Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Pharm Unit 4 - Endo > Pharmacology Unit 4 - Endocrine Pt. 1 > Flashcards

Pharmacology Unit 4 - Endocrine Pt. 1 Flashcards

1
Q

What hormones are released from the anterior pituitary gland?

A
  1. GH
  2. ACTH
  3. FSH
  4. TSH
  5. LH
  6. Prolactin
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

the __________________ receives signal/stimulation from hypothalamus to synthesize a hormone and release it

A

anterior pituitary (adenohyphysis)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

what hormones are released from the posterior pituitary

A

Oxytocin & ADH (vasopressin)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

T/F: hormones that are released from the posterior pituitary are also synthesized there

A

false; they are synthesized in the hypothalamus and then stored and released from the posterior pituitary

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

what inhibits growth hormone release from the anterior pituitary?

A

somatostatin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

________________ is a medication that is analogous to growth hormone and is considered an agonist

A

somatotropin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Growth hormone stimulates ________________

A

Insulin Like Growth Factor

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

_______________ inhibits the release of prolactin

A

dopamine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

pharmacology is applied to the pituitary hormones and glands in what 3 ways?

A
  1. replacement therapy for deficiency
  2. antagonists for excessive disease states
  3. Diagnostic tools
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

what medication is used in the treatment of IGF deficiency not responsive to Growth Hormone?

A

Mecasermin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

anabolic effects of growth hormone occur in ___________________

A

muscle

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

catabolic effects of growth hormone occurs in ___________________

A

lipid cells

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

_____________________ is d/t a growth hormone deficiency in females

A

turners syndrome

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

__________________ is a genetic disease associated with growth failure, obesity, and carbohydrate intolerance

A

Prader willi syndrome

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Growth Hormone increases _________________, thus higher doses of certain medications metabolized in this capacity may be required

A

CYP450

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What is acromegaly

A

abnormal growth of cartilage and bone tissue after epiphyseal plate closure (30-50 years old)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

what is gigantism

A

GH secretion (likely d/t adenoma) occuring in childhood before epiphyseal plate closure

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

how does octreotide affect insulin secretion?

A

reduces insulin secretion d/t somatostatin inhibiting GH

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

How do FSH, LH, and hCG signal transduce?

A

G-coupled protein receptors

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

what are the 3 classes of hormones?

A
  1. peptides
  2. amines
  3. steroids
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

which class of hormones are water soluble

A

peptides

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

which class of hormones are fat soluble

A

amines & steroids

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

name the hormones which are “amines”

A
  1. serotonin
  2. thyroid hormones
  3. catecholamines
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

name the hormones which are “steroids”

A
  1. glucocorticoids
  2. mineralcorticoids
  3. androgens
  4. estrogens and progestins
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

what amino acid are most “amine” hormones derived from?

A

tyrosine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

most “amine” hormones are derived from the same amino acid; however, serotonin is an amine that is derived from __________________

A

tryptophan

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

which hormone class is synthesized and released on demand and is not stored in vesicles?

A

steroids

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

what are the 3 hormone signaling pathways?

A
  1. endocrine function
  2. paracrine function
  3. autocrine function
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

__________________ is a hormone signaling mechanism in which transmission of hormone signal goes through the blood stream to a distant target cell

A

Endocrine signaling (function)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

________________ is a hormone signaling mechanism in which the hormone signal acts on neighboring cells of a different type

A

paracrine signaling (function)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

__________________ is a hormone signaling mechanism in which the hormone secreted acts on the producer cell itself or on neighboring identical cells

A

autocrine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

what is the target tissue of growth hormone

A

liver and most other tissues

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

what is the target tissue of ACTH

A

adrenal cortex

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

what is the target tissue of TSH

A

thyroid gland

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

what is the target tissue of FSH

A

ovaries

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
36
Q

what is the target tissue of LH

A

ovaries and testes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
37
Q

what is the target tissue of prolactin

A

mammary glands

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
38
Q

growth hormone stimulates the release of what in the liver

A

insulin like growth factors

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
39
Q

ACTH will stimulate the adrenal cortex to release what

A

glucocorticoids, mineralcorticoids, and androgens

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
40
Q

TSH will stimulate the thyroid to release what?

A

thyroxine (T3/T4)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
41
Q

the hypothalamus stimulates two hormones which regulate GH, ___________ which stimulates the production of GH, and _____________ which inhibits the production of GH

A

GHRH; somatostatin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
42
Q

growth promoting effects of GH are mediated principally through an increased production of ____________

A

IGF-1

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
43
Q

GH stimulates what?

A
  1. IGF-1 production in bone, cartilage, muscle, kidney, and other tissues
  2. longitudinal bone growth
  3. anabolic effects in muscle
  4. catabolic effects in lipid cells
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
44
Q

in turners syndrome treatment, in order to achieve maximal height _____________ must be started in conjunction with growth hormone to achieve maximum height

A

gonadal steroids (d/t absence of ovaries)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
45
Q

prader willi syndrome is a _____________________ genetic disease

A

autosomal dominant

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
46
Q

T/F: the long term effects of growth hormone treatment in childhood is unknown

A

true

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
47
Q

some adverse effects of somatropin?

A
  1. edema
  2. hyperglycemia
  3. pancreatitis
  4. gynecomastia
  5. increased CYP450 enzymes
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
48
Q

contraindications of somatropin

A
  1. patients with known malignancy
  2. critically ill pts (increases mortality)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
49
Q

______________ is a GH hormone agonist that is a recombinant human IGF-1

A

mecasermin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
50
Q

primary adverse effect of mecasermin

A

hypoglycemia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
51
Q

what are GH antagonists used for

A
  1. to reverse the effects of GH secreting cells (somatotrophs) from the anterior pituitary.
  2. Tx GH non-cancerous adenomas that cause acromegaly and/or gigantism
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
52
Q

what are the three growth hormone antagonist tx options (in order for how they should be implemented)

A
  1. Endoscopic transphenoidal surgery
  2. medical therapy if surgery unsuccessful
  3. radiation
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
53
Q

what are the drugs used as growth hormone antagonists

A
  1. somatostatin analogues: Octreotide and Lanreotide
  2. dopamine receptor agonists
  3. GH receptor antagonists (Pegvisomat)
54
Q

what is the most widely used Somatostain analogue

A

octreotide

55
Q

which drug is 2x more potent than somatostatin at decreasing insulin secretion from pancreatic beta cells?

A

octreotide

56
Q

adverse effects of octreotide

A
  1. GI effects
  2. biliary sludge –> gall stones
  3. bradycardia
  4. conduction defects
  5. B12 deficiency
57
Q

_________________ is used in the tx of acromegaly. It decreases GH levels and normalizes IGF-1 concentrations

A

Lanreotide

58
Q

fx of LH/FSH (gonadotropins)

A
  1. stimulate spermatogensis in men
  2. induce ovarian follicle development in women
59
Q

what is the most common clinical use of LH/FSH

A

controlled ovarian stimulation for in-vitro fertilization

60
Q

________________ is a placental glycoprotein nearly identical to LH, and actions are mediated through LH receptors

A

hCG

61
Q

what is the primary treatment for male and female infertility

A

gonadotropins and hCG

62
Q

_______________ GnRH secretion is required to stimulate the gondatroph cell to produce and release LH and FSH

A

pulsatile

63
Q

what happens if you have continous nonpulsatile administration of GnRH or GnRH analogs?

A

inhibits the release of FSH and LH by the pituitary in males and females –> desensitization and down regulation –>shut down of AP –> hypogonadism

64
Q

What is the most widely used GnRH agonist

A

Gonadorelin

65
Q

Gonadorelin is a synthetic ____________, that causes the release of ________&___________

A

GnRH; LH; FSH

66
Q

continuous administration of gonadorelin (or longer acting analogus) produces a biphasic response which are:

A
  1. flare
  2. inhibitory action of the continuous presence of GnRH
67
Q

how long is a GnRH agonist (like gonadorelin) expected to produce the “flare” response

A

7-10 days

68
Q

what happens in the first part of the biphasic response, “Flare”, with GnRH agonists (like gonadorelin)

A

produces increased concentration of gonadal hormones

69
Q

when would you use a GnRH analogue to stimulate the production of gondatrophins

A
  1. female infertility
  2. male infertility
  3. diagnosis of LH responsiveness (delayed puberty)
70
Q

when would you use GnRH antagonists to suppress gonadotropic release/production?

A
  1. endometriosis
  2. prostate cancer
  3. central precocious (early) puberty (female 8; male 9)
  4. breast and ovarian cancer
71
Q

GnRH receptor antagonists end in _____________

A

”- relix”

72
Q

GnRH receptor antagonist meds produce a _____________________ of the secretion of FSH and LH

A

dose dependent inhibition

73
Q

advantages of GnRH receptor antagonists over Agonists

A
  1. immediate antagonist effect results in shorter use time
  2. less suppressive effect on ovarian response to gonadotropin (decrease total duration and dose)
  3. reduces the concentrations of gondatropin and androgens more rapidly that GnRH agonists
  4. no testosterone surge
74
Q

what is the principle hormone responsible for lactation

A

prolactin

75
Q

hyperprolactinemia can result from ________________

A

prolactin secreting adenomas

76
Q

what is the effect of hyperprolactinemia in males

A

loss of libido and infertility

77
Q

what is the effect of hyperprolactinemia in females

A

amenorrhea and Galactorrhea

78
Q

____________________ are medications that act in the pituitary to inhibit prolactin release

A

dopamine agonists

79
Q

what are your dopamine agonists

A
  1. bromocriptine
  2. cabergoline
  3. quinagolide
80
Q

what is the half life of bromocriptine

A

7 hours

81
Q

what is the half life of cabergoline

A

65 hours

82
Q

what is the half life for quinagolide

A

20 hours

83
Q

high doses of ergot derivative dopamine agonists (bromocriptine, cabergoline, and Quinagolide) can cause ____________________; which means the anesthesia provider should move __________________

A

cold-induced peripheral digital vasospasm; pulse ox to ear or nose

84
Q

where is vasopressin (ADH) and oxytocin synthesized

A

in the neuronal cell bodies of the hypothalamus

85
Q

what are the 2 primary reasons oxytocin is used?

A
  1. stimulate uterine contractions
  2. milk letdown
86
Q

post-C section, the anesthesia provider should immediately start what drug to reduce the risk of post-partum hemorrhage

A

pitocin (oxytocin)

87
Q

what drug is an oxytocin antagonist, and is approved outside the US for preterm labor tx

A

atosiban

88
Q

Vasopressin acts on which G-coupled protein receptor

A

V1

89
Q

Desmopressin Acetate acts on which G protein coupled receptor

A

V2

90
Q

V1 receptors

A
  1. on vascular smooth muscle cells
  2. causes vasoconstriction (via Gq)
91
Q

V2 receptors

A
  1. on renal tubule cells
  2. reduces diuresis through increasing water resorption in CD (via Gs)
  3. Extrarenal V2 regulate the release of cogaulation factors VIII, and vWF
92
Q

what are your Vasopressin (ADH) antagonist drugs

A

“-vaptan”

  1. Conivaptan
  2. Tolvaptan
93
Q

______________ is a vasopressin (ADH) antagonist that has a high affinity for both V1 and V2 receptors

A

Conivaptan

94
Q

_______________ is a vasopressin (ADH) antagonist that has a 30-fold higher affinity for V2 than V1

A

Tolvaptan

95
Q

Conivaptan and Tolvaptan are both FDA approved for IV administration in the tx of ______________

A

hyponatremia

96
Q

what are the 3 zones of the adrenal cortex

A
  1. zona glomerulosa
  2. zona fasiculata
  3. zona reticularis
97
Q

what is secreted from the zona glomerulosa

A

aldosterone (mineralcorticoids)

98
Q

what is secreted from the zona fasciculata

A

cortisol (glucocorticoids)

99
Q

what is secreted from the zona reticularis

A

androgens

100
Q

decrease in adrenocortical hormone = _________________, and an increase in adrenocortical hormone = _________________

A

addisons; Cushings

101
Q

what are the 3 major hormones secreted from the adrenal gland

A
  1. mineralcorticoids (aldo)
  2. glucocorticoids (cortisol)
  3. androgens
102
Q

all adrenal hormones are made from the precursor __________________

A

cholesterol

103
Q

what is the fx of glucocorticoids (cortisol)

A

important effects on metabolism, CV function, growth, and immune function

104
Q

what is the primary fx of mineralcorticoids (aldo)

A

salt and water retaining activity

105
Q

the peak of cortisol secretion ins in the ___________

A

morning; fall throughout the day

106
Q

when are patient most sensitive to dosing of exogenous steroids?

A

at night, due to the decline of endogenous steroids in the eventing

107
Q

cortisol is 90% bound to ______________, and 5% bound to ____________

A

corticosteroid binding protein (CBG); albumin

108
Q

5% of endogenous cortisol is bound to ______________; however, the synthetic cortisol is signifcantly more bound to this protein

A

albumin

109
Q

_______________ is an exogenonous cortisol agonist that is used to prevent inflammation, high risk PONV, and peds undergoing tonsillectomy/adenoidectomy

A

dexamethasone (decadron)

110
Q

dexmethasone (decadron) is primarily bound to what protein

A

albumin

111
Q

what are the physiologic effects (pharmacodynamics) of cortisol

A
  1. metabolic
  2. catabolic and anabolic
  3. anti-inflammatory
  4. immunosuppressive
112
Q

chronic corticosteroid therapy can lead to:

A
  1. insomnia, euphoria, depression, and increased ICP
  2. suppression of ACTH, GH, TSH, and LH (d/t desensitization)
  3. PUD
  4. fat redistribution to viscera, face, nape of of neck and supraclavicular
  5. antagonize the effects of vitamin D on calcium absorption
  6. increases RBCs and plts
113
Q

how does cortisol decrease inflammation

A
  1. catabolizes proteins that cause inflammation
  2. anti-anabolic of things that cause inflammation
  3. profound effects on the concentration, distribution, and fx of peripheral leukocytes
  4. suppressive effects on inflammatory cytokines, chemokines, and other inflammatory mediators
114
Q

describe the immunosuppressive effect of a single dose of short acting glucocorticoids (cortisol)

A
  1. increase neutrophil concentration
  2. decrease lymphocytes, monocytes, eosinophils, and basophils
115
Q

the peak effect of single dose short acting glucocorticoid is ________, and then it decreases starting at _____

A

6hrs; 24 hrs

116
Q

what is a “large dose” glucocorticoid

A

20 mg/d of prednisone

117
Q

immunosuppresive effect of large dose glucocorticoids ?

A

decreases antibody production, which decreases phagocytosis ability, decreases TNF-alpha, decreases interleukins, metalloproteins, and plasminogen factor

118
Q

immunosuppressive effects of cortisol

A
  1. inhibits phospholipase A2
  2. decreases COX2 –> decreased prostaglandins
  3. vasoconstriction (transdermal)
119
Q

what is the net effect of cortisol?

A

to maintain adequate glucose supply to the brain

120
Q

cortisol deficiency has really important implications on ____________________

A

fetal lung development

121
Q

_________________ is adjunct in the creation of surfactant

A

cortisol

122
Q

which drug should you give for fetal lung development?

A

betamethasone

123
Q

what is the prodrug of synthetic corticosteroids?

A

prednisone

124
Q

prednisone is rapidly converted to _________________ (active product) in the body

A

prednisolone

125
Q

which are your short-to-medium acting glucocorticoids

A
  1. hydrocortisone
  2. prednisone
  3. methylprednisolone
126
Q

what are your long acting glucocorticoids

A
  1. betamethasone
  2. dexmethasone
127
Q

which are your synthetic corticosteroids that are mineralcorticoids

A

fludrocortisone

128
Q

which synthetic corticosteroid has the highest anti-inflammatory properties

A
  1. betamethasone (25-40)
  2. Dexmethasone (30)
129
Q

which synthetic corticosteroid is the best for increasing salt retention

A

fludrocortisone

130
Q

if a patient comes in for surgery on chronic steroids, you supplement intraoperatively with ______________, and give ___________ the amount of what they normally take the day of surgery

A

hydrocortisone; 2x

Pharm Unit 4 - Endo (4 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions