Endocrine

Question 1

finasteride

Answer 1

Propecia, Proscar

5-alpha reductase inhibitor

-NIOSH: do not handle if pregnant
-will not regrow hair, but can prevent additional loss
-when used for benign prostatic hyperplasia (BPH), not rapidly effective and may take 6+ months to shrink enlarged prostate and reduce symptoms; better if used in combo with alpha blocker (e.g. tadalafil) to reduct symptoms and prevent/delay need for surgical intervention
-can take with/without food

Question 2

isotretinoin

Answer 2

Accutane, Claravis, Zenatane

retinoid

-follow REMS system for dispensing and counseling
-teratogenic category X, major risks in pregnancy
-adverse lipid effects such as increased TG
-possible psychiatric effects such as increased suicidality
-acne may get worse before improving
-indicated for treatment of severe recalcitrant acne, retinoid derivative of vitamin A
-avoid alcohol, can lead to inflammation of liver
-avoid vitamin A supplements
-take with food; high-fat foods increase drug absorption

Question 3

testosterone

Answer 3

AndroGel

androgen

-use as directed on opper arm/shoulder (not genitals)
-women and children should avoid contact
-men with BPH may get worse
-indicated in treatment of hypogonadism, breast cancer in women, vasomotor symptoms of menopause

Question 4

metformin

Answer 4

Glucophage

biguanide antihyperglycemic

-may cuase GI upset and diarrhea
-best if titrated to minimize symptoms
-may lead to B12 deficiency related neuropathy
-usually used in conjunction with diet and exercise for glycemic control in type II diabetes mellitus
-used off-label for insulin resistance in polycystic ovary syndrom (PCOS)
-lowers blood glucose concentrations, insulin sensitizer and decreases insulin resistance
-can result in modest weight loss
-avoid alcohol, take with food to reduce irritation

Question 5

sitagliptin

Answer 5

Januvia

dipeptidyl peptidase-4 (DDP4) inhibtor antihyperglycemic

-take with or without food
-used in adjunct to diet and exercise to treat type II diabetes
-not used in treatment if pts have history of pancreatitis
-used in combination with metformin (Janumet)

Question 6

saxagliptin

Answer 6

Onglyza

dipeptidyl peptidase-4 (DDP4) inhibitor antihyperglycemic

-take without regard of food
-risk of pancreatitis
-if using together with any CYP3A4 inhibtors, use 2.5mg instead of 5mg every day
-indicated in treatment of type II diabetes mullitus to improve glycemic control
-used in combination with other agents or as monotherapy

Question 7

glimepiride

Answer 7

Amaryl

sulfonylurea antihyperglycemic

-take with breakfast or first meal of day
-avoid alcohol use
-indicated in treatment of type II diabetes mellitus as adjunct to diet and exercise to improve glycemic control
-may be used in combination with metformin or insulin where blood sugar levels do not respond to changes in diet/exercise

Question 8

glipizide

Answer 8

Glucotrol

sulfonylurea hypoglycemic

-avoid excessive/chronic alcohol consumption as risk of hypoglycemia increased with alcohol
-take 30-60 mins before breakfast
-indicated in treatment of type II diabetes to sensitize pancreatic beta cells and stimulate insulin release
-2nd gen sulfonylurea so it has enhanced hypolycemic potency
-rapid absorption, shortest half-life and duration of action compared to other sulonylureas
-often used in combination with metformin and as adjunct to diet and exercise

Question 9

glyburide

Answer 9

Micronase

sulfonylurea hypoglycemic

-take with breakfast
-avoid alcohol use, alcohol increases risk of hypoglycemia
-increased risk of hypoglycemia and weight gain due to active metabolite which is renally eliminated
-may increase risk of CV events
-indicated in treatment of non insulin dependent type II diabetes, usually when pts don’t respond to metformin