Pharm: Endocrine Flashcards
At high doses bromocriptine will also inhibit _______ in addition to prolactin.
Growth hormone secreting tumors
If there is a defect in GH receptor what drug do you give?
Mecasermin
T/F Abarelix or Leuprolide may be used for ovulation induction.
TRUE. BOTH GnRH agonist and antagonist have the same pituitary halting effects.
What are the 2 MOST SERIOUS complications of ovulation induction?
Multiple pregnancies AND ovulation hyper stimulation syndrome.
What are the signs and sxs ovarian hyperstimulatin syndrome?
Ascites increase in ovary size and shock/ hypovolemia.
What turns iodide ion to elemental iodine?
Thyroid peroxidase
What drugs inhibits the coupling and organification steps in thyroid hormone formation?
Thioamides.
Iodides inhibit iodination AND hormone release
What drugs inhibits the proteolysis step in thyroid hormone formation?
Iodides
Why can’t one use iodides as treatment for hyperthyroidism?
Thyroid gland escapes from block after a few week.
What is the dangerous adverse effect of giving perchlorate to inhibit iodide ion transport?
Aplastic anemia
In cases of hyperthyroidism due to Amiodarone induced leakage of thyroid hormones into the circulation what is the treatment?
Corticosteroids
At high doses what receptors are inhibited by mifepristone?
Glucocorticoids and progesterone
Which does cortisol stimulate? Lipolysis or lipogenesis?
Both
Which adrenal steroid synthesis inhibitor inhibits normal synthesis of cortisol BUT NOT of its precursors?
Metyrapone. Used for dxtic tests of renal fxn.
How does aminoglutemide work in inhibiting adrenal steroid synthesis?
Block conversion of cholesterol to pregnenolone.
Which has best topical activity? Dexa triamcinolone or prednisone or cortisol?
DExa. Cortisol has NONE.
Then use of hormonal contraceptives result in an increase in thromboembolic events in which population?
Older women
Smokers
PMH of such events
Genetic clotting factor diseases
What transporters for glucose are inserted in the liver as effect of insulin?
Glut 2
What transporters for glucose are inserted in the muscle as effect of insulin?
Glut 4
What 3 groups of people are most susceptible to hypoglycemia due to insulin?
Renal disease, elderly, children younger than 7 years
Which group of anti diabetic agents result in weight gain and blunting of the myocardial ischemic conditioning?
Sulfonylureas and meglitinides
Which group of anti diabetic agents result in lactic acidosis in alcoholics and vitamin b 12 deficiency?
Biguanides
Which group of anti diabetic agents may result in increased risk of bone fractures and MI?
Thiazolidinediones: pioglitazone and rosiglitazone
Alpha glucosidase inhibitors and pramlintide are only effective in controlling what kind of glucose levels?
Post prandial
Which group of anti diabetic agents act by inhibiting the enzyme responsible for degrading glucagon like peptide 1?
Sitagliptin by inhibiting DPP4
What pancreatic derived hormone may be useful in beta blocker overdose?
Glucagon
Enumerate the mechanisms of action of metformin.
1 Inhibit hepatic and renal gluconeogenesis
2 stimulation of glucose uptake and glycolysis in peripheral tissues
3 slowing of glucose absorption in the GI tract
4 reduction of plasma glucagon
Which bone cells are stimulate by PTH?
Osteoblasts and osteoclasts.
Osteoclasts stimulated by formation of the RANK ligand
What is the plant form of vitamin D?
Ergocalciferol or vitamin d2
Vit d3 natural form from diet
Vitamin D Can also be synthesized from the skin from 7 dehydrocholesterol
What 2 substances stimulate the renal synthesis of vitamin D?
Fibroblast growth factor 23 and PTH
At low intermittent doses of PTH what will the effect one bone be?
Net increase in bone formation
What is the net effect of PTH on urinary calcium?
Increased. Effects on bone and GI tract outweighs the effects on kidney (re absorption of calcium and potassium)
What dermatological disease may be treated with calcipotriol?
Psoriasis
What enzyme is inhibited by bisphosphonates?
Farnesyl pyro phosphate synthesis that is critical in osteoclasts survival
What is the primary toxicity of low oral bisphosphonates?
How to prevent?
Gastric or esophageal irritation
Take meds with large amount of water in standing position.
What is the toxicity of high dose bisphosphonates used to treat Hypercalcemia? Give 2.
Renal impairment AND Osteonecrosis of the jaw
At high concentrations what is the effect of fluoride on bone?
Increase bone formation.
How does strontium ranelate treat Osteoperosis?
Promotes osteoclast apoptosis
What is sevelamer for?
Treat Hyperphosphatemia
