Exam 2: Endocrine Pharmacology pt. 2

Question 1

What is the most popular oral drug for type 2 diabetes

Answer 1

Metformin (Glucophage)
    - class of Biguanides

Question 2

Benefits of Metformin

Answer 2

1. More effective than other agents
2. Reduces all-cause and cardiovascular mortality
3. Reduces rates of cancer in pts with Type 2 Diabetes.

-*there are more but these are bolded

Question 3

Risks of Metformin

Answer 3

1. Lactic acidosis if renal impairment
   
   • avoid alcohol
2. Gastrointestinal side effects

Question 4

Mechanism of action for Alpha-glucosidase Inhibitors

Answer 4

Inhibits the enzyme (alpha-glucosidase) responsible for degrading complex carbohydrates in gut
- thus no monosaccharides are made available for absorption after a meal.

Question 5

When taking Alpha-Glucosidase inhibitors, what occurs after a meal?

Answer 5

There is a delay in blood glucose concentrations after a meal when taking these drugs

Question 6

Mechanism of Action for Thiazolidinediones

Answer 6

Lower blood glucose by improving target cell response to insulin without increasing pancreatic insulin secretion
- reset insulin receptors = reduces insulin resistance

Question 7

Activity of Thiazolidinediones depends on what?

Answer 7

Depends on the presence of insulin for activity

Question 8

Name the Thiazolidinedione drugs

Answer 8

pioglitazone (Actos)

rosiglitazone (Avandia)

Question 9

Which Thiazolidinedione has been associated with liver failure

Answer 9

rosiglitazone (Avandia)

• associated with > 30 deaths due to liver failure
• also increased risk for heart failure

Question 10

Name the Incretins

Answer 10

GLP-1 receptor agonists (glucagon like peptide)

DPP-4 Inhibitors

Question 11

Action of GLP-1 receptor agonists

Answer 11

Boost insulin production by pancreas

Slow absorption of food

Question 12

Action of DPP-4 Inhibitors

Answer 12

Blocks the enzyme dipeptidyl peptidase-4 that breaks down GLP-1 peptide in gut

Question 13

What are the concerns with Incretin drugs

Answer 13

New concerns that these drugs cause inflammation and possible pre-cancerous changes of pancreas

Question 14

What is the primary intervention to lower glucose in diabetics?

Answer 14

Obesity management

Question 15

What is Estradiol

Answer 15

a steroid, natural estrogen

- Produced and secreted by the ovary

Question 16

Name the Estrogen Replacement Drugs

Answer 16

• Conjugated equine estrogens (Premarin)
• Esterified estrogens (Estratab, Menest)
• Estradiol preps (many names…)

Question 17

Conjugated equine estrogens are effective in what treatment?

Answer 17

In treatment of vasomotor symptoms of menopause

- May also be beneficial to prevent bone loss with osteoporosis (only while on drug)

Question 18

Describe the serious side effect with Premarin and in women with an intact uterus:

Answer 18

• Increased risk for endometrial cancer

- May also increase risk for breast cancer if taken after menopause

Question 19

What is the drug name of Estrogen with Progesterone?

Answer 19

Prempro

also Premarin + Provera

Question 20

Benefits of Prempro?

Answer 20

Adding progesterone to the estrogen preparation reduces risk for endometrial cancer

Question 21

Prempro usage may increase risk for what things?

Answer 21

1. Heart disease
2. Stroke
3. Pulmonary embolism
4. Invasive breast cancer

** May outweigh long term use to prevent osteoporosis

Question 22

What are the guidelines for HRT use today:

Answer 22

Short term use only
- less than 5 years
Used to treat symptoms of menopause

Question 23

Natural progesterone is produced and secreted by what body part?

Answer 23

corpus luteum

Question 24

Physiological action of natural progesterone

Answer 24

induces a secretory endometrium

- Affects uterine mobility and cervical mucous

Question 25

Progesterone replacement drugs are generally used for what?

Answer 25

1. Treatment of menstrual disorders 2. Prevention of habitual abortion 3. Treatment of endometriosis 4. Contraception

Question 26

What does it mean that testosterone is used as a male climacteric?

Answer 26

When testosterone slowly decreases as well as sexual function during fourth or fifth decades, men may exhibit "menopausal" symptoms and can be treated with testosterone.

Question 27

What is Hypogonadism

Answer 27

Clinical syndrome which comprises both symptoms and biochemical evidence of T deficiency

Question 28

Evidence suggests that testosterone levels are associated with what things

Answer 28

1. linked to general health of male population | 2. Biomarker for presence of occult diseases (cancer, early death, atherosclerosis)

Question 29

Is testosterone therapy beneficial for women?

Answer 29

Only if women are postmenopausal with hypoactive sexual desire disorder.

Question 30

T or F, There are NO FDA approved testosterone products for women

Answer 30

True

Question 31

Anabolic steroids can increase muscle mass how much?

Answer 31

by 30%