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Unit 5 ER > Pharmacology > Flashcards

Pharmacology Flashcards

1
Q

Synthetic aldosterone is called _________

A

Fludrocortisone

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2
Q

Blocks conversion of cholesterol to pregnenolone

A

Aminoglutethimide

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3
Q

Potent, nonselective inhibitor of adrenal and gonadal steroid synthesis and anti-fungal

A

ketoconazole

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4
Q

Nonselective cytotoxic action on adrenal cortex and DDT analog

A

Mitotane

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5
Q

Relatively selective inhibitor of 11-hydroxylation, interferes with cortisol and corticosterone synthesis

A

Metyrapone
Tx for cushing’s
Dx for adrenal insufficiency

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6
Q

Progesterone receptor antagonist; GR antagonist at high concentrations

A

Mifepristone (RU-486)

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7
Q

Binds to somatostatin receptorand blocks release of ACTH from corticotropes
treatment for cushings and acromegaly

A

Pasireotide

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8
Q

Which type of thyroid converting enzyme is expressed in the kidney and liver? (D1/ D2/ D3)

A

D1

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9
Q

Which type of thyroid converting enzyme does the majority of conversion? (D1/ D2/ D3)

A

D2

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10
Q

Which type of thyroid converting enzyme is expressed in the brain and skin? (D1/ D2/ D3)

A

D3

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11
Q

How does Iodine get into the follicular cells of the thyroid gland?

A

The Sodium-Iodide symporter

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12
Q

What are 2 ways that the Sodium-Iodide symporter can be affected and cause disease

A
  1. gene mutations -> congenital hypothyroidism

2. Autoimmune Dz -> Hashimoto’s thyroiditis

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13
Q

What is the synthetic T4 replacement?

A

Levothyroxone

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14
Q

What is the synthetic T3 replacement?

A

Liothyronine

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15
Q

What is the 4:1 mix of T4:T3?

A

Liotrix

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16
Q

Readjustments to thyroid medication should be made ____ weeks after beginning therapy

A

4-6 weeks

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17
Q

Which thyroid medication can be give IV in an emergency?

A

Liothyronine

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18
Q

What are the 3 drugs that inhibit thyroid hormone synthesis?

A
  1. Propylthiouracil, PTU
  2. Methimazole
  3. Carbimazole
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19
Q

What step in thyroid hormone synthesis do Propylthiouracil, Methimazole and Carbimazole work?

A

organification of iodine

and coupling of iodotyrosine

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20
Q

Which is the pro-drug? What is it’s active form? (Propylthiouracil/ Methimazole/ Carbimazole)

A

Carbimazole —-> Metimazole

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21
Q

What are the 3 major side effects of Propylthiouracil, Methimazole and Carbimazole?

A
  1. agranulocytosis
  2. Hepatitis
  3. Lupus-like reaction
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22
Q

Which is best used in pregnancy? (Propylthiouracil/ Methimazole/ Carbimazole)

A

Propylthiouracil,
crosses placenta less,
lower conc in breast milk,
but high risk of agranulocytosis

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23
Q

How does 1,25(OH)2D increase serum calcium?

A

By increasing efficiency of intestinal absorption

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24
Q

Lithium therapy leads to (increased/ decreased) calcium levels

A

increased

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25
Q

Thiazide diuretics cause (increased/ decreased) serum calcium levels

A

increased

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26
Q

Loop diuretics (increased/ decreased) serum calcium levels

A

decrease

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27
Q

What are the 5 bisphosphonates that reduce osteoclastc bone resorption?

A
  1. Alendronate
  2. Risedronate
  3. Ibandronate
  4. Pamidronate
  5. Zoledronic acid
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28
Q

Which bisphosphonates cause fever and flu like reactions?

  1. Alendronate
  2. Risedronate
  3. Ibandronate
  4. Pamidronate
  5. Zoledronic acid
A

Pamidronate and Zoledronic acid

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29
Q

Which bisphosphonates cause esophageal irritation?

  1. Alendronate
  2. Risedronate
  3. Ibandronate
  4. Pamidronate
  5. Zoledronic acid
A

Alendronate
Risedronate
Ibandronate

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30
Q

Why can’t calcitonin be used long term for lowering serum calcium?

A

Osteoclasts will down-regulate their receptors

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31
Q

How do hydrocortisone and prednisone lower serum calcium?

A

decrease production of 1,25 vitamin D

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32
Q

Synthetic PTH, used for osteoporosis

A

Teriparatide

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33
Q

Why does high potassium increase aldosterone?

A

it indicates that H2O volume is low

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34
Q

What are the 2 most powerful regulators of aldosterone release?

A
  1. Potassium
  2. Angiotensin II
    Other factors:
    ACTH, Sodium deficiency
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35
Q

synthetic mineralocorticoid: Binds aldosterone receptor (AR) which increases Na+K+ATPase expression and increase epithelial sodium channel expression

A

Fludrocortisone

for chronic adrenal insufficiency

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36
Q

in primary adrenal insufficiency there is hyperpigmentation due to increased _____, a bi-product of ACTH production from POMC

A

MSH, melanocyte-stimulating hormone

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37
Q

Chronic primary adrenal insufficiency is called ______ ______

A

Addison’s disease

38
Q

Acute primary adrenal insufficiency is most often caused by ______ ______ ______

A

Waterhouse–Friderichsen syndrome

39
Q

The MC cause of Congenital adrenal hyperplasia is deficiency in the enzyme __________

A

21-hydroxylase

40
Q

In congenital adrenal hyperplasia there is an excess production of _______ (steroids) and a lack of ______

A

excess of sex steroids, lack of cortisol

41
Q

hypercortisolism is also called ________ syndrome

A

cushings syndrome

42
Q

Dx: Acute adrenal insufficiency
Rx: _________?

A
  1. dexamethasone, won’t interfere with blood measurments

2. cortisol, works but will interfere

43
Q

Dx: Congential adrenal hyperplasia w/ 21-hydroxylase def.
Rx: _________?

A
  1. replace glucocorticoids (cortisol)

2. replace Mineralocorticoids (fludrocortisone)

44
Q

What drugs are used to treat cushing’s syndrome?

A
  1. Ketoconazole - antifungal, blocks hormone synth
  2. Mitotane- cytotoxic to adrenal
  3. Metyrapone- blocks cortisol synth
  4. Aminoglutethimide- blocks conversion of choles to preg
  5. Mifpristone- creates cortisol resistance
  6. Pasireotide- blocks release of ATCH
45
Q

Dx: Aldosteronism
Rx: ________?

A
  1. Spironolactone

2. Eplerenone

46
Q

This drug is a PTH analog

A

Teriparatide

47
Q

Insulin is necessary for (T1/T2) diabetes, as needed for (T1/T2) diabetes

A

necessary for T1

as needed for T2

48
Q

In the endocrine pancreas, alpha cells secrete _________, beta cells secrete _______

A

Alpha cells: glucagon

Beta cells: insulin

49
Q

The metabolic hormones that increase in the amount of insulin released from pancreatic beta cells are called ______

A

Incretin hormones

50
Q

The most important incretin in humans is ________

A

GLP-1, glucagon like peptide 1

51
Q

GLP-1, glucagon like peptide 1 is made by the _______

A

L cells of the ileum and colon, response to meal

52
Q

GLP-1 is degraded by ______

A

DPP-4, dipeptidyl peptidase-4

53
Q

At the time of T2DM diagnosis, first line therapy is _______

54
Q

What is the mech of action of metformin?

A

Activates AMP kinase, inhibits mitochondrial isoform of glycerophosphate dehydrogenase
Reduces gluconeogenesis from the liver

55
Q

when you put you patient on metformin, you must monitor their _____ level

56
Q

What are the 4 sulfonylureas for Diabetes?

A
  1. Glyburide
  2. Glipizide
  3. Glaclazide
  4. Glimepiride
57
Q

Which drug decreases hepatic glucose production?

A

Metformin, a Biguianide

58
Q

Which drug closes Katp channels on beta cell plasma membranes?

A
  1. Sulfonylureas

2. Meglitinides

59
Q

Which drugs increase insulin secretion?

A
  1. Sulfonylureas

2. Meglitinides

60
Q

What are the 2 Meglitinides?

A
  1. Repaglinide

2. Nateglinide

61
Q

Which drugs that increase insulin secretion work faster? (Sulfonylureas/ Meglitinides)

A

Meglitinides

62
Q

Which drug activates PPAR-gamma?

A
  1. Pioglitazone
  2. Rosiglitazone
    the thiazolidinedione
63
Q

Which drugs increase peripheral insulin sensitivity?

A

Thiazolidinediones: e.g. Pioglitazone

64
Q

What are the intestinal α-glucosidase inhibitors?

A
  1. Acarbose

2. Miglitol

65
Q

Which drugs slows intestinal carbohydrate metabolism? (Sulfonylureas/ Meglitinides/thiazolidinedione/ GLP-1 receptor agonists/ α-glucosidase inhibitors)

A

α-glucosidase inhibitors

66
Q

What are the (4) GLP-1 receptor agonists/activators?

A
  1. Exenatide, variable
  2. Liraglutide, daily
  3. Albiglutide, weekly
  4. Dulaglutide, weekly
67
Q

Which diabetes drugs cause weight gain? weight loss?

A

Gain:
Sulfonylureas
Meglitinides
thiazolidinedione

Neutral:
Biguanides
α-glucosidase inhibitors
DPP-4 inhibitors

Loss:
GLP-1 receptor agonists
SGLT-2 inhibitors

68
Q

What are the DPP-4 inhibitors (incretin enhancers)?

A
  1. Sitagliptin
  2. Alogliptin
  3. Saxagliptin
  4. Linagliptin
69
Q

What are the SGLT-2 inhibitors?

A
  1. Canaliflozin
  2. Dapagliflozin
  3. Empagliflozin
70
Q

Which class of drugs lower serum glucose by reducing glucose reabsorption in proximal tubule?

A

SGLT-2 inhibitors

71
Q

Which to Diabetes drugs most frequently result in hypoglycemia?

A
  1. insulin

2. sulfonylureas

72
Q

Patients at risk for hypoglycemia should carry both glucose tablets and _______ _______

A

glucagon injection

73
Q

What is the peptide released with insulin from beta cells that SLOWS GASTRIC EMPTYING and suppresses glucagon?

74
Q

What is the injectable drug analog of amylin?

A

Pramlintide

75
Q

Glucagon causes the liver to convert stored ______ into glucose

76
Q

What are the (3) Rapid Insulin therapies?

A
  1. Lispro 2. Aspart 3. Glulisine
77
Q

What are the (3) Intermediate Insulin therapies?

A

The neutral protamine w/ zinc:

  1. NPH
  2. NPL
  3. NPA
78
Q

What are the long acting insulin therapies?

A
  1. Dentemir DoA: 6-24hrs

2. Glargine DoA: 24-30hrs

79
Q

What is the best insulin for maintaining a basal level of insulin throughout the day?

80
Q

What is the ultra long acting insulin?

A

Degludec, DoA 42 hrs

81
Q

What cells have GLUT-1 receptors that do not require insulin for uptake of glucose?

A
  1. RBC’s
  2. Brain
  3. Cornea
  4. Placenta
82
Q

repeatedly injecting insulin in the same place can lead to __________

A

lipohypertrophy

83
Q

What are the 3 defining characteristics of hyperosmolar hyperglycemic state, HHS

A
  1. hyperglycemia
  2. hyperosmolality
  3. dehydration
84
Q

The 4 major counter regulatory hormones that increase serum glucose are:

A
  1. glucagon
  2. cortisol
  3. growth hormone
  4. Epinephrine
85
Q

What are the 3 defining characteristics of DKA?

A
  1. Hyperglycemia
  2. Metabolic Acidosis
  3. Ketone Production
86
Q

Insulin (promotes/prevents) fatty acid oxidation

87
Q

winter’s formula is that PaCO2 =

A

1.5 * HCO3 +8

88
Q

An octapeptide that mimics natural somatostatin is called ________

A

octreotide

89
Q

In an adrenal crisis there is hyperkalemia and hyponatremia due to increased ______

90
Q

What are the 3 phosphate binders for secondary hyperparathyroidism from renal failure?

A
  1. Selavemer 2. Calcium carbonate 3. Calcium acetate
91
Q

What is the calcimimetic, reduced PTH and serum calcium level?

A

Cinacalcet

92
Q

This is a mAb that targets RANKL to inhibit osteoclast maturation

Unit 5 ER (3 decks)

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