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clin med exam 2 > Pharm test 2 > Flashcards

Pharm test 2 Flashcards

1
Q

somatostatin analogs

A

inhibit release of GH, glucagon, insulin and gastrin

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2
Q

Octreotide (Sandostatin)

A

a long acting somatostatin analog- inhibits release of GH, glucagon, insulin, and gastrin

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3
Q

Bromocriptine (Parlodel)

A

dompamine D2 receptor agonists- effective at inhibiting prolactin release (more than GH) but high does have some efficacy in small GH secreting Tumors
(use: agromegaly, hypeprolactinemia)

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4
Q

Dopamine

A

physiologic inhibitor of prolactin release

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5
Q

thyroid hypofunction

A

(trh HIGH) tsh HIGH, t3-t4 LOW

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6
Q

pituitary hypofunction

A

(trh HIGH) tsh LOW

T3-T4 LOW

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7
Q

Thyroid hyperfunction

A

(trh low) TSH low, t3-t4 HIGH

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8
Q

Pituitary hyperfunction

A

(trh low) tsh HIGH

t3-t4 HIGH

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9
Q

Levothyroxine

and adverse effects

A

synthetic T4 thyroid replacement

AE: nervousness, heat intolerance, palpitation/ tachycardia, weight loss

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10
Q

131 I (radio active iodine)

A

treat thyrotoxicosis
rapidly absorbed, concentrated in the thyroid, and incorporated into storage follicles
crosses the placenta and excreted in breat milk (contraindicated)

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11
Q

Methimazole (Tapazole)

A

thioamide- antithyroid agent

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12
Q

Propylthiouracil

  • mechanism
  • adverse effects
A

Thioamide- also inhibits conversion of T4–>T3 so brings level down faster
Mechanism: inhibit thyroid peroxidase- catalyzed reactions and blocking iodine organification (prevents binding of iodine to tyrosine)
AE: rash, SEVER HEPATITIS (PTU), Agranulocytosis (infrequent but potentially fatal)

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13
Q

Potassium Iodine

SSKI- super saturated KI

A

mechanism: block release of t4/t3 and inhibit Iodine from being used in new hormone synthesis
- given a week after RAI, normalizes thyroid function earlier than RAI alone
- given to protect thyroid from radioactive iodine fallout (uptake of RAI is inversely proportional to serum concentration of stable iodine

cross placenta—fetal goiter

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14
Q

Beta Blockers

A

useful in controlling tachycardia and other cardiac abnormalities of severe thyrotoxicosis

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15
Q

Propranolo

A

beta blocker- inhibits peripheral conversion of t4 to t3

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16
Q

Aspirin & NSAIDs

A

decrease protein binding (ass. with displacement of thyroid hormone from TBG)

cause increase in free thyroid hormone

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17
Q

old people’s heart is very sensitive to levels of circulating ______?

A

thyroxine- becareful when treating long standing hypothyroidism with cardiac issues

18
Q

Hypothyroid in pregnancy

A

early fetal brain development depends on maternal thyroxine

-May have to increase in dose to normalize TSH levels

19
Q

most patients with primary hyperparathyroidism also have _______________?

A

hypercalcemia

20
Q

estrogen replacement

risk

A

breast cancer, stroke, and heart attack

21
Q

BisphosphoNATES

A

use is osteoporosis, hypercalcemia, hyper-parathyroidism

inhibits bone reabsorption by suppressing osteoclast activity

22
Q

Calciminetic (cinacalcet)

A

treat hypercalcemia

allosterically increase the sensitivity of the Ca sensing receptor (CaSR) in the parathyroid gland to calcium

23
Q

calciminetic side effects

A

nausea vomiting

24
Q

secondary hyper-parathyroidism

A

usually caused by chronic renal failure
-PTH and decreased GFR increase proximal tubular reabsorption of phosphate

  • formation of insoluble calcium phosphate
  • reduces circulating free calcium, rather as insoluble calcium phosphate
25
Q

Treatment of Secondary hyper- parathyroidism

A

phosphate binders-
- non calcium containing
SEVELAMER CARBONATE

26
Q

phosphate binders actions and side effects

A

actions: bind to dietary phosphate, form insoluble complex, carry through bowel unabsorbed
SE: hypercalcemia (ca load plus unbinding of circulating Ca-Phoshate complexes)

27
Q

non calcium containing phosphate binders

A

sevelamer carbonate
seelamer hydrocholride
lanthanum carbonate

28
Q

Vit. D active

A

Calcitriol (d3)
most potent agent

-also can be a treatment for hypoparathyroidism

29
Q

vit D inactive

A

Cholecalciferol (vit d3)

ergocalciferol (vit d2)

30
Q

Calcium Carbonate (Caltrate)

A

40% ca

better absorption in acidic environment

31
Q

calcium citrate (Citracal)

A

21% calcium

better for patients taking acid reducing medications

32
Q

Sodium Fluoride

A

deposits in bone and teeth

makes bones hard but “brittle” fewer breaks but more shattering

33
Q

HMG CoA Reductase Inhibitors (statins)

  • Atorvastatin
  • Fluvastatin
  • Lovastatin
A

ATP pReference: statins block early step in cholesterol synthesis

-improves endothelial function (non-lipid effect)

34
Q

do not drink what when taking statins

A

grapefruit juice! contains furanocoumarin (inhibit cyp 450)

35
Q 
Bile acid sequestrants (aka Bile acid resins) 
"COLES" 
-cholestyramine
-colestipol
-colesevelam
A

reduce gastric reabsorption of cholesterol

-inhibit enterohepatic recirculation of bile acids leading and increased expression of LDL receptors

36
Q

what vitamin may be deficient with bile acid sequestrants

A

K

37
Q

nicotinic acid

  • niacor
  • niaspan
  • nicobid
  • nicolar
  • slo-niacin

SE?

A

SE: high dose/ fast release promote flushing!
- sustained release preparations minimize flushing episodes, but have higher incidence of hepatic toxicities (monitor liver functions)

  • trigger gout attacks
  • now questionable if niacin really does much
38
Q

fibric acid derivatives (fibrates)

“FIBR”

A

increase LDL receptor expression
markedly reduce triglycerides
- drive uptake utilization, and catabolism of fatty acids

39
Q

Fibrates - side effects

A

Rhabdomyolysis

40
Q

Ezatimibe (Zetia) component of Vytorin

A

reduces LDL-C, but there is limited evidence on improvement in clinical outcomes
- not evidence it improves long term outcomes. has been combined with statins

41
Q

Fish Oil- omega 3

A

triglycerides exceed 500mg.dl

clin med exam 2 (5 decks)

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