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Endocrine/Reproductive Flashcards

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0
Q

Octreotide

A

Somatostatin analog
Tx: acromegaly, Upper GI bleeding (varices), hyperinsulinism
Side Effects: Injection site reaction, gallbladder sludge, n/v, glucose intolerance, carcinoid tumors (diarrhea)
IM

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1
Q

Somatropin

A 
Recombinant human GH
Tx: GH deficiency, short stature
C/I: Active malignancy, ICU pts
Side Effects: ICP, SCFE, scoliosis, DM, soft tissue deposition
SQ daily
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2
Q

Pegvisomant

A

Pegylated recombinant GH (GHR antagonist)
Tx: acromegaly
Adverse Fx: Local reaction, hepatitis, tumor growth
SQ
Cross-reacts with GH; use IGF-1 to monitor effects

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3
Q

Bromocriptine

A

Prototype Dopamine agonist
Tx: hyperprolactinemia
Adverse Effects: n/v, orthostasis (with first dose), blunts antipsychotics
PO daily

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4
Q

Cabergoline

A

Dopamine agonist
Tx: hyperprolactinemia, acromegaly (mixed adenomas)
Higher affinity with longer-half life than bromocriptine
PO weekly
Fewer adverse effects than bromocriptine
High doses (for Parkinson’s) linked to valvular disease

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5
Q

hCG

A

Dx pregnancy
Tumor marker for germ cell tumors
Tx: Stimulate ovulation in fertility treatment and IVF, cryptorchidism

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6
Q

FSH

A

Dx: Precocious puberty or delayed puberty
Tx: Follicle/sperm stimulation in fertility treatment and IVF
Adverse Effects: Multiple gestations, OHSS

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7
Q

Leuprolide

A

GnRH agonist
Tx: Central precocious puberty, hormone-dependent cancers, endometrious/uterine fibroids, and fertility treatment (short-term therapy)
IM

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8
Q

ACTH

A

Tx: infantile spasms

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9
Q

Cosyntropin

A

ACTH fragment
Screen for adrenal insufficiency
IM or IV push

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10
Q

Dexamethasone

A

Potent, long-acting glucocorticoid with no mineralocorticoid activity
Hormone replacement therapy
Tx: stress, inflammation and cerebral edema, chemo adjunct, immunosuppression

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11
Q

Fludrocortisone

A

Potent mineralocorticoid

Hormone replacement therapy

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12
Q

Fluticasone

A

Potent glucocorticoid
Tx: asthma, allergic rhinitis
Inhalant/nasal spray (limit systemic side effects)

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13
Q

Hydrocortisone

A

Short-acting glucocorticoid (mineralocorticoid at higher doses)
Hormone replacement
Tx: inflammation
Topical prep available

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14
Q

Methylprednisolone

A

Intermediate-acting glucocorticoid
Hormone replacement therapy
Tx: inflammation

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15
Q

Prednisone

A 
Intermediate-acting glucocorticoid
Requires liver metabolism into active prednisolone 
Hormone replacement therapy
Tx: inflammation
Used with pregnancy
PO
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16
Q

Prednisolone

A

Intermediate-acting glucocorticoid
Tx: inflammation
Used instead of prednisone with hepatic failure

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17
Q

Triamcinolone

A

Potent, intermediate-acting glucocorticoid (no MR activity)
Tx: asthma, inflammation, psoriasis
PO, IM, topical

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18
Q

Spironolactone

A

MR antagonist
Tx: HTN and CHF
Weak androgen receptor antagonist
Tx: hirsutism

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19
Q

Glyburide

A

Sulfonylurea
Inhibit ATP sensitive K channel (enhances physiological response)
C/I: sulfa allergy, hepatic disease, low GFR
Adverse Effects: hypoglycemia (esp. in elderly), weight gain
1-2 times daily PO, cheap

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19
Q

Glipizide

A

Sulfonylurea
Inhibit ATP sensitive K channel (enhances physiological response)
C/I: sulfa allergy, hepatic disease, low GFR
Adverse Effects: hypoglycemia (esp. in elderly), weight gain
1-2 times daily PO, cheap

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20
Q

Glimepiride

A

Sulfonylurea
Inhibit ATP sensitive K channel (enhances physiological response)
C/I: sulfa allergy, hepatic disease, low GFR
Adverse Effects: hypoglycemia (esp. in elderly), weight gain
1-2 times daily PO, cheap

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21
Q

Repaglinide

A

Meglitinide
Inhibit ATP-sensitive K channel
Most active post-prandially (skip a meal, skip dose)
C/I: hepatic or renal dysfunction, increases cipro and clarithromycin concentration
Side Effects: Hypoglycemia (less than SUs), weight gain

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22
Q

Metformin

A

Biguanide
Improves insulin sensitivity in liver
C/I: renal or liver dysfunction (risk of lactic acidosis)
Side Effects: B12 deficiency, GI effects (titrate dose up)
No hypoglycemia or weight loss
1st line for T2DM
1-3x daily

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23
Pioglitazone
Thiazolidinediones (TZDs) Activates PPARgamma - Regulates FA metabolism and improve insulin sensitivity Long time (weeks to months) for maximum response C/I: CHF/edema, hepatic disease, retinopathy, drug interactions (phenyotin, warfarin and amiodarone) Side Effects: hepatotoxic, weight gain, edema, increase CV risk 1-2x daily
24
Acarbose
``` Alpha-glucosidase inhibitor Reduce carbohydrate absorbtion Taken with meals Variable response GI side effects ```
25
Sitagliptin
DPPIV Inhibitor Increases endogenous incretin levels C/I: acute pancreatitis, heart failure, renal dysfunction Side Effects: Hypersensitivity (angioedema and urticaria), nasopharyngitis Daily dosage, costly
26
Saxagliptin
DPPIV Inhibitor Increases endogenous incretin levels C/I: acute pancreatitis, heart failure, renal dysfunction Side Effects: Hypersensitivity (angioedema and urticaria), nasopharyngitis Daily dosage, costly
27
Canagliflozin
SGLT-2 Inhibitor Lowers renal glucose reabsorption - osmotic diuresis C/I: renal dysfunction, elderly, diuretics, hypovolemia, bladder cancer Side Effects: GU infection, polyuria, volume depletion, LDL increase Improves blood pressure Daily dosing, costly
28
Liraglutide
GLP-1 analog Stimulates insulin release;decreases gastric emptying; suppress appetite C/I: acute pancreatitis, medullary thyroid cancer Side Effects: GI, tachycardia, acute pancreatitis
29
Exenatide
GLP-1 analog Stimulates insulin release;decreases gastric emptying; suppress appetite C/I: acute pancreatitis, medullary thyroid cancer, GFR < 30 Side Effects: GI, tachycardia, acute pancreatitis
30
Pramlintide
Amylin agonist Decreases glucagon secretion; slows gastric emptying; satiety Frequent injections (before meals)
31
Lispro
Rapid-acting bolus insulin - post-prandial hyperglycemia PK suited to carbohydrate absorption Costly
32
Aspart
Rapid-acting bolus insulin - post-prandial hyperglycemia PK suited to carbohydrate absorption Costly
33
Glulisine
Rapid-acting bolus insulin - post-prandial hyperglycemia PK suited to carbohydrate absorption Costly
34
Insulin
Short-acting bolus insulin Low immunogenicity, cheap Must taken 30 minutes before meal; PK don't overlap w/ CHO absorb. Delayed post-prandial hyperglycemia
35
NPH
Intermediate acting, basal insulin | Inexpensive; can be mixed with bolus insulin
36
Mixed insulin (70 aspart protamine suspension/30 aspart; 70 NPH/30 insulin)
Twice daily at breakfast and dinner | Mimic physiologic insulin
37
Glargline
Long-acting basal insulin Once daily dose; ~ body's basal secretion Less hypoglycemia More costly; Cannot be mixed Acidic - forms microprecipitates --> slow release Acidity causes injection site irritation
38
Determir
``` Long-acting basal insulin Once daily dose; ~ body's basal secretion Albumin-bound --> slow release Less hypoglycemia More costly Cannot be mixed ```
39
Iodine
Blocks thyroid hormone release (Wolff-Chaikoff effect) and decreases gland vascularity Tx thyroid storm (MUST give thionamide first)
40
Methimazole
Thionamide - TPO inhibitor; does not inhibit deiodinase 1st line tx for hyperthyroidism Teratogenic during 1st trimester Side Effects: Rash, LFTs, lupus-like syndrome, agranulocytosis Once daily dosing
41
Propylthiouracil (PTU)
Thionamide - TPO inhibitor; Type I 5'-deiodinase inhibitor 2nd line tx for hyperthyroidism Drug of choice in pregnancy - doesn't penetrate placenta Hepatotoxic Side Effects: Rash, LFTs, lupus-like syndrome, agranulocytosis Twice daily dosing
42
Radioactive Sodium Iodide
Ablates thyroid gland C/I: children and pregnant women Few side effects - doesn't concentrate in other parts of body Requires lifetime thyroid hormone replacement therapy
43
Levothyroxine
T4 hormone replacement | 7 day half-life - Takes 6-8 weeks for steady state concentration
44
Liothyronine
T3 7 hour half-life 4x more potent than T4 Side effects: tachycardia and jitteriness (due to rapid onset)
45
Beta blockers
Tx symptoms of hyperthyroidism Atenolol has advantages of single-day dosing Propanolol can also inhibit Type I 5'-deiodinase (SLOW effect; contributes little)
46
Thyrotropin Alfa
Recombinant TSH Monitor recurrence of thyroid cancer - "reveals" thyroid cells Increases radioablation efficacy - stimulates thyroid uptake of I
47
Dessicated Procine Thyroid Extract
"Natural" thyroid hormone derived from dsesicated porcine thyroid glands
48
Thryolar
Synthetitc combination of T4 and T3
49
Lithium
Tx hyperthyroidism; MOA unknown | In vitro, decreases colloid droplet formation within thyroid cells - decreased pinocytosis and proteolytic digestion
50
Dexamethasone
Anti-inflammatory Blocks T4 to T3 conversion Tx: thyroid storm
51
Abiraterone
17alpha-hydroxylase inhibitor Decreases androgen (adrenal and gonadal) production Tx castration-resistant prostrate cancer Used in combination with glucocorticoid (inhibits production) Pregnant women and children should avoid
52
Degarelix
GnRH receptor antagonist Suppresses gonadotropin release; immediate action Tx prostate cancer
53
Danazol
Weak synthetic androgen Suppresses FSH/LH release Tx endometriosis and fibrocystic breast disease
54
Finasteride
5alpha-reductase inhibitor; Type II (urogenital tract) Prevents conversion of T to DHT Tx BPH and androgenic alopecia (some Type I inhibition) Larger dose for BPH; often in combo with alpha-1 adrenergic blockers Avoid in pregnant women (danger to male fetus)
55
Dutasteride
5alpha reductase inhibitor (both type) Tx BPH and androgenic alopecia Avoid contact with pregnant women
56
Bicalutamide
Androgen receptor antagonist No cross-specificity Treat prostate cancer Does not inhibit HPA (used in conjunction with leuprolide) Receptor eventually develops acquired resistance --> agonist effects
57
Fluoxymestrone
``` Potent synthetic androgen HRT for hypogonadism in males 17alpha-alkylated (slow metabolism, PO) Liver toxicity Reduced estrogenic activity; not a good substrate for aromatase ```
58
Methyltestosterone
Synthetic androgen HRT for hypogonadism in males 17-alkylated (slow metabolism; PO) Liver toxicity, edema, virilization, gynecomstic, polycythemia, prostate
59
Nandrolone
Synthetic androgen | Anabolic steroid abused by athletes
60
Testosterone and ester derivatives
HRT for hypogonadism and delayed puberty in males Transdermal patch, gel and buccal capsule for T Esters delivered by IM injection (slowly absorbed, more sustained)
61
Estradiol and esterifid/conjugated derivatives
HRT in women Tx abnormal uterine bleeding, and atrophic vaginitis Also used in OCP
62
Drospirenone
Synthetic progestin Spironolactone derivative (can lower BP) Used in OCP
63
Hydroxyprogesterone caproate
Synthetic progesterone | Tx amenorrhea, metorrhagic and induction of secretory endometrium
64
Norethindrone
Synthetic potent progestin | HRt, amenorrhea and OCP
65
Norgestrel and Norgestimate
3rd generation progestins | OCP, emergency contraception
66
Medroxyprogesterone acetate (MPA)
Synthetic progestin HRT, endometrial hyperplasia, prostate cancer and sex offenders Progestin-only OCp
67
Progesterone
HRT, amennorrhea
68
Estradiol/Norethindrone
Combination of E and P for HRT in postmenopausal women
69
Estrogen/Medroxyprogesterone
E and P combo | HRT
70
Estrogen/Methyltestosterone
Estrogen and T | HRT in postmenopausal women
71
Tamoxifen
SERM Mixed function estrogen receptor agonist/antagonist Tx breast cancer (chemotherapy and chemoprevention) Thromoboembolic risk Stimulates GU growth Doesn't prevent hot flashes
72
Raloxifene
SERM Primary indication in osteoporosis prevention and PM HRT Chemoprevention in breast cancer
73
Clomiphene
Anti-estrogen Induce ovulation in female infertility Stimulates gonadotropin release in male infertility
74
Mifepristone
Anti-progestin Abortion pill Must be used in combination with misoprostol
75
Fulvestrant
Anti-estrogen | Tx breast cancer in PM women
76
Anastrozole
Aromatase inhibitor Tx locally advanced or metastatic breast cancer (postmenopausal only) Can cause joint pain

Pharm (6 decks)

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