Pharmacology

Question 1

Growth hormone analog used in growth hormone deficiency

Answer 1

Somatropin

Question 2

Somatostatin analog used for acromegaly, carcinoid, glucagonoma and other growth hormone-producing pituitary tumors

Answer 2

Octreotide

Question 3

Gonadotropin-releasing hormone analog used for infertility (pulsatile administration) or suppression of gonadotropin production (continuous administration)

Answer 3

Leuprolide

Question 4

Competitive antagonists at gonadotropin releasing hormone receptors used to prevent LH surge during controlled ovarian hyperstimulation

Answer 4

Ganirelix

Question 5

Ergot dopamine agonist used to suppress prolactin release

Answer 5

Bromocriptine

Question 6

Synthetic human corticotropin used for diagnosis of adrenal insufficiency

Answer 6

Cosyntropin

Question 7

Agent used to stimulate uterine contraction and labor, milk letdowns, and control postpartum bleeding

Answer 7

Oxytocin

Question 8

Agent of choice for the treatment of hypothyroidism

Answer 8

Levothyroxine (T4)

Question 9

An isomer of T3 which may be used in myxedema coma

Answer 9

Liothyronine (T3)

Question 10

Thioamide agents used in hyperthyroidism

Answer 10

Methimazole and propylthiouracil (PTU)

Question 11

Thioamide less likely to cross placenta, inhibits peripheral conversion of T4 to T3 in high doses, and indicated for pregnant women in 1st trimester

Answer 11

Propylthiouracil (PTU)

Question 12

Propylthiouracil (PTU) mechanism of action

Answer 12

Inhibits thyroid peroxidase

Question 13

Can be effective for short term therapy of thyroid storm, but after several weeks of therapy causes an exacerbation of hyperthyroidism

Answer 13

Iodide salts (potassium iodide)

Question 14

Permanently cures thyrotoxicosis, patients will need thyroid replacement therapy thereafter. Contraindicated in pregnancy

Answer 14

Radioactive iodine

Question 15

Used for the symptomatic treatment of thyrotoxicosis by blocking cardiac adverse effects

Answer 15

Propranolol and Esmolol

Question 16

Used for Addison’s disease, congenital adrenal hyperplasia inflammation, immune suppression, and asthma

Answer 16

Glucocorticoids

Question 17

Two short-acting glucocorticoids

Answer 17

Hydrocortisone (cortisol), cortisone

Question 18

Four intermediate-acting glucocorticoids

Answer 18

Prednisone, Prednisolone, Methylprednisolone and Triamcinolone

Question 19

Two long-acting glucocorticoids

Answer 19

Betamethasone, dexamethasone

Question 20

Mineralocorticoids

Answer 20

Fludrocortisone and deoxycorticosterone

Question 21

Side effects of corticosteroids

Answer 21

Iatrogenic Cushing’s syndrome, hyperglycemia, impaired wound healing, osteoporosis, peptic ulcers, myopathy, adrenal suppression (> 2 week treatment)

Question 22

Inhibits conversion of cholesterol to pregnenolone therefore inhibiting corticosteroid synthesis

Answer 22

Aminoglutethimide

Question 23

Antifungal agent used to inhibit adrenal and gonadal steroid synthesis

Answer 23

Ketoconazole

Question 24

Selective inhibitor of 11-hydroxylation and interferes with cortisol and corticoterone synthesis; used for adrenal function tests and is the only adrenal-inhibiting medication that can be administered to pregnant women with Cushing’s syndrome

Answer 24

Metyrapone

Question 25

Glucoroticoid receptor antagonist that is used as an antiabortifacient due to its strong antiprogestin activity

Answer 25

Mifepristone (RU486)

Question 26

Three rapid-acting insulin used for postprandial glycemia

Answer 26

Aspart, lispro, glulisine

Question 27

Short-acting insulin used intravenously for ketoacidosis

Answer 27

Regular insulin

Question 28

Intermediate-acting insulin with variable pharmacokinetics; use is mostly replaced by long-acting insulin

Answer 28

Neutral protamine Hagedorn (NPH) insulin

Question 29

Two long-acting insulin preparations that provide basal glycemia control

Answer 29

Glargine, detemir

Question 30

Major side effect of insulin

Answer 30

Hypoglycemia

Question 31

First generation sulfonylurea that is safest for elderly diabetics due to its short half-life

Answer 31

Tolbutamide

Question 32

First generation sulfonylurea contraindicated in elderly diabetics because of very long half-life

Answer 32

Chlorpropamide

Question 33

Three second generation sulfonylureas

Answer 33

Glyburide, glipizide, glimepiride

Question 34

Mechanism of action of sulfonylureas

Answer 34

Close K+ channels, depolarize cell, open voltage-gated Ca2+ channels, release insulin

Question 35

Common side effect of first generation sulfonylureas

Answer 35

Disulfiram-like reactions with alcohol use

Question 36

Common side effect of second generation sulfonylureas

Answer 36

Hypoglycemia

Question 37

A meglitinide insulin secretagogue that has no sulfur in its structure and may be used in type 2 diabetics with sulfonylurea allergy

Answer 37

Repaglinide

Question 38

A D-phenylalanine derivative insulin secretagogue that is useful for type 2 diabetics with very reduced renal function

Answer 38

Nateglinide

Question 39

Mechanism of action of repaglinide and nateglinide

Answer 39

Close K+ channels, depolarize cell, open voltage-gated Ca2+ channels, release insulin

Question 40

First line drug for the treatment of type 2 diabetes

Answer 40

Metformin

Question 41

Mechanism of action of metformin

Answer 41

decrease gluconeogenesis, ­ increase peripheral glucose uptake; increase insulin sensitivity

Question 42

Most serious side effect of metformin

Answer 42

Lactic acidosis

Question 43

Two thiazolidinediones

Answer 43

Pioglitazone, rosiglitazone

Question 44

Mechanism of action of thiazolindinediones

Answer 44

Activate PPAR-gamma, ­ increase transcription of insulin-responsive genes, ­ increase GLUT4 glucose transporter, ­increase insulin sensitivity

Question 45

Side effect of thiazolindinediones

Answer 45

Weight gain, edema, heart failure, hepatotoxicity

Question 46

Two alpha-glucosidase inhibitors

Answer 46

Acarbose, miglitol

Question 47

Mechanism of action of alpha-glucosidase inhibitors

Answer 47

Act on intestine, delay digestion and absorption of glucose

Question 48

Side effect of alpha-glucosidase inhibitors

Answer 48

Flatulence , diarrhea, abdominal cramps

Question 49

Amylin analog that delays gastric emptying and suppresses glucagon release

Answer 49

Pramlintide

Question 50

Two glucagon-like polypeptide-1 (GLP-1) analogs that increase insulin secretion and suppress postprandial glucagon release

Answer 50

Exenatide, liraglutide

Question 51

Three dipeptidyl peptidase-4 (DPP-4) inhibitors that reduce breakdown of glucagon-like polypeptide-1, resulting in increased insulin secretion and suppress postprandial glucagon release

Answer 51

Sitagliptin, saxagliptin, linagliptin

Question 52

Bisphosphonates

Answer 52

Alendronate and -dronates

Question 53

Mechanism of action of bisphosphonates

Answer 53

Inhibits osteoclast activity and prevent bone resorption

Question 54

Uses of bisphosphonates

Answer 54

Osteoporosis, Paget's disease, hyperglycemia

Question 55

Major side effects of bisphosphonates

Answer 55

Corrosive esophagitis, osteonecrosis of the jaw

Question 56

First generation bisphosphonate when used long-term causes osteomalacia

Answer 56

Etidronate

Question 57

May be used intranasally to decreases bone resorption

Answer 57

Calcitonin (salmon prep)

Question 58

Vitamin given with calcium to ensure proper absorption

Answer 58

Vitamin D

Question 59

Tx for Gestational DM

Answer 59

dietary modifications, exercise, insulin replacement if lifestyles modification fails

Question 60

GLP-1 analog toxicities

Answer 60

N/V and pancreatitis

Question 61

DPP-4 inhibitors

Answer 61

mild urinary or respiratory infections

Question 62

Propylthiouracil Toxicity

Answer 62

Skin rash, agranulocytosis, aplastic anemia, hepatotoxicity

Question 63

aplasia cutis

Answer 63

Methimazole toxicity

Question 64

tx Central DI

Answer 64

ADH (DDAVP)

Question 65

Demeclocycline

Answer 65

ADH antagonist used for SIADH

Question 66

Toxicity of Demeclocycline

Answer 66

Nephrogenic DI, photosensitivity, abnormalities in bone teeth

Question 67

She sells sea shells

Answer 67

at the sea shore