antagonist

LD: suppresses LH

HD: suppresses FSH

goal is to suppress endogenous LH and FSH

A

cetrorelix

ganirelix

106
Q

antiestrogen that is

pure estrogen receptor antagonist

effective in pts w/ tamoxifen resistant tumors

A

fulvestrant

107
Q

testosterone, methyltestosterone effects on puberty and embryo

A

development of secondary sex characteristics

108
Q

flutamide

bicalutamide

nilutamide

A

androgen receptor antagonists

reduce male sex accessory organ function

109
Q

in times of stress, what do you do with glucocorticoids

A

INCREASE THE DOSE

110
Q

fludicortisone

A

mimics the effects of aldosterone

mineralcorticosteroid and glucocorticosteroid effects

111
Q

weak progestin, androgen, and glucocorticoid

decreases function of the ovaries

A

danazol

112
Q

“gliptins”

A

DPP-4 inhibitors that inhibit the the enzyme that degrades GLP-1 (increasing insulin secretion)

113
Q

hydrocortisone

cortisone

prednisone

methylprednisone

dexamethasone

fluticasone

A

anti-inflammatory glucocorticoids

increase glucose, FFA, and amino acids in blood

antagonize insulin

redistribute fat

increase SNS heart effects

Na and H20 retention (some)

bone loss

immunosuppression

114
Q

only anti inflammatory effects

NO

salt retaining effects

A

methylpredinsolone

fluticasone

dexamethasone

traimcinolone

betamethasone

115
Q

2nd gen sulfonylureas that close the K channel, depolarize the membrane, and cause insulin to be exocytosed

A

glyburide, glipizide, glimepride

116
Q

clomiphene

A

antiestrogen that is

antagonist in the hypothalamus

agonist everywhere else

117
Q

progesterone effects on breasts

A

loguloalveolar development

118
Q

stops uterus smooth muscle contractions (CCB)

prevents early labor

A

nifedipine

119
Q

fulvestrant

A

antiestrogen that is

pure estrogen receptor antagonist

effective in pts w/ tamoxifen resistant tumors

120
Q

PCP bond analogs of pyrophosphate that

INCORPORATE INTO BONE

inhibit osteoclasts

DOC for osteoporosis

A

“dronates”

121
Q

5 alpha reducatse inhibitors

stop the conversion of testosterone to DHT

decreases DHT and PSA

increases total testosterone (so might make more estrogen)

A

finasteride

dutasteride

122
Q

lots of anti inflammatory effects

some salt retaining effects

A

prednisone

prednisolone

123
Q

acarbose and miglitol

A

alpha glucosidase inhibitors that delay CHO digestion and decrease intestinal glucose absorption

124
Q

spironolactone

A

androgen receptor antagonist

competes for androgen and estrogen receptors when

AT VERY HIGH DOSES

125
Q

prednisone MOA

A

must be converted to prednisolone in the liver to be active

126
Q

pramlintide

A

USED IN T1DM AND T2DM to regulate postprandial glucose

127
Q

testosterone, methytestosterone anabolic effects

A

increases bones

amino acids getting into muscles

RBC mass

antagonizes steroids

128
Q

tranexamic acid

A

anti-fibrinolytic that inhibits the activation of plasminogen

reduces death due to postpartum hemorrhage

“along with standard uterotonic therapy”

129
Q

nonsteroidal

inhibitor of aromatase

(final step in estrogen synthesis)

A

anastrozole

letrozole

130
Q

estradiol, estrone, estriol uterus effects

A

endometrial cell division and growth

(in the follicular phase)

131
Q

androgen receptor antagonist

competes for androgen and estrogen receptors when

AT VERY HIGH DOSES

A

spironolactone

132
Q

estradiol, estrone, estriol effects on blood clotting

A

makes clotting protein

increases platelet adhesiveness

133
Q

progesterone effects on endocervical glands

A

cervical mucus

134
Q

ketoconazole

A

inhibitor of corticosteroid synthesis

at high dose this antifungal inhibits steroid synthesis

NON-SELECTIVE

used in pre-op suppression

135
Q

raloxifene

A

antiestrogen that is

antagonist in the breast AND the uterus

agonist in the bone and liver

136
Q

PTH analogs that intermittently stimulate the PTH receptor to cause

OSTEOBLASTIC activity

used in osteoporosis

only anabolic osteoporosis drug

A

“paratides”

teraparatide, abaloparatide

137
Q

levothyroxine sodium

A

synthetic T4- takes 4-6 weeks to reach steady state

138
Q

raises blood sugar by inhibiting insulin secretion or decreasing glucose utilization

A

diazoxide

139
Q

derived from testosterone and have both progestin and androgenic activity:

norethindrone

norgestrel

levonorgestrel

norgestimate

A

19- nortestosterones

140
Q

recombinant PTH that binds to receptor to stimulate the RANK ligand to cause

OSTEOCLASTIC activity

used in tx of hypOthyroidism

A

rhPTH (1-84)

141
Q

estradiol, estrone, estriol bone

A

maintain bone mass

stop resorption

142
Q

increases GI Ca and phos absorption

must be adequate for optimal absorption of Ca

decreses renal excretion of Ca and Phos

A

cholecalciferol (skin)

ergocalciferol (diet)

calcitriol (active)

143
Q

estradiol, estrone, estriol breast effeccts

A

ductal epithelial cells

144
Q

mag sulfate

A

relaxes the uterus

stops premature labor

145
Q

antiprogestin that blocks progestin binding to the progesterone receptor

A

mifepristone

146
Q

gradually blocks the conversion of T4 to T3

A

propylthiouracil

147
Q

1st- hMG (for 9-12 days)

2nd- hCG (1 dose)

**in sequence**

A

female fertility tx

(fertilization)

148
Q

inhibits COX to reduce prostaglandin synthesis

and delay early labor

A

indomethacin

149
Q
A
150
Q

colesevelam

A

bile acid sequestrant that lowers A1C somehow

151
Q

(1) decreases gluconeogenesis, glycogenolysis, and CHO intestinal absorption (2) increases insulin sensitivity

A

metformin

152
Q

leuprolide

goserelin

A

long acting GnRH agonist

initially causes an LH surge

BUT THE ULTIMATE EFFECT IS

INHIBITION OF GONADOTROPIN RELEASE

(goal is to reduce androgens)

153
Q

metyrapone

A

inhibitor of corticosteroid synthesis

SELECTIVE inhibitor of the last enzyme in cortisol synthesis

used short term

ok for preggos

154
Q

IM DM drugs

A

GLP-1 agonists

pramlintide

insulin

OBGYN pharmacology (6 decks)

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