Repro/Endocrine Drugs Flashcards
What drug is useful in inhibiting bone resorption for a pt. with hypercalcemia? This drug is superior to calcitonin.
Gallium Nitrate
Phosphate binder used for renal failure pt.
Sevelamer
Calcitriol analog used for chronic kidney disease
Doxercalciferol
What drug interacts selectively with estrogen receptors causing an inhibition of bone resorption?
Raloxifene
What drug activates the calcium sensing receptors resulting in the inhibition of PTH secretion?
Cinacalcet
What group of drugs suppress the activity of osteoclasts inhibiting bone resporption?
Bisphosphonates (dronates)
What drug is a recombinant form of PTH?
Teriparatide
Phosphate binding agent that uses Aluminum for the treatment of chronic kidney disease
Deferoxamine
Somatropin and Somatrem
Growth hormone analogues
1) Somatostatin analogue
2) 45x more potent than somatostatin
3) Used for treatment of acromegally, gastrinoma, and VIPoma
Octreotide
GHRH peptide analogue
Sermorelin
GH receptor antagonsit
Pegvisomant
1) Synthetic human ACTH
2) Stimulates activity of cholesterol esterase (key enzyme for cholesterol –> pregnenolone)
Cosyntropin and Porcine
1) GnRH analogue
2) D-amino substituted at position 6 and ethylamide substituted for glycine at position 10
Leuprolide, Nafarelin, Goserelin
What occurs when you give a sustained, non-pulsatile administration of GnRH
It inhibits the release of FSH and LH by the pituitary in both men and women
MOA of Bromocripitine/Cabergoline
1) Selective for D2 dopamine receptor
2) Decreases dopamine trnover in the arcuate nucleus
Modified forms of FSH with LH
Menotropins
GnRH antagonist
Cetrorelix acetate
Insulin with a glutamate substituted at the C terminus?
1) Apidra (Insulin Glulisine)
2) Rapid
Insulin with a aspartate substituted at the C terminus?
1) Novolog (Insulin aspart)
2) Rapid acting
Insulin with a lysine and proline substituted at the C terminus?
1) Humalog (Lispro)
2) Rapid
Non-insulin hypoglycemic agents that target the ATP regulated Potassium channel?
1) Sulfonylureas
2) Meglitinides
What are some characteristics of sulfonylurea?
1) Act on the sulfonylurea receptor to inhibit ATP regulated K channel and stimulates insulin release
2) After initial period insulin levels go back down
3) Drug may fail completely
4) Has drug interactions with salicylates
Glimepiride, Glipizide, and Glyburide
Sulfonylureas
Repaglinide
Meglitinide
What is the MOA for Biguanides (metformin)
1) Activates the AMP dependent protein kinase
2) Results in decreased gluconeogenesis and increased glycogenesis
What drug interactions are important with metformin? What adverse reactions are there?
1) Furosomide
2) GI disturbances
MOA for Rosiglitazone and Pioglitazone (Thiazolidinediones)
1) Act on the PPAR gamma receptor
Rosiglitazone and Pioglitazone
Thiazolidinediones
Exenatide
Glucagon like peptide agonist
MOA of GLP agonists
Increases insulin secretion, decreases glucagon secretion, and decreases intestinal mobility
Sitagliptin
GLP-1 protease inhibitor
Acarbose
Alpha Glucosidase Inhibitor
Adverse Effects of Acarbose
1) GI malabsorption (flatulence, diarrhea, bloating)
Adverse effects of Rosiglitazone and Pioglitazone
1) Weight gain
2) Edema (macular edema)
3) Increased adiposity
4) HEPATOTOXICITY
Sitagliptin
GLP-1 protease inhibitor (DPP-4 inhibitor)
Drug interactions of sitaglipitin
1) Anti-viral agents
Pramlintide
Synthetic amylin
MOA of Pramlintide
1) Decrease glucagon
2) Slow GI mobility
3) Increase satiety
Colesevelam
Bile acid seqestrant
Canagliflozin
Sodium Glucose co-transporter 2 (SGLT-2)
MOA of Canagliflozin
Block the reabsorption of glucose from the proximal renal tubule
How does amiodarone (anti-arrhythmic) cause hypothyroidism?
1) Inhibits diodinase activity
What does insulin do to potasssium?
- Cause an intracellular shift of potassium
MOA of anastrozole
1) Aromatase inhibitor
2) Used in postmenapusal women with breast cancer
Competitive inhibitor of prgestins at progestin receptors; used as a postcoital contraceptive
Mifepristone
MOA of Terbutaline
Beta 2 agonisth that relaxes the uterus
MOA of Tamsulosin
Alpha 1 antagonist used to treat BPH
What drugs inhibit phosphodiesterase causing increased cGMP leading to smooth musccle relaxation
Sldenafil and vardenafill
MOA of Raloxifene
Agonist on bone; reduces resorption of bone
What drug is used to treat osteoporosis
Raloxifene
MOA of Tamoxifen
1) Antagonist on breast tissue
2) May cause endometrial polyp
MOA of Propylthiouracil and methimazole
Block thyroid peroxidase
REsults in inhibition of organification of iodide and coupling of thyroid hormone
What additional mechanism does propylthiouracil do that methimazole doesnt?
1) Blocks conversion of T4 to T3
2) Inhibition of 5 deiodinase
What is the function of propranolol when given for a pt. with thyrotoxicosis?
1) Decreases heightened adrenergic response from T3/T4
2) Inhibits the conversion of T4 to T3