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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
MOA for Protirelin
synthetic TRH | - stimulates release of TSH
26
How is Protirelin used to diagnose hypothyroidism
- TSH, T3, T4 levels are normal: hypothalamic defect - TSH, T3, T4 not increased: pituitary failure - TSH increased, T3, T4 not increased: thyroid gland problem
27
What is used as a diagnostic drug for ACTH
Cosyntropin
28
How is GnRH released from the hypothalamus
pulses
29
hCG mimics the action of what hormone
LH
30
what is hCG FDA indicated for
- stimulation of ovulation in anovulatory women | - treat male infertility and cryptorchidism
31
What does Menotropins contain
equal amounts of partially degraded FSH and LH
32
what is Menotropins FDA indicated for
- female infertility in order to stimulate the development of ovarian follicles - promotes spermatogenesis in males
33
what is in Urofollitropin
mostly FSH
34
what is in Follitropin beta and alpha
recombinant human FSH
35
What is in Choriogonadotropin alpha
recombinant human LH
36
What are side effects of Gonadotropin mimic drugs
- women risk of multiple births - ovarian hyperstimulation - gynecomastia in men
37
MOA for Clomiphene
- increases levels of LH and FSH | - inhibiting estrogen negative feedback at level of hypothalamus
38
FDA indications for Clomiphene
female infertility due to polycystic ovary syndrome
39
what are side effects of Clomiphene
multiple births | ovarian cysts
40
Name the anti-estrogen and anti-androgen drugs
Leuprolide Goserelin Nafarelin Histrelin
41
What is the mechanism of action of anti-estrogen and anti-androgen drugs ( long acting)
- 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
what are anti-estrogen and anti-androgen drugs ( long acting) used for
endometriosis uterine fibriods advanced prostate cancer central precocious puberty
43
Adverse effects of anti-estrogen and anti-androgen drugs ( long acting)
hot flashes vaginal atrophy erectile dysfunction
44
Name 2 androgen receptor antagonists
Flutamide | Bicalutamide
45
Flutamide and Bicalutamide are usually given with what other drug and why
- long-acting GnRH analog | - not given alone b/c increase LH synthesis
46
What is the black box warning for Flutamide and Bicalutamide
reversible liver damage | - liver function should be assayed prior and during treatment
47
Name a 5alpha-reductase inhibitor
Finasteride
48
MOA of Finasteride
blocks conversion of testosterone to DHT
49
What is 5alpha-reductase used to treat
benign prostatic hyperplasia | male pattern baldness
50
What are 2 types of diabetes insipidus
central and nephrogenic
51
What are symptoms of diabetes insipidus
polyuria polydipsia dilute urine
52
how do you treat central Diabetes inspidius
Desmopressin
53
what are the effects of Desmopressin
- reduced vasopressor activity - enhanced antidiuretic activity compared with vasopressin - stimulate VIII and von Willebrand factor
54
What is Desmopressin FDA indicated for
von-Willebrand disease type I | Primary nocturnal enuresis
55
What are adverse effects of vasopressor activity
facial pallor nausea, cramps more prominent in vasopressor activity than in Desmopressin
56
Overstimulation of V2 in tubules can cause what
water intoxication
57
Chlorpropamide and Carbamazepine will cause what drug interactions with diabetes insipidus drugs
- increase sensitivity of collecting duct to vasopressin
58
What drug interaction inhibits the action of vasopressin on collecting duct within kidney
Lithium and Demeclocycline with Diabetes insipidus drugs
59
As many as 3 patients taking lithium will develop what
nephrogenic DI
60
how do you treat nephrogenic DI
thiazide diuretics | amiloride
61
What is SIADH
impaired H2O excretion
62
what is treatment for SIADH
fluid restriction | Demeclocycline and Tetracylcine
63
what is FDA approved for euvolemic or hypervolemic hyponatremia associated with SIADH
Conivaptan | Tolvaptan
64
what is oxytocin used for
aborption adjunct, induction of labor postpartum hemorrhage induction of lactation
65
how is oxytocin administered
IV - induce labor | Im control post-abortion hemorrhage
66
adverse effects of overstimulation of oxytocin
trauma to mother or fetus uterine rupture water intoxication allergic reactions

D&T 4 exam 1 (17 decks)

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