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Pharm Part II > E2: Endocrine Pt 3: BONE drugs, Pituitary, Vit D > Flashcards

E2: Endocrine Pt 3: BONE drugs, Pituitary, Vit D Flashcards

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1
Q

SERMS – raloxifene (Evista)…Activates _______ receptors in _____…Where does it NOT activate these receptors? How is that helpful?

A

estrogen…bone…does not activate in breast, less risk of cancer!

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2
Q

EVISTA is the only medicine proven to reduce both the risk of spinal fractures due to osteoporosis and the risk of invasive breast cancer in postmenopausal women with osteoporosis.

A

SERMS-raloxifene-EVISTA

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3
Q

SERMS, Ral-ox-ifine (Evista) Summary of effects: has ______ action on bone, there is an Absence of ______ bleeding, Absence of endometrial and ______ stimulation…Most common SIDE EFFECTS: _______ and Leg cramps

A

Anti-resorptive.. vaginal.. breast… Hot flashes

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4
Q

WHAT IS THE BEST AVAILABLE BONE BUILDING DRUG?

A

Bisphosohonate!

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5
Q

Bisphos Mech of Action: Increases _______ …Inhibits _______ activity

A

bone mineral density…. osteoclastic

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6
Q

Bisphos Mech of Action: inhibits bone ________….Inhibits formation, growth and dissolution of bone ________ crystals

A

resorption… hydroxyapatite

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7
Q

What do all the Bisphosphonates end in?

A

“-DRONATE”

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8
Q

What are the three Oral Bisphosphanates?

A

1.Alen-dronate (Fosamax) 2.Rise-dronate (Actonel 3.Iban-Dronate (Boniva)

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9
Q

What is the IV Bisphosphonate that is used BOTH for Tx AND Prevention of bone pathology…What is a DENTAL (rare) side effect?

A

ZOL-E-DRONIC ACID (zometa)….Osteonecrosis of the Jaw

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10
Q

Bisphosphonates have a poor ________, so take on empty stomach Water only (everything else decreases absorption by >___%) Remain upright for at least ___ minutes…No eating for at least ___ minutes

A

bioavailability…..60%!…30 minutes (both)!!

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11
Q

Bisphosphonates: 3 common side effects…

A

1.Erosive Esophagitis 2.Headache 3.GI distress

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12
Q

What is usually the indication for Bisphosphonates when Osteonecrosis of the Jaw occurs?

A

Cancers that have metastasized to bone (breast, prostate)

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13
Q

Pretty interesting: what is the normal half life of Bisphoshonates?

A

10 years! (so will probably be with you for 40+ years!

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14
Q

Most cases of jaw osteonecrosis are in patients undergoing chemotherapy with IV Bisphosphonates who also received _______; possible other risk factors

A

steroids

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15
Q

What are the 3 IV Bisphosphonates?

A

1.Pam-i-dronate (Aredia) 2.Zole-dronic Acid (Zometa) 3.Til-u-dronate (Skelid)

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16
Q

Hormones are produced by ______ glands and are transported by ______ to target cells

A

ductless….body fluids

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17
Q

What are the 4 therapeutic uses of Hormones?

A
  1. Replace 2.Diagnose 3.Stimulate 4.Inhibit
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18
Q

What are the 5 Hypothalamic Releasing Hormones? (just abbreviations will do…) ALSO, what is the ONLY one used as a drug?

A

1.GnRH 2.TRH 3.CRH 4.GHRH 5.SRIF…GnRH is the only one used as a drug

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19
Q

GnRH is the only Hypolathamic Releasing Hormone used as drug…it is used as a synthetic ______ (which has GREATER receptor affinity!)

A

analog

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20
Q

What is the INDICATION for the use of GnRH as a drug in women?

A

Ovulation induction in women with Primary Hypothalamic Amenorrhea (Fertility drug!)

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21
Q

The GnRH drug _______ is used as an OVULATORY stimulant.

A

CLOM-i-phene (CLOMid)

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22
Q

The GnRH drug CLOM-i-phene (CLOMid) Stimulates the release of pituitary ________ and _______.

A

luteinizing hormone (LH)….follicle stimulating hormone (FSH)

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23
Q

CLOM-i-phene (CLOMid) Action is at “______” (testes, ovaries) to induce gametogenesis and gonadal hormone production

A

“end organs”

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24
Q

What is the INDICATION for the use of GnRH as a drug in men?

A

to Tx idiopthic Hypogonadotropic Hypogonadism for achieving more Spermatogenesis

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25
Which Anterior Pituitary Hormone is used to diagnose apparent adrenal dysfunction?
ACTH
26
What hormone is an ALTERNATIVE to CorticoSteroids in inflammatory conditions???
ACTH (huh! never heard of that!)
27
ACTH Stimulates release of _________ from adrenal glands and therefore ________ feedback to shut down ACTH output from pituitary
glucocorticoids... Cortisone
28
What is the MOST ABUNDANT hormone in the Anterior Pituitary?
Growth Hormone
29
Which hormone?? Stimulates growth of epiphysis and all cells in organs and tissues
Growth Hormone :)
30
Since therapeutic GH was found to have prions disease from cadavers, where does it come from now?
Recombinant DNA techniques
31
Growth Hormone is officially used to Tx _______
dwarfism
32
HOLY A-ROD BAtman! Steroids cost more than $______ per year!!!
$20,000
33
TSH used as a diagnostic tool to differentiate between _____ and _____ hypothyroidism
pituitary and primary hypothyroidism
34
Promotes development of ovarian follicles and maintains spermatogenesis
Follicle Stimulating Hormone
35
FSH Deficiency in males causes _______; in females, causes _______ abnormalities
sterility... menstrual
36
Induces ovulation and regulates progesterone secretion in women, testosterone secretion in men
Luteinizing Hormone
37
What do FSH and LH have in common as it pertains to administration and type of molecule they are?
they are both glycoproteins and administered IM
38
Which hormone Induces ovulation in 90% of women...More than one follicle may develop and ovulate (TW-TW-TWINS in 20% of pregnant women)
Human Menopausal Gonadotropin (HMG)
39
Which hormone is secreted by fetal placenta as early as day 7...Detected in PREGNANCY TEST (diagnostic use) Used to INDUCE ovulation and pregnancy...MALES Used to stimulate interstitial cells of TESTES to secrete androgen; cryptorchidism...Given by IM
Human Chorionic GonadoTropin (HCG)
40
What are the 2 hormones of the POSTERIOR PITUITARY?
P.P.O.V...Oxytosin..and..Vasopressin (ADH)
41
Vasoconstrictor and antidiuretic hormone; used for replacement in diabetes insipidus
Vasopressin
42
Vasopressin: Vasoconstrictor and antidiuretic hormone; used for replacement in diabetes _______
INSIPIDUS
43
Contracts uterine smooth muscle at term...Induction of labor....Control postpartum bleeding or hemorrhage
OXYTOSIN
44
Saaaay WHaaaat? the posterior pituitary hormones are very similar to each other..._______ slight antidiuretic function and High levels of _______ can trigger uterine contractions..COOOL!
oxytosin.... vasopressin
45
Increases plasma calcium and maintains at ___ mg%.. Increases calcium mobilization from bone to plasma...Increases calcium reabsorption in renal tubules
Parathyroid hormone...10%
46
What is the HORMONAL form of Vitamin D?
CalCiTriOL
47
Calcitriol is produced by the ______ in response to stimulation by the _______ hormone
kidneys... parathyroid
48
Calcitriol increases ______ absorption from the intestine
calcium
49
_______ limits calcium excretion when blood calcium levels are low
Calcitriol
50
thyrocalcitonin (calcitonin)....Synthesized in the ________ and it REVERSES the action of _______ hormone
hyroid gland....parathyroid
51
Which hormone decreases plasma calcium and phosphate levels??
Thyrocalcitonin (calcitonin)
52
Calcitonin is a ______ regulator of blood calcium compared to the actions of PTH and calcitriol
MINOR
53
Calcitonin is used in medicine to treat ________
hypercalcemia
54
Formed in the skin when a cholesterol precursor, 7-dehydroxycholesterol, is exposed to ultraviolet light...Primary action of _______ = promote gut absorption of calcium by stimulating formation of calcium-binding protein within the intestinal epithelial cells
Vitamin D3-Cholecalciferol
55
Which hormone?? In bone, synergistic role with parathyroid hormone (PTH) = stimulates osteoclast proliferation and bone resorption
Vitamin D3 (cholecalciferol)
56
Compared to __________, vitamin D exerts a much slower regulatory effect on calcium balance
parathyroid hormone (PTH)
57
Look at all these benefits! increases bone mass, decreases fracture rates, decreases PTH which decreases resorption, potentially increases bone formation...SOOO which hormone?
Vitamin D! dawg!
58
What is the preparation of Vitamin D?
Ergo-calciferol
59
Vitamin D and systemic diseases: with low Vit D there is a higher risk for these 3 cancers:
1.Prostate 2.Breast 3.Ovarian
60
Vitamin D and systemic diseases: low sun exposure = increased ________ whaaaaa?
Type I diabetes
61
Ok this is just random: Vitamin D and systemic diseases: hypertension increases with distance away from _______
equator
62
Vitamin D and systemic diseases: ________ (pre-vitamin D) = protective
calcitriol
63
What should my Vit D level be greater than per day?

Pharm Part II (28 decks)

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