Week 3 Pharm

Question 1

What do Glucocorticoids like Prednisone, Prednisolone, Hydrocortisone, and Dexamethasone do?

Answer 1

Replaces endogenous cortisol, causes inhibition of phospholipaseA2; ↓ Cyclooxygenase (prostaglandins, leukotriene), Cytokines (Tumor necrosis factor, IL-3,4,5,13, Granulocyte-Macrophage Stimulating factor)

Question 2

What are side effects of Glucocorticoids like Prednisone, Prednisolone, Hydrocortisone, and Dexamethasone?

Answer 2

Acute: mood changes, hypokalemia, GI upset/ulcer, hyperglycemia. Chronic: HPA-axis suppression, muscle wasting, cushingnoid, gluconeogenesis, salt&water retention, GI ulcer, osteoporosis, psychosis, immunosuppression, thin skin, cataract, glaucoma.

Question 3

What do Mineralocorticoids like Fludrocortisone do?

Answer 3

Very potent affinity for mineralocorticoid receptor (↑ Na+/K+ATPase & ENaC expression) leads ↑ Na+ reabsorption and K+ excretion in distal tubules

Question 4

What are the side effects of Mineralocorticoids like Fludrocortisone?

Answer 4

Hypertension, edema, headache, hypokalemia, weight gain.

Question 5

Which hypercortisolism drug inhibits cytochrome P450-dependent enzymes~cortisol synthesis?

Answer 5

Ketoconazole

Question 6

What does Fludrocortisone treat?

Answer 6

Adrenal insufficiency, hypopituitarism

Question 7

What does Ketoconazole treat?

Answer 7

Cushing’s syndrome

Question 8

What are the side effects of Ketoconazole?

Answer 8

Nausea, vomiting, headache, impotence and hepatotoxicity

Question 9

Which hypercortioslim drug is a cytotoxic drug that suppresses ACTH secretion and reduces synthesis of cortisol?

Answer 9

Mitotane

Question 10

What does Mitotane treat?

Answer 10

Inoperable adrenocortical carcinoma; Cushing’s syndrome

Question 11

What are the side effects of Mitotane?

Answer 11

Nausea, vomiting, diarrhea and tiredness

Question 12

Which hypercortisolism drug decreases cortisol synthesis by inhibition of 11-hydroxylase activity?

Answer 12

Metyrapone

Question 13

What does Metyrapone treat?

Answer 13

Cushing’s syndrome

Question 14

What are the side effects of Metyrapone?

Answer 14

Nausea, vomiting, dizziness and sedation

Question 15

What does the hypothyroid drug, Levothryoxine, do?

Answer 15

Activation of nuclear receptors, gene expression, and protein synthesis

Question 16

What are the side effects of Levothyroxine?

Answer 16

Cardiovascular (tachycardia, arrhythmia, MI), CNS (headache, nervousness, insomnia, irritability, GI (diarrhea, vomiting, cramps), weight loss

Question 17

Which hyperthyroid drug inhibits both thyroid peroxidase reactions and 5’-deiodinase?

Answer 17

Propylthiouracil (Methimazole preferred to PTU except during the 1st trimester of pregnancy and in thyroid storms)

Question 18

What are the side effects of Propylthiouracil?

Answer 18

Nausea, GI distress, hepatitis (black box warning), hypothyroidism, agranulocytosis is rare but life-threatening side effect of thiomides. PTU has higher hepatotoxicity than methimazole.

Question 19

Which hyperthyroid drug inhibits thyroid peroxidase reactions?

Answer 19

Methimazole (Methimazole is preferred to PTU except in the 1st trimester of pregnancy and in thyroid storm)

Question 20

What are the side effects of Methimazole?

Answer 20

Nausea, GI distress, hepatitis (black box warning), hypothyroidism, agranulocytosis is rare but life-threatening side effect of thiomides. Methimazole causes serious congenital defects.

Question 21

Which hyperthyroid drug inhibits iodine organification and hormone release; reduces size and vascularity of the thyroid gland?

Answer 21

Potassium Iodide (SSKI)

Question 22

What is potassium Iodide (SSKI) used for?

Answer 22

Preparation for surgical thyroidectomy; Thyroid storm

Question 23

What are the side effects of Potassium Iodide (SSKI)?

Answer 23

Side effects are rare.

Question 24

Which hyperthyroid drug inhibits β receptors and the conversion of T4 to T3?

Answer 24

Propranolol

Question 25

What does Propranolol treat?

Answer 25

Thyroid Storm

Question 26

What are the side effects of propranolol?

Answer 26

Asthma, AV blockade, hypotension, bradycardia

Question 27

What does somatropin (growth hormone deficiency drug) do?

Answer 27

Recombinant form of human GH. Binds to GH receptors and increases production of IGF-1

Question 28

What does somatropin treat?

Answer 28

Treatment of growth failure in children with GH deficiency, short stature, turner syndrome, chronic kidney disease, short bowel syndrome, wasting in HIV infection

Question 29

What are the side effects of somatropin?

Answer 29

Gynecomastia, hyperglycemia, scoliosis, arthritis

Question 30

Which excess growth hormone drug is an agonist at somatostatin receptors and inhibits production of GH and to a lesser extent, of TSH, glucagon, insulin, and gastrin?

Answer 30

Somatostatin analogs: Octreotide, Lanreotide, Pasireotide

Question 31

What do Somatostatin analogs (Octreotide, Lanreotide, Pasireotide) treat?

Answer 31

Acromegaly and several other hormone-secreting tumors and acute control of bleeding from esophageal varices

Question 32

What are the side effects of Somatostatin analogs (Octreotide, Lanreotide, Pasireotide)?

Answer 32

GI, gallstones, bradycardia, cardiac conduction problems, hypothyroidism, hyperglycemia

Question 33

Which excess growth hormone drug blocks GH receptors?

Answer 33

Pegvisomant

Question 34

What does Pegvisomant treat?

Answer 34

Acromegaly; used in patients with inadequate response to surgery, radiation, or other therapies.

Question 35

What are the side effects of Pegvisomant?

Answer 35

Infection, pain, nausea, diarrhea, increased liver enzymes.