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Endocrine > Pharm: Focus Drug List MOA and AE: Cook > Flashcards

Pharm: Focus Drug List MOA and AE: Cook Flashcards

1
Q

Acarbose

A

a-glucosidase inhibitor:

  • -reduce intestinal disaccharide/starch absorption
  • -reduce post-eating glucose elevation
  • -not used alone

Use:
DM2

AE:
-Terrible gas…

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2
Q

Alendronate
Ibandronate
Risedronate
Zoledronic acid (Zonedronate)

A

Bisphosphonates:

  • non-hydrolyzable analog of pyrophosphate swallowed up by osteoclasts who die
  • inhibit bone resorption

Use:
Paget’s
Osteoporosis

AE:

  • Esophageal/GI ulcers (no food 30 min, sit upright)
  • Osteonecrosis of jaw
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3
Q

Breakdown of bisphosphonate potency?

A 
10-100x: 2nd gen
    Alendronate
    Ibandronate
1k-10k x: 3rd Gen
    Risendronate
    Zonendronate/Zolendronic Acid
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4
Q

Who do you give 3rd generation bisphosphonates to?

A

Cancer patients: Maybe 1 dose to stop bone resorption by mets. IV only!

  • Risendronate
  • Zonendronate
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5
Q 
Hydrocortisone
Prednisolone/Prednisone
Methylprednisolone
Betamethasone
Dexamethasone
A

Cortisol:

  • Bind GCRs to modify transcription of GREs
  • Inhibit: NFkB, AP-1, NFAT, Phospholipase A2
  • Decrease: TNFa, IL1, IL6; (PLP: decrease LT, PGs)

Use: Adrenal removal, inflammation, etc…

AE: 
WEAN OFF!!!!! due to pituitary atrophy
Osteoporosis
DM
Peptic ulcers
CNS: euphoria
Men: Hypogonadism (pit. decrease)
Women: Dyrhythmic cycles, bleeding
Kids: GH inhibition, IGF1 decrease, decrease growth
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6
Q

What is the potency of Hydrocortisone?

A

1x
Short acting
Cortisol equivolent
Oral/IV/IM

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7
Q

What is the potency of prednisolone/prednisone?

A

4x
Short acting
0.3Na–>swelling
Oral ONLY

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8
Q

What is the potency of methylprednisolone?

A

5x
Short acting
0.5 Na–>swelling
ALLERGIES?

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9
Q

What is the potency of betamethasone?

A

25-40x
Powerful
Oral/Topical

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10
Q

What is the potency of dexamethasone?

A

30x
All administrations
EYE disease

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11
Q

What class of glucocorticoids have mineralocorticoid action?

A

Short acting: prednisolone/methyl

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12
Q

Capergoline

Bromocriptine

A

Capergoline: D2 Dopamine agonist
Bromocriptine: poorly tolerated D2 agonist

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13
Q

Calcipotriol

A

PSORIASIS Vit D!

Vit D derivative for calcium regulation, stimulates Ca and Phos. absorption in GI

Used for psoriasis, hypoparathyroidism, osteoporosis.

More effective than glucocorticoids for psoriasis?

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14
Q

Calcitriol

A

Active 1,25 D3
Made in skin–>liver–>kidney

Vit D derivative for calcium regulation, stimulates Ca and Phos. absorption in GI

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15
Q

Calcium supplements

A

Increase calcium in hypocalcemia

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16
Q

Cetrorilix

Ganirelix

A

GnRH receptor antagonist:

-Block GnRH to delay LH surge and ovulation for in vitro ovulation.

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17
Q

Degarelix

A

GnRH receptor antagonist for prostate cancer LH reduction.

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18
Q

Menotropin

A

LH/FSH purification for infertility.

IM injection.

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19
Q

Octreotide

A

Somatostatin analog:

Block GH, Insulin, Glucagon

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20
Q

Goserelin

A

GnRH agonist for prostate cancer, give high dose to cause chemical castration and prevent T release.

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21
Q

Levothyroxine (synthroid)

A

L-T4.
Higher doses required in kids.
Can take weeks for steady state.
Monitor T3/T4 closely: narrow TI

22
Q

Liothyronine sodium

A

L-T3

Tablets or injection

23
Q

Propylthiouracil

Methimazole

A

Thyroid peroxidase inhibitor (oxidation, ionidation, coupling)

24
Q

PTU or Methimazole in pregnancy?

A

Ptu=Pregnancy

Methimazole crosses the placental barrier

25
Q

More potent, PTU or Methimazole?

A

Methimazole: 10x with longer t1/2

Will destroy fetal thyroid

26
Q

Peripheral thyronine 5’ deionidase, PTU or Methimazole?

A

PTU only: tissues cannot convert T4 to T3

27
Q

AE of PTU?

A

Rash

Agranulocytosis

28
Q

What imaging material can kill fetal thyroid?

A

Radioactive iodine contrast

29
Q

What two insulin have 1x daily injection?

A

Insulin glargine

Insulin demetir

30
Q

How are insulins made to have such a long half life?

A

isoelectric point increase (with zinc?)

31
Q

What is the structure of insulin glargine?

A

B21 asparagine to glycine and 2 asparagines added to Bchain C terminus

32
Q

What is the pH of insulin demetir?

A

Acidic solution is neutralized, forming a precipitate

33
Q

Glucagon

A

Alpha cells secrete
Opposite of insulin
Elevated in fasting
Used for hypoglycemia rarely, usually just use glucose solution

34
Q

Glyburide

A

Sulfonylurea: Block K/ATP channel, causing beta cell depolarization and Ca influx, leading to Insulin release.

DM2

AE: Liver toxicity, hepatitis, hypoglycemia

35
Q

Repaglinide

Nateglinide

A

Meglitinides: ATP/K channel, like sulfonylureas.
Benzoic acid derivative.

Taken before meal to control BG after absorption.

AE: Hypoglycemia

36
Q

Metformin (+glyburide)

A

Decrease PEPCK and PC in liver, decreasing glucose production.

Stimulate Insulin sensitivity

DM2

AE: lactic acidosis

37
Q

Fludrocortisone

A

Aldosterone synthetic

38
Q

Pioglitazone

A

Thiazolidinedioines:
PPARy to increase GLUT4 activity
Major drug for increasing insulin sensitivity

39
Q

What pancreatic tumor is octreotide used for ?

A

Glucagonoma
Insulinoma
GH release too!

40
Q

Exanitide

A

GLP-1 receptor agonist: decrease post prandial glucose

  1. Make you feel full
  2. Inhibit glycogen breakdown in liver
  3. increase insulin secretion for digestion
  4. Slows gastric emptying
  5. decrease glucagon secretion
41
Q

Teriperidide

A

Pulsatile PTH stimulates bone formation due to PTH–>osteoblasts action without making RANKL.

May stimulate IGF-1.

Important for women post bisphosphonate tx.

42
Q

Raloxifen

A

SERM: Selective Estrogen Receptor Modulator
Inhibit osteoclasts
Prevent breast cancer

Osteoporosis approved

43
Q

Desunomab

A 
RANKL mAb. 
Blocks osteoclast activtion
Prevent bone resorption.
Increase bone mass in cancer patients
Biannual dose administration
44
Q

Cincalcinet

A

Ca Sensing Receptor allosteric binding, allows PTH suppression at lower blood Ca levels.

Lowers PTH.

HyperPTH and PTadenoma Tx

45
Q

Fluoride

A

Prevent cavities
Mottles enamel, prevents decay.
Binds to Ca, can prevent clotting.

Toxicity: Osteosclerosis

46
Q

Cosyntropin: Synthetic ACTH

A

aa1-24

Prefered to natural due to decreased ADH/AVP content (impurity in animal ACTH)

47
Q

Cholesevalam

A

Bile acid sequestrate

Prevent bile (cholesterol) cycling

48
Q

Semilenthe insulin

A

Short acting

12 hour insulin

49
Q

Sitagliptin

A

Dipeptidyl peptidase 4 inhibitor:

prevents the degradation of incretin (GLP-1) hormones by DP4, allowing GLP-1 to act to increase insulin release

50
Q

Somatropin

A

Generic hGH

51
Q

Menotropin

A

Menopause FSH/LH purificaiton from urine of old lady used for in vitro ovulatio control

52
Q

Ganirelix

A

GnRH receptor antagonist used for in vitro fertilization delay of LH surge and ovulation

Endocrine (15 decks)

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