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Pharm > Repro > Flashcards

Repro Flashcards

1
Q

hormone

A

any substance secreted by glandular tissue in the body which stimulate a specific physiological response in cells or activate certain tissues

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2
Q

endocrine

A

referring to glands that secrete hormones and other substances INTO the body (central circulation)

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3
Q

exocrine

A

referring to glands that secrete hormones and other substances OUTSIDE the body (into the GI tract, onto the skin)

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4
Q

catecholamine

A

an organic compound that functions like a neurotransmitter; can occur outside the CNS - specifically EPI, NE, DA

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5
Q

corticosteroid

A

any steroid type hormone produced by the adrenal cortex; ‘steroids’

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6
Q

Components of the Endocrine System (8)

A

Hypothalamus/pituitary gland
pineal gland
thyroid
parathyroid
thymus
adrenal glands
pancreas
gonads

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7
Q

Hypothalamus and Pituitary Gland components

A

anterior and posterior hypophysis

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8
Q

adrenal gland parts

A

cortical and medullary

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9
Q

Male and female gonads

A

M - testes
F - ovaries

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10
Q

Pituitary lobe

A

endocrine extension of hypothalamus: ‘master regulator,’ links the CNS to systemic endocrine function
anterior and posterior lobes

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11
Q

anterior pituitary gland secretions

A

secretes GH, tropic hormones, prolactin, ACTH, TSH, FSH, and LH

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12
Q

Anterior pituitary regulation

A

growth rate, sexual maturation, metabolism, stress response, metabolism, fluid balance

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13
Q

Anterior pituitary gland tumor rate

A

1 in 5 patients with intercranial tumors present with a pituitary tumor

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14
Q

Growth hormone (GH; HGH) primary function

A

growth regulation during childhood and puberty

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15
Q

GH; HGH

A
  • HGH levels are mediated by hypothalamic signaling
  • HGH released daily; metabolically important to growth of peripheral tissues (HGH synthesis increases after 18 mo; greatest levels during puberty, steadily declines > about 40 yrs old)
  • HGH essential for normal growth/development (deficiency in childhood/puberty results in growth deficits)
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16
Q

GH; HGH opposes and stimulates what

A
  • opposes activity of insulin
  • stimulates gluconeogenesis + glycogenolysis
  • acute phase reactant in stress/illness states
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17
Q

ACTH -> adrenocorticotropic hormone primary function

A

regulates the release of cortisol and other corticosteroids and androgens

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18
Q

ACTH signaled by. . .

A

the hypothalamus by CRH (corticosteroid releasing hormone)

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19
Q

ACTH -> augmenting metabolism and euvolemic fluid balance. . .

A
  • cortisol and glucocorticoids 1) increase blood sugar, 2) induce catabolism of proteins and fats, 3) cause bone reabsorption
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20
Q

ACTH -> help increase muscle/bone mass, critical role in male secondary sex characteristics. . .

A
  • spermatogeneis and testicular development
  • testicular androgen production
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21
Q

Thyroid stimulating hormone (thyrotropin; TSH) primary function

A

control the release of thyroxine (T4) from the thyroid. helps decrease triiodothyronine (T3) to a lesser degree

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22
Q

TSH

A
  • neg feedback loop btwn TRH, TSH, and T4
  • TSH is not an ‘active thyroid hormone;’ T4 and T3 are
  • as more TSH binds to TSH receptors in the thyroid, more active thyroid hormone is released (`80% as T4, 20% T3)
  • iodine intake and utilization is necessary for normal thyroid and thyrotropic function
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23
Q

Follicle stimulating hormone; FSH

A
  • primarily responsible for the initiation of the menstrual cycle
  • stimulates the maturation of follicular oocytes in the ovaries
  • men; lower levels of FSH help maintain/control spermatogenesis
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24
Q

Luteinizing hormone -> LH

A
  • LH levels rise in females to stimulate ovarian production of estradiol
  • peak after ~14 days in tandem with a surge in FSH -> causes ovulation
  • after ovulation; the ovarian follice forms a corpus luteum, can make progesterone if implantation occurs
  • men; lower levels of FSH stimulate the testes to produce testosterone
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25
Q

Posterior pituitary gland

A
  • secretes ADH, oxytocin
  • ADH (vasopressin) stimulates the formation of aquaporins in the renal tubules -> resorption of soulte-free water
  • oxytocin: important neurotransmitter, ‘let down,’ uterine contractility
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26
Q

anti-diuretic hormone (vasopressin)

A
  • reduces renal secretion
  • causes retention of free water and sodium
  • secretion stimulated by angiotensin 2
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27
Q

Oxytocin

A
  • stimulates contraction of uterine smooth muscle, facilitates normal childbirth
  • stimulates smooth muscle of mammary glands, allows for mechanical ‘let down’ of breast milk
  • different effects within the CNS: associated with bonding, trust, familial association, romantic dyads
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28
Q

pineal gland

A
  • small, cone-shaped organ in the epithalamus (mid brain), not isolated in the BBB
  • evolutionary, an atrophied photo-receptor (receives info from optic ganglia, knows when it is getting dark)
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29
Q

Pineal gland secretes. .

A
  • melatonin based on the circadian rhythm information
  • helps to induce somnolence; regulates sleep-wake cycle
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30
Q

thyroid gland

A

T3 and T4 (thyroxine)
- regulate metabolic activity
- cellular division and tissue growth
- caloric consumption and BMR
- organ system activity and responsivity
T4>T3 in terms of regulatory function
too much = hypermetabolic state
too little = hypometabolism

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31
Q

Parathyroid gland

A
  • PTH or parathormone
  • essential regulator of calcium balance
  • hypocalcemia stimulates the parathyroid gland to secrete PTH -> increases the activity of osteoclasts in bone tissue (more clacium and phosphorous available in serum)
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32
Q

Adrenal gland

A
  • cortex (bark), and medulla (marrow)
  • mineralcorticoids: primarily influence salt balance
  • glucocorticoids: influence blood sugar regulation
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33
Q

Corticosteroids used for. . .

A

suppress inflammation

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34
Q

Corticosteroids examples

A

-one, prednisone, dexamethasone, hydrocortisone

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35
Q

Corticosteroids

A
  • potent anti-inflammatory action suppresses inflammatory cascade at mx sites, sometimes given for other dx
  • multiple routes
  • shortest tx period; lowest dose
  • watch for side effects
  • client education very important
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36
Q

Corticosteroid side effects

A
  • weight gain (esp centrally)
  • fluid retention and edema (esp in the facial region)
  • elevated blood sugar and sodium levels
  • thinning skin and brittle bones
  • stomach irritation and gastric ulcers
  • mood changes - irritability, insomnia
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37
Q

Pancreas

A
  • retroperitoneal glandular organ adjacent to the stomach
  • inserts into the duodenum via the ampulla of vader
  • endocrine and exocrine
  • endocrine function = Isle of Langerhans
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38
Q

Which pancreas cells secrete glucagon?

A

alpha cells

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39
Q

which pancreas cells secrete insulin?

A

beta cells

40
Q

insulin

A
  • naturally secreted by the pancreas after we eat (postprandially)
  • allows glucose to enter cells; driving blood sugar levels
  • insulin also causes intracellular potassium shift; can result in relative hypokalemia
41
Q

glucagon

A
  • hormone, stimulates glycogenolysis and glyconeogenesis
  • not a sugar or a carb
  • levels are reciprocally proportional to blood sugar levles
  • glucagon for when the glucose is gone
42
Q

glycogenolysis

A

break down of storage form of glucose in the liver - glycogen

43
Q

gluconeogenesis

A

making new glucose molecules

44
Q

estrogen

A

primary group of hormones responsible for female secondary sex characteristics
- repro development; menarche (menstruation cycle), pubescent changes
- thelarche (breast development), bone development and bone density

45
Q

progesterone

A

hormone that is instrumental in menstruation and pregnancy, helps facilitate embryogenesis
- promotes blood flow to the uterine lining -> allows for importation of fertilized egg
- promotes placental blood flow; helps maintain the early stages of pregnancy

46
Q

testosterone

A

androgen
primary group of hormones responsible for male secondary sex characteristics
- reproductive development: penile/scrotal growth, spermarche (sperm production), pubescent changes
- increased lean muscle mass (anabolic effect)

47
Q

Dihydrotestosterone (DHT)

A

chemically derived from testosterone; the most potent hormone among the androgens
- promotes maturation of the prostate and seminal vesicles; fertility factor
- as males age -> drives prostatic hypertrophy (BPH) and male pattern baldness

48
Q

pituitary gland goal

A

replacement therapy

49
Q

pituitary gland MOA

A
  • augment or antagonize the natural effects of the pituitary hormone
  • exogenously given corticotropin elicits the same response as ACTH
50
Q

Cosyntropin

A
  • pituitary gland
  • travels to the adrenal cortex and stimulates secretion of cortisol
  • used for adrenalcortical insufficiency
51
Q

Somatropin

A
  • pituitary gland
  • synthetic drugs that mimics growth hormones through various processes
52
Q

Octreotide

A
  • pituitary gland
  • antagonizes the effects of GH
53
Q

Vasopressin

A
  • pituitary gland
  • used to prevent and control polydipsia, polyuria, and dehydration with diabetes insipidus (DI)
54
Q

thyroid hormones

A
  • T4, thyroxine
  • T3, triiodothyronine
  • TSH, thyroid stimulating hormone
55
Q

thyroid replacement drugs natural and synthetic

A

natural: thyroid
synthetic: levothyroxine (chemically pure and more predictable)

56
Q

thyroid replacement drugs MOA

A
  • should be taken before food, at the same time every morning
  • works in the same manner as endogenous thyroid hormones, effecting many body systems
  • works to induce change in the metabolic rates, increased O2 consumptions, and body temperatures
  • increases beta-adrenergic receptors, making the heart more sensitive to catecholamines, increases CO
57
Q

anti-thyroid drugs goal

A

treat underlying disease, like hypothyroidism, Grave’s, cancer

58
Q

anti-thyroid drugs examples

A

iodides, ionic inhibitors, radioactive isotopes of iodine
- thioamide derivatives: methimazole and propylthiouracil (PTC)

59
Q

anti-thyroid drug MOA

A
  • inhibit the incorporation of iodine molecules into the amino acid tyrosine (a process required to make the precursors of T3 and T4). Impedes the formation of thyroid hormone.
  • PTU inhibits the conversion of T4 to T3 in peripheral circulation
  • neither drug can inactivate existing thyroid hormone
60
Q

adrenal medulla

A

epi and norepi

61
Q

adrenal cortex

A
  • corticosteriods, glucocorticosteriods, mineralcorticoids (regulates electrolytes) (aldosterone, helps control Na+/K+ balance)
62
Q

adrenal gland over secretion + drug example

A

cushing’s, adrenal crisis
Osilodrostat

63
Q

adrenal gland under secretion + drug examples

A

addison’s disease
hydrocortisone, prednisone, prednisolone, dexamethasone. Exclusive mineralcorticoid activity: fludrocortisone

64
Q

Adrenal drugs MOA, SE, and indications

A

MOA
- under secretion
- r/t to their involvement with synthesis of specific
- effects fluid and water retention
- inhibit inflammatory and immune response

SE
- many

Indications
-many

65
Q

pancreas

A

exocrine gland, secreting digestive enzymes through the pancreatic ducts, and an endocrine gland, secreting hormones into the bloodstrem

66
Q

2 pancreas hormones

A
  • insulin
  • glucagon
67
Q

glucose definition

A

primary source of energy for cells

68
Q

glycogen definition

A

the stored excess of glycose in the liver (mostly), until it is needed

69
Q

glycogenolysis definition

A

conversion of glycogen back into glucose

70
Q

Rapid insulin example and pharmacokinetics

A

-SQ
- Insulin Lispro
- onset = 15 minutes
- peak = 1-5 hours
- duration = 3-5 hours

71
Q

Short acting insulin example and pharmacokinetics

A
  • SQ
  • regular insulin
  • onset: 30-60 minutes
  • peak: 2.5 hours
  • duration: 6-10 hours
72
Q

long acting insulin example and pharmacokinetics

A
  • SQ
  • insulin glargine
  • onset: 1-2 hours
  • no peak
  • duration: 24 hours
73
Q

intermediate insulin example and pharmacokinetics

A
  • SQ
  • NPH
  • onset: 1-2 hours
  • peak: 4-8 hours
  • duration: 10-18 hours
74
Q

Insulin MOA

A
  • replaces the insulin either not made or made defectively
  • restores the ability to metabolize carbs, fats, and proteins
  • allows glucose to be stored in the liver
  • helps convert glycogen to fats
  • does NOT reverse defects in insulin receptor sensitivity
75
Q

insulin adverse effects

A

hypoglycemia

76
Q

Basal-Bolus Insulin Therapy

A
  • preferred tx method
  • attempting to mimic a healthy pancreas by delivering long-acting insulin constantly )basal) and giving rapid/short acting insulin when glucose levels rise (like with food)
77
Q

sliding slide insulin tx plan

A
  • used to “correct” elevated blood glucose levels
  • helpful when BG levels are elevated due to stress, infx, etc
78
Q

biguanides example and MOA

A
  • ex: metformin (first line drugs and commonly used for DM2)
    MOA
  • decrease glucose production by the liver
  • decreases intestinal absorption of glucose and improve insulin receptor sensitivity
    -> increased peripheral glucose uptake and use, decreased hepatic production of triglycerides and cholesterol
79
Q

sulfonylureas ex and MOA

A
  • ex: glipizide, glyburide, and glimepiride
    MOA
  • bind to specific receptors on beta cells in the pancreas to stimulate the release of insulin
  • decrease the secretion of glucagon
  • pt must have functioning cells in the pancreas
80
Q

Glinides ex, MOA, indication, and contraindications

A
  • ex: repaglinide, nateglinde
    MOA
  • increase insulin secretion from the pancreas
  • very short duration and must be given with each meal
  • indication: DM2
  • contraindications: can’t take with sulfonylureas
81
Q

thiazolidinediones (glitazones) ex and MOA

A
  • ex: pioglitazone
    MOA
  • decrease insulin resistance by enhancing the sensitivity of insulin receptors
  • directly stimulate peripheral glucose uptake and storage
  • inhibits glucose and triglyceride production in the liver
  • slow onset (several weeks-months for benefit)
82
Q

alpha-glucosidase inhibitors ex and MOA

A
  • ex: acarbose and miglitol
    MOA
  • inhibits enzyme alpha-glucosidase in the sm intestine
  • this enzyme normally is responsible for hydrolysis of oligosaccharides and disaccharides to glucose
  • when blocked: glucose absorption is delyaed
  • timing is important: must be taken with meals
83
Q

sodium glycose cotransporter inhibitors (SGLT2)

A
  • glucose is reabsorbed into circulation but SGLT, which transport Na+ and glucose into cells
  • inhibition of SGLT2 leads to a decrease in blood glucose and an increase in renal glucose secretion
84
Q

female replacement hormones

A
  • estrogen
  • progesterone
85
Q

estrogen ex and MOA

A
  • ex: estradiol transdermal, estradiol cypionate, estradiol valerate, ethynyl estradiol
    MOA
  • steroidal and nonsteroidal (in the US, only have steroidal)
  • the binding of estrogen to intracellular estrogen receptor stimulates the synthesis of nucleic acids and proteins
  • produces effects in estrogen-responsive tissue receptors
86
Q

progesterone ex, MOA, and indications

A
  • ex: hydroxyprogesterone, pregnenolone, medroxyprogesterone, norethindrone, megestrol
    MOA
  • most active pro-gestational hormone
  • produced after ovulation by the corpus luteum and during pregnancy by the placenta
  • indications: hormonal imbalance, fibroids, uterine cancer, amenorrhea, contraception, helps prevent threatened miscarriage
87
Q

contraception ex, MOA, SE

A
  • note: oral contraception does not protect against STD/STI
  • ex: estrogenic, pregestational steroids
    MOA
  • prevents ovulation
  • inhibits the release of gonadotropins
  • increases uterine mucous viscosity
  • decreased sperm movement and fertilization of the ovum
  • inhibits implantation of fertilized egg
  • SE: HTN, thromboembolism (increased risk with smoking)
88
Q

fertility drugs and MOA

A
  • ex: clomiphene (clomid)
    MOA
  • blocks estrogen receptors in the uterus and brain -> a fake signal of low estrogen levels is sent to the brain
  • increased the production of GNRH (from the hypothalamus), FSH and LH (from the pituitary gland) -> stimulates maturation of the ovarian follicles -> ovulation
89
Q

uterine stimulation: ergot derivatives

A

during pregnancy, the uterus is sensitive to oxytocin

90
Q

uterine stimulation: prostaglandins

A

during childbirth, it stimulates uterine contraction

91
Q

uterine stimulation: progesterone antagonist mifepristone

A

aids in lactation

92
Q

Uterine stimulation: oxytocin

A

regulates smooth muscles in the uterus

93
Q

androgens ex, MOA, SE

A
  • ex: methyltestosterone, fluoxymesterone
  • note: oral testosterone has a significant first pass effect

MOA
- stimulates normal growth and development of male sex organs
- development and maintenance of secondary sex characteristics
- helps retain nitrogen which has important metabolic roles

  • SE: weight gain
94
Q

androgen inhibitor: benign prostatic hyperplasia (BPH)

A
  • androgen inhibitors blocks the effects of naturally occurring endogenous androgens
  • ex: finasteride and dutasteride
95
Q

androgen inhibitors: prostate cancer

A
  • blocks activity of androgen hormones at the receptor level
  • ex: flutamide, nilutamide, and bicalutamide

Pharm (4 decks)

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