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Elliot > Pharmacology Renal, GU, Endocrine > Flashcards

Pharmacology Renal, GU, Endocrine Flashcards

1
Q

Lutropin: 1) Use 2) MOA 3) Toxicities

A

1) LH deficienty women; used with follitropin alpha
2) LH Agonist
3) Ovarian hyperstimulation; multiple pregnancies

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2
Q

Amiloride: MOA?

A

Block ENaC channel in CCT

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3
Q

Inhibits steroid synthesis vis p450C17?

A

Ketoconazole

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3
Q

Urofollitropin: 1) Use 2) MOA 3) Toxicity

A

1) Hypogonadotropic infertility in men; controlled ovarian hypestimulation in women
2) Mimics FSH
3) Ovarian hyperstimulation syndrome; multiple pregnancies

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3
Q

Thryoid drug that may cause dry mouth; ulcerations of mucous membranes; metallic taste and induce fetal goiter

A

Iodide

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4
Q

Non pregnancy related side effect of Oxytocin?

A

Can activate vasopressin–>volume overload–>cardiac failure and seizures

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5
Q

Metformin- MOA? Toxicities?

A

1) Activate AMPK. Dec. gluconeogensis; inc. glycolysis; inc. peripheral glucose uptake 2) GI; LACTIC ACIDOSIS; dec. vit B12

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5
Q

Acarbose: Class? MOA? Toxicities?

A

1) alpha glucosidase inhibitor 2) Inhibits intestinal brush border alpha glucosidases (reduces intestinal glucose absorption) 3) GI Disturbances!

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5
Q

Carboprost: Indication? Mechanism? Side Effects?

A

1) Postpartum hemorrhage 2) Prostoglandin analog–>myometrial contraction–>hemostasis 3) DIARRHEA; pulm. edema; Transient BRONCHOconstriction

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5
Q

Aminophylline: Use? MOA?

A

1) Bronchodilator: CO and Inc. renal blood flow 2) Phosphodiesterace inhibitor–>inc. cAMP

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5
Q

PTU vs MMI

A

MMI is a teratogen; PTU is hepatotoxic

Agranulocytosis is a very rare finding in these drugs

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5
Q

Treatment for hyperaldosteronism when surgery isn’t warranted?

A

Sprinolactone

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6
Q

Anastrazole: Indication? Mechanism? Side Effects?

A

1) Postmenopausal ER+ breast cancer 2) Reversible Aromatase comp inhibitor 3) Dyspnea; peripheral edema; bone weakness (fractures)

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6
Q

Furosemide: Use? MOA? Toxicity?

A

1) Diuretic (K wasting) 2) Blocks NKCC2 3) Metabolic alkalosis; OTOTOXIC; gout; hyperURICEMIA; hypomagnesemia

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6
Q

Which patients are resistant to loop diuretics?

A

Cirrhotic patients

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6
Q

Cabergoline: MOA? Toxicity?

A

1) D2 agonist to block prolactin secretion
2) Cardiac vavulopathy

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7
Q

Amylin analog: MOA? Toxicities?

A

1) Inhibit glucagon and slows gastric emptying 2) Hypoglycemia, nausea, diarrhea

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7
Q

Sprintec: Indication? Mechanism? Side Effects?

A

1) Contraception; dec. bloos loss; dec. risk of ovarian cysts 2) Estrogen and progesteron analog 3) VTE; gallbladder; CARDIOvascular; n/v/d

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8
Q

Pasireotide: Use? MOA? Toxicities?

A

1) Suppressed pituitary secretion of ACTH (Cushings) 2) Somatostatin Receptor agonist 3) N/V/D; hearing issues

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9
Q

1) Major use for anionic inhibitors and 2) MOA 3) Names of anionic inhibitors

A

1) Amiodarone induced hyperthryoid
2) Block iodide uptake; compete with NIS
3) Percholate; thyocyonate

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10
Q

Acetazolamide: Use? MOA? Toxicity? Pitfalls of this drug? Contraindications?

A

1) Diuretic; glaucoma (dec aqueous humor); acute mountain sickness (stabilizing deoxyhemoglobin); 2) Carbonic anhydrase inhibitor 3) Hyperchloremic Metabolic acidosis (obviously); numbness and tingling; Kidney stones; SULFA drugs 4) NaCl is absorbed at other areas 5) Hepatic cirrhosis

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11
Q

Pegvisomant: 1) Use 2) MOA 3) Toxicity

A

1) Acromegaly
2) Blocks GH receptors
3) Well tolerated

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11
Q

Choriogonadotropin alpha: 1) Use 2) MOA 3) Toxicities

A

1) Controlled ovarian hyperstimulation in females; hypogonadotropic intertility in males
2) LH receptor agonist
3) Ovarian hyperstimulation and multiple pregnancies

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12
Q

Non diabetes use for insulin?

A

Life-threatening hyperkalemia

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13
Q

Exenatide and Liraglutide

A

GLP-1 Agonist

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15
Q

Toxicities of K sparing diuretics (Triameterene; sprinolactone; amiloride)

A

1) Metabolic Acidosis 2) Hyperkalemia 3) Gynecomastia

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17
Q

Pramlintide: Class? MOA? Toxicities?

A

1) Amylin analog (prAMYLINtide) 2) Inhibits glucagon and slows gastric emptying

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17
Q

Methergine: Indication? Mechanism? Side Effects?

A

1) Management of uterine bleeding 2) Ergot Alkoid; partial agonist/antagonist on serotonergic, dopaminergic and alpha-adrenergic receptors 3) DON’T GIVE TO HTN PT.; PULM htn; systemic htn; respiratory depression; HALLUCINATIONS

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18
Q

Mecasermin: 1) MOA 2) Use? 3) Toxicities?

A

1) Recombinant form of IGF-1
2) in lieu of GH
3) hypoglycemia

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19
Q

This drug does not block conversion of t4 to t3 periphreally

A

Methamizole (MMI)

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20
Q

Glimepiride: Class? MOA? Toxicities?

A

1) Sulfonylureas- second generation 2) Close K+ channel–>depolarization of beta cells–>influx of Ca2+–>release of insulin 3) Hypoglycemia and weight gain

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21
Q

Ketoconazole/Metyrapon: 1) Use 2) MOA 3) Toxicities

A

1) Cushings
2) cyp17, 11, 3bhsd (metyrapone selectively inhibits 11)
3) Keto= hepatotoxicity

Metryrapone= salt and water retention; hirsutism

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22
Q

Mineralocorticoid replacement in primary adrenal insufficiency? and side effects?

A

Fludrocortisone

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23
Q

Sprinolactone: MOA? Uses? Toxicities?

A

1) Aldosterone antagonist; weak androgen antagonist 2) Aldosteronism of any cuase 3) Gynecomastia; hyperkalemia

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24
Q

Raloxifene: Indication (2)? Mechanism? Side Effects?

A

1) Osteoporosis and invasive breast cancer 2) ER agonist for bone; Antagonist for breast 3) Hot flashes; VTE; teratogenic (you have breast cancer? RALOX, (relax) it’ll be fine)

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25
Q

Glyburide: Class? MOA? Toxicities?

A

1) Sulfonylureas- second generation 2) Close K+ channel–>depolarization–>Ca2+ influx–>release of insulin 3) Hypoglycemia and weight gain

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25
Q

Extrapyrmaidal side effects; used to treat pheo 1) drug 2) MOA

A

1) Metyrosine
2) blocks tyrosine kinase

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27
Q

Miglitol: Class? MOA? Toxicities?

A

1) Alpha glucosidase inhibitor 2) Inhibits intestinal brush border alpha glucosidase (reduces intestinal glucose absorption) 3) GI disturbances

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28
Q

Octreotide 1) Use? 2) MOA 3) Toxicity

A

1) Acromegaly
2) Somatostatin AGOnist
3) Gallstones; conduction disturbances

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29
Q

Incretins: 1) what the hell are they? 2) name 2

A

DPP inhibitors (DPP breaks down GLP-1)

Saxagliptin and Sitagliptin

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30
Q

Lispro

A

Rapid acting Insulin analog

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30
Q

Digitalis: Use? MOA

A

1) Important in Na recovery; used to increase cardiac output and renal plasma flow 2) Inhibits renal Na/K ATPase

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31
Q

Mifepristone: Indication? Mechanism? Side Effects?

A

1) Abortion 2) Progesterone antagonist–>endometrial degeneration, cervical softening and dilatation–>trophoblast detachment 3) Vaginal bleeding and infection; leg and back pain; vaginal discharge burning itching etc.. uterine cramping

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32
Q

Pitocin: Indication? Mechanism? Side Effects?

A

1) Labor induction 2) Binds oxytocin rec. in myometrium–>inc. ca2+–>contractions 3) Uterine hypertonicity; placental abruptia; tetany; arryhthmia

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34
Q

Thyroid replacement; T4? Half life?

A

Levothryoxine– once a day; best option

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35
Q

Mifepristone: Use (other than abortion)? MOA? Toxicity?

A

1) Cushings 2) Inhibits Glucocorticoid receptors (in addition to progesterone receptors) 3) Menstrual abnormalities

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36
Q

Terbutaline: Indication? Mechanism? Side Effects?

A

1) Preterm labor 2) B2 agonist–>relaxation of smooth muscle 3) Anxiety sx; inc. HR; PULM EDEMA!!; POTENTIAL FOR SERIOUS CARDIOTOXICITY

37
Q

Metronidazole: Indication? Mechanism? Side Effects?

A

1) Trich; bact. infect of vag; C diff 2) Antiprotozoal; bactericidal; forms free radical toxic metabolites in bacterial cell 3) Alcohol intolerance (similar to disulfiram); use with caution in PTS WITH CNS disease; metallic taste; neutropenia

37
Q

2 alpha glucosidase inhibitors?

A

1) Miglitol 2) Acarbose

38
Q

Sulfonylureas: MOA? Toxicities? Drugs that cause decreased effectiveness?

A

1) Close K+ channel in Beta cell membrane leading to cell depolarization triggering insulin release via Ca2+ influx 2) Hypoglycemia; weight gain 3) Rifampin and barbiturates

39
Q

Antihypertensive that may ameliorate exopthalmos?

A

Guanethidine

40
Q

Cabergoline: MOA? Use? Toxicities?

A

1) Dopamine receptor agonist 2) Pituitary adenoma (prolactinoma) 3) Cardiac; restless leg syndrome when treating Parkinsons

41
Q

Glipizide: Class? MOA? Toxicities?

A

1) Sulfonylureas- second generation 2) Close K+ channel–> beta cell depolarization–>Ca2+ influx–> insulin release 3) Hypoglycemia and weight gain

42
Q

Pioglitazone: Class? MOA? Toxicities?

A

1) Glitazones 2) Binds PPAR-gamma. Inc. insulin sensitivity peripherally 3) Hepatotoxicity and CHF!! weight gain and edema

42
Q

Amiloride: MOA? uses? Toxities?

A

1) Blocks ENaC in CCT 2) Reduces Li reduced polyuria; hypokalemia from other diuretics 3) Hyperkalemic metabolic acidosis

43
Q

Glulisine

A

Rapid acting insulin analog

45
Q

1) MOA of Insulin 2) Effects on Liver 3) Effects on muscle 4) Effects on Fat

A

1) Binds insulin receptor (tyrosine kinase activity 2) Inc glucose stored as glyogen 3) Inc glycogen and protein synthesis, K+ uptake 4) Aids TG storage

47
Q

Alpha Glucosidase Inhibitor: MOA? Toxicities?

A

1) Inhibits intestinal brush border alpha glucosidases (i.e. reduces intestinal glucose absorption) 2) GI disturbances (obviously!)

49
Q

Cirrhotic edema responds to which diuretic?

A

Sprinolactone

50
Q

Eplerenone: MOA? Uses?

A

1) Aldosterone receptor antagonist 2) Conn syndrome; CHF; K+ depletion

51
Q

Misoprostol: Indication? Mechanism? Side Effects?

A

1) Labor induction 2) Synthetic prostoglandin 3) Miscarriage; MI; hyperstimulation; thromboembolism; anaphylaxis; teratogenic

52
Q

Loop diuretics: MOA? Uses?

A

1) Block NKCC2–> Ca and Mg excretion; potassium wasting; also blocks TGF feedback mechanism which would inhibit its effectiveness 2) Acute Pulmonary edema; acute hypercalcemia;mild hyperkalemia; NOT USED FOR HTN BEC OF SHORT HALF LIFE

53
Q

Ketoconazole: use? MOA? Toxicity?

A

1) Inhibits 17 hydroxylase: used in Cushings 2) Hepatoxic

54
Q

What should you check before giving Pioglitizone? What class is pioglitizone? MOA and major site of action?

A

1) Liver function tests bec. it is hepatotoxic 2) Glitizone 3) PPAR gamma; major site of action is adipose tissue

55
Q

Ethacrynic acid: what is special about this drug?

A

Loop diuretic that is non SULFA containing

57
Q

Mannitol: Use? MOA? Delivery? Toxicity?

A

1) Osmotic Diuretic; reduct. of intraocular and cranial pressure; removal of renal toxins 2) Pull out H2O from intracellular space 3) Parenterally 4) If given enterally–>osmotic diarrhea; dehydration and hypernatremia (can cause inc. ECF fluid before takes complete effect)

58
Q

DM2 pt is started on drug that blocks K+ channel. Patient starts to gain some weight, as well. Drug class?

A

Sulfonylureas Other toxicity is hypoglycemia

59
Q

Caffeine as a diuretic? MOA?

A

Caffeine blocks adenosine which is involved in Na reabsorption

61
Q

SGLT2 inhibitor

A

Dapgliflozin

63
Q

Activates DA D2 receptors?

A

Cabergoline

64
Q

Doxycycline: Indication? Mechanism? Side Effects?

A

1) UTI; 2) Tetracyclin; inhibits 30s ribosome; broad spectrum; bacteriostatic t 3) CI in children bc of teeth discoloration; don’t go out in Sun! Kidney and liver toxicity

65
Q

Inhibits steroid synthesis via p450C11?

A

Metyrapone

66
Q

Rapid Acting Insulin analogs (3)

A

1) Lispro 2) Aspart 3) Glulisine The rapid acting insulin drugs don’t LAG

67
Q

Two drugs used to treat Cushings– inhibitors of steroid biosynthesis?

A

Ketoconazole and Metyrapone

69
Q

Leuprolide/Goserelin: 1) Use 2) MOA 3) Toxicities

A

1) Prostate cancer; endometriosis; ovarian suppression; central precocious puberty
2) GnRH analog
3) Constant use in women can lead to signs of menopause; in men= gynecomastia; hot flashes; dec bone density

70
Q

Somatostatin Receptor agonist that may cause conductance issues?

A

Pasireotide

72
Q

DM 2 patient with a history of renal disease was started on a commonly prescribed diabetes drug. The patient begins to develop lactic acidosis. Likely drug? Class of drug?

A

1) Metformin 2) Biguanide

74
Q

Dopamine: Renal use?

A

Increases blood supply to kidney

75
Q

Thiazides: MOA? Uses? Toxicities?

A

1) NCC blocker; dec calcium excretion 2) HTN; nephrolithiasis dt hypercalceuria; 3) Can lead to elevated uric acid levels; met. alkalosis; hyperlipidemia; hypernatramia;

76
Q

Long acting insulin drugs (2)

A

1) Glargine 2) Detemir

78
Q

Magnesium Sulfate: Indication? Mechanism? Side Effects?

A

1) Preeclampsia off label; preterm labor; may have neuroprotective effect against cerebral palsy 2) Blocks calcium 3) Muscle weakness and CNS and cardiac depression; LOSS OF PATELLAR REFLEXES FOLLOWED BY DEC. URINE OUTPUT

79
Q

Chlorpropamide: Class? MOA? Toxicities?

A

1) Sulfonylureas- first generation 2) Close K+ channel leading to depolarization of beta cell membrane, which triggers insulin release via Ca2+ influx 3) Hypoglycemia and weight gain

80
Q

Ganirelix (anything ending in relix): 1) Use 2) MOA 3) Toxicities

A

1) Prevention of premature LH surge; also advanced symptomatic prostate cancer
2) GnRH anatagonist
3) Sx of androgen deprivation (hot flashes, edema)

81
Q

Two nonselective ADH antagonists?

A

1) Lithium 2) Demecocycline

82
Q

Detemir

A

Long acting insulin analog

82
Q

Leuprolide: Indication? Mechanism? Side Effects?

A

1) Prostate, breast cancer; fibroids; precocious puberty 2) GnRH agonist (pulsatile for infertility and continuous for precocious puberty) 3) Gynecomastia in men; dizziness; nausea vomiting (bronchospasms are rare)

83
Q

Clomiphine Citrate: Indication2? Mechanism? Side Effects?

A

1) Infertility and PCOS 2) SERM– inhibits negative feedback–>LH/FSH surge 3) Ovarian enlargement; multiple pregnancies (Clomifene for pCos)

84
Q

Side effects of Levothyroxine (2 big ones)

A

Osteoporosis and cardiac side effects

85
Q

NPH

A

Intermediate acting insulin analog

87
Q

T3; half life? use?

A

Liothyronine; short half life–requires multiple dosing

short term suppression of TSH

88
Q

Tercanozole: Indication? Mechanism? Side Effects?

A

1) Candida Albicans in the vag 2) Inhibition of fungal p450; reduces ergosterol 3) Burning and irritation in the vag

89
Q

Paseriotide: 1) Use 2) MOA 3) Toxicities

A

1) Cushings
2) Somatostatin analog
3) conduction disturbances

90
Q

Glargine

A

Long acting insulin analog

91
Q

Valacyclovir: Indication? Mechanism? Side Effects?

A

1) HSV 1,2, and Zoster 2) Prodrug converted to acyclovir (guanosine analog); requires pyruvate- ferredoxin oxidoreductase 3) HALLUCINATIONS AND SEIZURES dizziness; arthralgia; crystal uria; steven-johnson syndrome

92
Q

Aldosterone receptor antagonist– two drugs?

A

1) Eplerenone 2) Spironolactone

94
Q

Ketoconazole: MOA? Use?

A

1) Inhibits steroid synthesis 2) Cushings

95
Q

Aspart

A

Rapid acting insulin analog

96
Q

2 drugs used for uterine bleeding? and MOAs?

A

1) Methergine= Ergot alkaloid 2) Carboprost= Prostoglandin agonist

97
Q

Bromocriptine: MOA? Toxicities?

A

1) D2 agonist; blocks prolactin secretion
2) psych issues; hypotension; light headedness

98
Q

Somatotropin: 1) MOA 2) Side effects a)child b)adult

A

1) Acts through the GH receptor to increase IGF-1 production
2a) pseudotumor cerebri; edema
b) peripheral edema and myalgias

99
Q

Glitazones/thiazolidinedions: MOA? Toxicities?

A

1) Binds to PPAR gamma. Inc. Insulin sensitivity in peripheral tissue (adipose tissue is major site of action) 2) Hepatotoxicity!; Blackbox warning for Heart failure; weight gain and edema

100
Q

MOA of Biguanides

A

Activated AMPK. They decrease gluconeogenesis, increase glycolysis and increase peripheral glucose uptake. Increase insulin sensitivity but do NOT increase insulin release

101
Q

Rosiglitazone: Class? MOA? Toxicities?

A

1) Glitazones 2) Binds PPAR-gamma. Inc. insulin sensitivity peripherally 3) Hepatotoxicity and CHF!; weight gain and edema

102
Q

Fludrocortisone: Use? MOA? Toxicities?

A

1) CAH and Addison’s disease 2) Binds mineralocorticoid receptors–>inc aldosterone 3) Hypernatremia; hypokalemia; metabolic alkalosis

103
Q

Cardiac drug that may inhibit thyroid production? Explain

A

Amiodorone–has significant amount of iodide–> decreased production of thyroid hormone

104
Q

Triamterene: MOA?

A

Block ENaC channel in CCT

105
Q

Tolbutamide: Class? MOA? Toxicities?

A

1) Sulfonylureas- first generation 2) Close K+ channel leading to depoloraization of beta cell membrane, which triggers insulin release via Ca2+ influx 3) Hypoglycemia and weight gain

107
Q

Levonorgestrol: Indication? Mechanism? Side Effects?

A

1) Plan B; 2)prevents ovulation by inhibiting hypothalamus 3) Breast tenderness; depression; n/v/d

109
Q

Soy; iron and calcium may interefere with absorption of this drug

A

Vague question! But, the answer is Levothyroxin

110
Q

Norethindrone: Indication? Mechanism? Side Effects?

A

1) Contraceptive and endometriosis 2) Progestin only; thickens cervical mucous to prevent sperm penetration 3) Screwed up cycle + loss of VISION and CARDIOVASCULAR effects; ECTOPIC PREGNANCY

111
Q

Indomethecin: Indication? Mechanism? Side Effects?

A

1) Preterm labor 2) Block prostoglandins which usually contribute to contractions; 3) OLIGOHYDRAMNIOS; ductur arteriosus; significant RENAL AND HEPATIC impairment

112
Q

Vasopressin: 1) Use 2) MOA 3) Toxicities

A

1) Diabetes Insipidus
2) Activates V2 receptors
3) hyponatremia and seizures

Vasopressin (not desmopressin) can cause vasoconstriction and should not be used in patient with Coronary Artery disease

113
Q

Nifedipine: Indication? Mechanism? Side Effects?

A

1) Preterm Labor 2) Calcium Channel Blocker 3) Constipation; swelling of face lips; CV Issues; do not give with MAG SULFATE

114
Q

Intermediate acting Insulin analog (1)

A

NPH

115
Q

Metyrosine: MOA? Uses? Toxicities?

A

1) Blocks tyrosine hydroxylase (tyrosine to Dopa step in norepi production) 2) Treat pheochromocytomas 3) Extrapyramidal sx;

Elliot (11 decks)

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