Pharma 3🧿 Flashcards
Hydrocortisone
1:1
Corticosteroids replacement
Oral
Prednisolone
4 GC:0.8
Inflammatory disease
Oral
Dexamethasone
25 GC:0
Tumor or edema
Oral
Betamethasone
25 GC:0
Topical tx
Topical
Fludrocortisone
10:125 MC
Mineralocorticoid
Replacement
Oral
fluticasone
Inhaled steroids 80% swallowed (rest stays in lungs)
Lipophilic compounds retained longer in lungs
methylprednisolone
Iv
beclomethasone
Inhibitors
CG
flexor>
flexor>forehead>scalp>face>forearm
triamcinolone
Intra-articular
GC
depo-medrone
Intra articular is Methylprednisolone GC
Used for joint staff
Adrenal insufficiency
Primary adrenal failure TX
Hydrocortisone (10/5/5mg) Fludrocortisone (100ug) Mimic normal physiology Fludrocortisone not in pituitary diseas
DX of cushing syndrome
Dexamethasone suppression test 2 days dexamethasone Measure cortisol levels before and after Normal individuals suppress < 50 nmol/l )
failure to suppress in cashing syndrome
Antitussives
butamirate.
Suppress the cough itself
Side effect of GC
Osteoporosis Avascular necrosis Peptic ulcers Increased infections Hypertension Diabetes
Impaired growth Skin atrophy Cataracts Corneal damage Cushingoid features
Cushingoid features
Rounded face Plethoric features Acne Poor wound healing Central obesity Proximal myopathy
Buffalo hump Thin skin Easy bruising Abdominal striae Hypertension Diabetes mellitus
Steroid sparing agent
Reduced steroid requirement Azathioprine 🌸Cyclophosphamide Biological therapies Important for reducing steroid side effects
Synthetic estrogen analogs
ethinyl-estradiol,
m-estranol
and estradiol valerate,
analogs have a prolonged action and a higher potency compared to those of natural estrogens.
Progesterone derivatives
Medroxy-progesterone,
Dyhdro-gesterone,
deso-gestrel,
etono-gestrel .
Testosterone derivatives
Nore-thiste-rone, Nore-thindr-one , nor-gest-rel, Nor-gest-imate Testosterone Enenthate, Pro-prionate Undecanoate, Mesterolone
Implant co
Eto-no-rgestrel
اتو نو جستيشن
It is an pro-gesterone
Last for 3 y
Progestogens: which generation?
1: nore-thyno-drel
2 nd : levo-norgestrel, nore-thister-one
3 rd : des-ogestrel, gesto-dene, nor-ges-timate
4 th : dros-pire-none (Yasmin),
norel-gestro-min (Evra: patch)
Raloxifene
Protects against osteoporosis No proliferative effects on endometrium No proliferative affect breast 🤮🤮🤮Increases hot flushes increased risk of DVT, pulmonary embolism, & retinal vein thrombosis
SERM☺️
Clomiphene
ovulation induction: inhibit oestrogen binding anterior pituitary, inhibit negative feedback, results in increased GnRH and FSH, LH .Side effects : hot flushes, ovarian enlargement & risk of multiple pregnancy
Tamoxifen
used for treatment of metastatic breast cancer, or as adjuvant therapy following mastectomy or radiation for breast cancer , and as prophylactic therapy to reduce the risk of breast cancer in high-risk patients.
Ospemifene
is indicated for the treatment of dyspareunia (painful sexual intercourse)
related to menopause.
Mife-pristone
Midwife 😁
progesterone antagonist inhibits progesterone action Sensitises the uterus to prostaglandins
Used for medical termination of pregnancy with 🤷🏻♀️miso-prostol, and induction of labour
Cypro-terone
Anti androgen
Weak progestogenic effect. Partial agonist to progesterone receptor, competes with dihydrotestosterone Used in combined contraceptive pill (Dianette)
Fina-steride
👾👾inhibit 5α-reductase resulting in decreased formation of dihydrotestosterone. used for the treatment of 👉🏿👉🏿benign prostatic hyperplasia .
Selective
Flu-tamide
👾👾act as competitive inhibitor of androgens at the target cell and are effective orally for the treatment of 👉🏿👉🏿prostate cancer .
