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D&T 4 exam 1 > Neuroendocrine pharmacology > Flashcards

Neuroendocrine pharmacology Flashcards

1
Q

How is hypothalamic dwarfism treated

A

GH replacement

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2
Q

when can you not use GH replacement for hypothalamic dwarfism

A
  • closed epiphysis
  • 15 years and older
  • cannot make IGF1
  • active malignancy
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3
Q

usually GH replacement is given with what hormone

A

sex steroids

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4
Q

name a GH replacement drug? when is it administered

A

Somatropin

evening

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5
Q

name a synthetic GHRH ?

A

Sermorelin

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6
Q

early in GH treatment what are some side effects

A
  • increased intracranial pressure

- anti-insulin actions, decreases glucose utilization

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7
Q

What is human recombinant IGF-1 used to treat?

A

growth deficiency due to low levels of IGF-1

- Laron Dwarfism

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8
Q

What is Laron Dwarfism

A

mutations in GH receptor

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9
Q

what are adverse effects of human recombinant IFG-1

A

hypoglycemia

lipohypertrophy

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10
Q

what is used to treat acromegaly in adults and gigantism in children

A

somatostatin analogs

Pegvisomant

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11
Q

name somatostatin analogs

A

Octerotide

Lanreotide

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12
Q

what is the difference between Octerotide and Lanreotide

A

Octreotide shorter half life

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13
Q

what are adverse effects of Somatostatin analogs

A

GI: diarrhea, nausea, abdominal pain

  • gallstones
  • reduce levels of thyrotopin secretion
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14
Q

MOA for Pegvisomant

A

competitive GH receptor antagonist

reduces levels of IGF-1

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15
Q

what is second line therapy for acromegaly

A

Pegvisomant

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16
Q

adverse effects of Pegvisomant

A

Lipohypertrophy at injection site

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17
Q

Symptoms for hyperprolactinemia

A
  • amenorrhea, galactorrhea, infertility in women and impotence
  • galactorrhea, infertility in men
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18
Q

what is used to treat hyperprolactinemia

A

dopamine receptor agonists

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19
Q

name 2 dopamine receptor agonists

A

Cabergoline

Bromocriptine

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20
Q

MOA for Cabergoline and Bromocriptine

A

stimulate D2 receptor

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21
Q

difference between Cabergoline and Bromocriptine

A

Cabergoline has longer half life and greater selectivity for D2 receptor

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22
Q

Bromocriptine is FDA approved to treat what

A

Acromegaly and hyperporlactinemia

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23
Q

What are adverse affects for D receptor agonists

A
  • cabergoline has lower nausea
    • hypotension and dizziness
    • linked with valvular disease, attribute to ergot activity
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24
Q

what drug is used to treat hypothyroidism

A

Protirelin

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25
Q

MOA for Protirelin

A

synthetic TRH

- stimulates release of TSH

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26
Q

How is Protirelin used to diagnose hypothyroidism

A
  • TSH, T3, T4 levels are normal: hypothalamic defect
  • TSH, T3, T4 not increased: pituitary failure
  • TSH increased, T3, T4 not increased: thyroid gland problem
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27
Q

What is used as a diagnostic drug for ACTH

A

Cosyntropin

28
Q

How is GnRH released from the hypothalamus

A

pulses

29
Q

hCG mimics the action of what hormone

A

LH

30
Q

what is hCG FDA indicated for

A
  • stimulation of ovulation in anovulatory women

- treat male infertility and cryptorchidism

31
Q

What does Menotropins contain

A

equal amounts of partially degraded FSH and LH

32
Q

what is Menotropins FDA indicated for

A
  • female infertility in order to stimulate the development of ovarian follicles
  • promotes spermatogenesis in males
33
Q

what is in Urofollitropin

A

mostly FSH

34
Q

what is in Follitropin beta and alpha

A

recombinant human FSH

35
Q

What is in Choriogonadotropin alpha

A

recombinant human LH

36
Q

What are side effects of Gonadotropin mimic drugs

A
  • women risk of multiple births
  • ovarian hyperstimulation
  • gynecomastia in men
37
Q

MOA for Clomiphene

A
  • increases levels of LH and FSH

- inhibiting estrogen negative feedback at level of hypothalamus

38
Q

FDA indications for Clomiphene

A

female infertility due to polycystic ovary syndrome

39
Q

what are side effects of Clomiphene

A

multiple births

ovarian cysts

40
Q

Name the anti-estrogen and anti-androgen drugs

A

Leuprolide
Goserelin
Nafarelin
Histrelin

41
Q

What is the mechanism of action of anti-estrogen and anti-androgen drugs ( long acting)

A
  • synthetic GnRH agonists ( or analogs) have longer half-lives than endogenous GnRH
  • improves receptor binding affinity
  • down-regulate the GnRH receptor and inhibit gonadotropin secretion
42
Q

what are anti-estrogen and anti-androgen drugs ( long acting) used for

A

endometriosis
uterine fibriods
advanced prostate cancer
central precocious puberty

43
Q

Adverse effects of anti-estrogen and anti-androgen drugs ( long acting)

A

hot flashes
vaginal atrophy
erectile dysfunction

44
Q

Name 2 androgen receptor antagonists

A

Flutamide

Bicalutamide

45
Q

Flutamide and Bicalutamide are usually given with what other drug and why

A
  • long-acting GnRH analog

- not given alone b/c increase LH synthesis

46
Q

What is the black box warning for Flutamide and Bicalutamide

A

reversible liver damage

- liver function should be assayed prior and during treatment

47
Q

Name a 5alpha-reductase inhibitor

A

Finasteride

48
Q

MOA of Finasteride

A

blocks conversion of testosterone to DHT

49
Q

What is 5alpha-reductase used to treat

A

benign prostatic hyperplasia

male pattern baldness

50
Q

What are 2 types of diabetes insipidus

A

central and nephrogenic

51
Q

What are symptoms of diabetes insipidus

A

polyuria
polydipsia
dilute urine

52
Q

how do you treat central Diabetes inspidius

A

Desmopressin

53
Q

what are the effects of Desmopressin

A
  • reduced vasopressor activity
  • enhanced antidiuretic activity compared with vasopressin
  • stimulate VIII and von Willebrand factor
54
Q

What is Desmopressin FDA indicated for

A

von-Willebrand disease type I

Primary nocturnal enuresis

55
Q

What are adverse effects of vasopressor activity

A

facial pallor
nausea, cramps
more prominent in vasopressor activity than in Desmopressin

56
Q

Overstimulation of V2 in tubules can cause what

A

water intoxication

57
Q

Chlorpropamide and Carbamazepine will cause what drug interactions with diabetes insipidus drugs

A
  • increase sensitivity of collecting duct to vasopressin
58
Q

What drug interaction inhibits the action of vasopressin on collecting duct within kidney

A

Lithium and Demeclocycline with Diabetes insipidus drugs

59
Q

As many as 3 patients taking lithium will develop what

A

nephrogenic DI

60
Q

how do you treat nephrogenic DI

A

thiazide diuretics

amiloride

61
Q

What is SIADH

A

impaired H2O excretion

62
Q

what is treatment for SIADH

A

fluid restriction

Demeclocycline and Tetracylcine

63
Q

what is FDA approved for euvolemic or hypervolemic hyponatremia associated with SIADH

A

Conivaptan

Tolvaptan

64
Q

what is oxytocin used for

A

aborption
adjunct, induction of labor
postpartum hemorrhage
induction of lactation

65
Q

how is oxytocin administered

A

IV - induce labor

Im control post-abortion hemorrhage

66
Q

adverse effects of overstimulation of oxytocin

A

trauma to mother or fetus
uterine rupture
water intoxication
allergic reactions

D&T 4 exam 1 (17 decks)

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