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review for Pharm Block 3 Quiz (up to Diabetes) Flashcards

0
Q

purpose of LH in males

A

in Leydigs cells–> regulates testosterone synthesis

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1
Q

purpose of FSH in males (Sertoli cells)

A

promote Spermatogenesis in Seminiferous tubules

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2
Q

step that produces testosterone

A

androstenedione–> testosterone

via 17 beta hydrosteroid dehydrogenase*****

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3
Q

most circulating testosterone is bound to…

A

SHBG= sex hormone binding globulin( which has hepatic origin)

testosterone weakly binds to albumin and testosterone bound to albumin is considered unbound testosterone

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4
Q

what is the active form of testosterone and what is the enzyme that produces the

A

testosterone–> DHT= dihydrotestosterone

via 5 alpha reductase–>
1= non genital skin and liver
2= urogenital skin and genital skin of both sexes

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5
Q

what is the purpose of androgens in males?

A

development of the male phenotype

  • growth of penis
  • thicker oily skin
  • increase height and musculature
  • axillary hair
  • growth of larynx
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6
Q

why is testosterone not given orally

A

LARGE 1ST PASS EFFECT METABOLISM VIA LIVER–> inactivated via 1st pass effect

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7
Q

what are the therapeutic androgens

A
  1. testosterone aqueous= short acting
  2. testosteronr cypionate= depot–> last longer and has anabolic effects
  3. testosterone gel
  4. Fluoxymesterone–> most effects are anabolic
  5. DANAZOLE= weak androgenic and interacts with progesterone and androgen receptors–> PANCREATITIS
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8
Q

describe the androgenic vs anabolic effects

A

androgenic= used for those with inadequate androgen secretion
–> for development and maintenance of masculine characteristics

anabolic= for senile osteoporosis and severe burns–> speeds up recovery from surgery
–> promotes cell growth

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9
Q

adverse affects of androgens in females

A
  1. masculinization with acne
  2. facial hair
  3. deep voice
  4. male pattern baldness
  5. menstrual irregularities
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10
Q

adverse effects of androgens in males

A
  1. priaprism= boner for longer than 4 hrs
  2. impotence= cant get/keep it up
  3. decrease in spermatogenesis
  4. gynecomastia= MOOBS
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11
Q

effects of androgens in kids

A

growth disturbances–> promote pre-mature closing of epiphyseal plates

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12
Q

general adverse effect of androgens

A
  1. increase LDL–> increases risk for pre-mature coronary heart disease
  2. fluid retention–> edema
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13
Q

4 anti-androgens

A
  1. spiro-no-lactone
  2. flutamide
  3. ketoconazole
  4. cimetidine
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14
Q

which antiandrogen is used to treat hirsutism= excessive hairiness in women

A

spironolactone–> have to give at high doses

–> in men it causes impotence

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15
Q

drug that competitively inhibits the binding of DHT to androgen receptor

and what is it used for

A

flutamide–> used for

1. prostatic cancer when combined with GnRH blockade or estrogen

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16
Q

SE of flutamide

A
  1. hepatitis

2. anemias

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17
Q

ketoconazole inhibits…. and is used for…

A
  • 17 alpha-hydroxylase

used to treat prostatic cancer= HEPATOTOXIC

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18
Q

at high doses what does cimetidine do

A

competes for androgen receptors–> used for hirsutism

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19
Q

what is the only 5 alpha reductase inhibitor

A

FINASTERIDE= competitive inhibitor for both enzymes (prefers 5 alpha reductase 2)

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20
Q

used of FINASTERIDE= 5 alpha reductase inhibitor

A

in high doses= PROSCAR–> for prostatic hyperplasia
in low doses= PROPECIA–> for male pattern baldness

CAUSES IMPOTENCY

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21
Q

what 3 drugs can you use for impotence

A
  1. sil-denafil
  2. var-denafil
  3. tada-lafil= weekender–> single dose can last 36 hrs
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22
Q

MOA of impotence drugs

A

NO–> + guanylyl cyclase–> increase cGMP–> smooth muscle relaxation of corpus cavernosum–> increase blood flow–> boner

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23
Q

what is AN ABSOLUTE CONTRAINDICATION for taking impotence medication

A

CONCURRENT NITRATE USE

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24
describe the 2 things where you see an increase in GH
in kids= gigantism--> due to open long bone epiphyses in adults= acromegaly= abnormal growth of tissue esp. CT --> leads to metabolic abnormalities and cardiac dysfunction
25
what are the 2 groups of hypothalamic hormones
1. GnRH agonists | 2. GnRH antagonists
26
what are the GnRH agonists
1. leuprolide | 2. -relins
27
what are the 2 ways you can administer a GnRH agonist
1. pulsatile= for replacement therapy--> for infertility or delayed puberty 2. continuous= for suppression--> - endometriosis - uterine fibroid - prostate cancer - early puberty
28
what do you see when you administer a GnRH agonist
FLARE UP 1st 7-10 days= agonist effect 2nd= flare up= increase in gonadal hormone 3rd= desensitization/inhibitory effect--> decrease in gonadal hormone
29
what is the bonus of using a GnRH antagonist
1. no flare up | 2. rapid onset of effects
30
what are the GnRH antagonists
- relix 1. gani-relix 2. ceto-relix 3. aba-relix 4. dega-relix
31
the anterior pituitary secretes what 3 hormones
1. GH 2. FSH/LH 3. Prolactin
32
what is the GH agonist
somatropin
33
what is the GH antagonist
somatotropin 1. octreotide 2. lanreotide
34
GH antagonists lower which hormones and how does this affect their uses?
1. GH 2. glucagon 3. insulin 4. gastrin can be used for hormone secreting tumor or BLEEDING ESOPHAGEAL VARICES
35
Name the FSH/LH hormones
``` mixed= menotropin FSH= uroFollitropin LH= Lutropin= recombinant form--> almost identical to hcG ``` ***first 2= used for infertility
36
what 2 hormones does the posterior pituitary release
1. oxytocin--> alters transmembrane ion channels--> induces labor 2. Vasopressin/ADH
37
the purpose of ADH agonists and what they target
1. 8-L-arginine vasopression= V1 blocker (blood vessels)--> BLEEDING ESOPHAGEAL VARICES 2. Desmopressin= V2 blocker (primary cells/ principal cells of collecting ducts--> DOC for central diabetes insipidus
38
what is the DOC for central diabetes insipidus (ADH insufficiency)
ADH agonist= retain H20 and constricts blood vessels
39
what are the ADH/vasopressin antagonists
1. conivaptan--> V1 and V2 2. Tolvaptan--> V2 blocker - for euvolemic and hypervolemic hyponatremia - SIADH
40
side effects of GH antagonists
1. biliary sludge and gallstones 2. sinus bradycardia alt for acromegaly= PEGVISOMANT
41
prolactin is the primary hormone responsible for lactation and is inhibited by
hypothalamus releases DOPAMINE--> inhibits prolactin
42
a prolactin antagonist=
dopamine agonist= 1. bromocriptine--> for acromegaly 2. cabergoline--> for hyper-prolactinemia
43
what causes hyperprolactinemia
1. antipsychotics which are dopamine receptor blockers--> they inhibit dopamine= no inhibition of prolactin production 2. benign prolactinoma
44
SE of hyperprolactinemia
females--> - ovulations= menstrual irregularities - amenorrhea= no periods - galactorrhea= leaky nipples men - decreased libido - gynecomastia= man boobs
45
what blocks oxytocin
1. Beta blockers 2. magnesium sulfate 3. inhaled anesthetics
46
what enzyme is used to produce T4 and T3 in thryoglobulins
thyroid peroxidase
47
purpose of TH in kids and adults
kids--> normal development--> esp CNS | adults--> maintain metabolic homeostasis
48
which TH is more active
T3 T4--> T3 via deiodinase enzymes
49
T3 and T4 are highly bound to
thyroxine binding globulin if bound--> they are not active
50
high concentrations of iodide can prevent
TH release
51
what is a thyroid storm and how do you treat it
life-threatening complication of hyperthyroidism ``` give PTU (propylthiouracil) +iodates in high doses control tachyarrhythmia with B blockes or Ca channel blockers supportive therapy= dexamethasone (long acting corticosteroid) ```
52
radioactive iodine= DOC
for Graves Disease cannot give in pregnant women or younger patients
53
adenohypophysis releases
TSH= thyrotropin stimulating hormone--> causes the TRH from the thyroid gland
54
what do you give for hypothyroidism
1. desicated thyroid= T3 and T4 2. levothyroxine= T4= DOC for hypothyroidism 3. Livothyronine= T3
55
what is the DOC for hypothyroidism
levothyroxine= T4--> low cost and long T1/2
56
treatment for hyperthyroidism
1. remove thyroid gland 2. local radiation with radioactive iodine--> DOC for Graves' disease 3. antithyroid agent
57
what is the DOC for Graves' disease (diffuse toxic goiter)
radioactive iodine
58
what are the 2 anti-thyroid agents
1. PTU=propyl-thio-uracil--> DOC for thyroid storm | 2. methimazole
59
what are the side effects of the anti-thyroid agents
1. agranulocytosis= low WBC 2. BM aplasia can cross placenta and get secreted in mothers milk

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