Exam 5 Flashcards
(30 cards)
Levothyroxine
Liothyronine
Liotrix
Triiodothyronine
Hypothyroid drugs
M: activation of T3 receptors
C: hypothyroidism, myxedema
T: tachycardia, heat intolerance, tremors arrhythmias. insomnia, a fib and osteoporosis in geriatric population.
Methimazole
Propylthiouracil
Hyperthyroid drugs
M: block thyroid peroxidase, inhibiting the oxidation of iodide and the organification of iodine > inhibition of thyroid hormone synthesis. Propylthiouracil also blocks 5’-deiodinase, which decreases peripheral conversion of T4 to T3.
C: hyperthyroidsism. PTU blocks Perpheral conversion (and more protein bound) so used in Pregnancy
T: skin rash, agranulocytosis, aplastic anemia, hepatotoxicity (PTU). Methimazole-altered taste/smell. do not use in pregnancy.
ethinyl estradiol
mestranol
dethylstilbestrol (DES)
first two steroidal synthetic, DES non-steroidal synthetic
M: bind estrogen receptors
C: hypogonadism or ovarian failure, menstrual abnormalities, HRT in postmenopausal women, use in men with androgen dependent prostate cancer.
T: increase risk of endometrial cancer, bleeding in postmenopausal women, clear cell adenocarcinoma of vagina in females exposed to DES in utero, increase risk of thrombi. contraindicated in ER + breast cancer, history of DVTs
medroxyprogesterone (MPA)
norethindrone
norgestrel
Progestins
MPA=depo-provera shot
M: bind progesterone receptors, decrease growth and increase vascularization of endometrium.
C: used in oral contraceptives and in the treatment of endometrial cancer and abnormal uterine bleeding.
T: breakthrough bleeding, impaired glucose tolerance, changes in lipid metabolism. 19-nor can cause acne and hirsutism
nor=19 nor testosterone derivative
Clomiphene
M: partial agonist of estrogen receptors in hypothalamus. prevents normal feedback inhibition and increase release of LH and FSH from pituitary, which stimulates ovulation.
C: usted to treat infertility due to lack of ovulation
T: may cause hot flashes, ovarian enlargement, multiple simultaneous pregnancies, and visual disturbances.
Tomoxifen
Selective estrogen receptor modulators
M: agonist to bone, partial agonist to endometrium, antagonist to breast/HPG axis
C: ER + breast CA
T: hot flashes, endometrial CA, nausea, vomiting, thromboembolic events
Raloxifene
Selective estrogen receptor modulators
M: agonist to bone, antagonist to breast/uterus/HPG axis
C: CA, post menopausal osteoporosis
T:hot flashes, nausea, vomiting, thromboembolic events
danazol
M: synthetic androgen that acts as partial agonist at androgen receptors
C: endometriosis, breast fibrocystic disease, and hereditary angioedema
T: weight gain, edema, acne, hirsutism, masculinization, decrease HDL, hepatotoxicity
anastrozole
letrozole
exemestane
M: aromatase inhibitors
C: postmenopausal women with breast cancer
T: go disturbances, hot flashes, lethargy
Mifepristone (RU486)
Ulipristal
M: competitive inhibitor of progestins at progesterone receptors leading to uterine contractions and shedding of uterus lining
C: termination of pregnancy (less than 7 weeks), administered with misoprostol (PGE1)
T: heavy bleeding, GI effects, abdominal pain
Lispro
Aspart
Glulisine
Rapid-acting insulin
M: duration of 3-5 hrs
C: DM1, DM2, GDM postprandial glucose control
T: hypoglycemia, rare hypersensitivity rxns
regular insulin
M: bind insulin receptor, increase liver glucose stored as glycogen, increase glycogen and protein synthesis in muscles, increase K+ uptake, and increase TG storage in adipose tissue. duration 4-12 hours
C: DM1, DM2, GDM, DKA (IV), hyperkalemia (+glucose), stress hyperglycemia
NPH
M: duration 10-20 hours
C: DM1, DM2, GDM
Glargine
Detemir
M: duration 12-20 for G, 22-24 for D
C: DM1, DM2, GDM (basal glucose control)
Metformin
Biguanides
M: unknown, causes increase in peripheral glucose utilization and decrease in hepatic glucose output (increase glycolysis, decrease gluconeogenesis)
C: 1st line agent in type 2 DM, does not produce hypoglycemia, and can be used in patients without islet function
T: GI upset, lactic acidosis (do not use in renal failure), B12 deficiency in long term use.
Tolbutamide Chlorpropamide Glyburide Glimepiride Glipizide
Sulfonylureas
M: close K+ channel in Beta-cell membrane, so cell depolarizes triggering insulin release via Ca influx
C: stimulate release of endogenous insulin in DM2, require some islet function so useless in DM1
T: hypoglycemia (especially in renal failure), weight gain.
Tol and Chl are first generation, can have disulfiram like effects (ETOH)
Acarbose
Miglitol
glucosidase inhibitors
M: inhibit intestinal brush border alpha glucosidases. delayed sugar hydrolysis and glucose absorption. decrease postprandial hyperglycemia.
C: used as mono therapy in DM2 or in combo with other agents
T: GI disturbances, contraindicated for patients with GI diseases
Pioglitazone
Rosiglitazone
Thiazolidinediones
M: increase insulin sensitivity in peripheral tissue by activating PPAR gamma nuclear transcription regulator.
C: used as mono therapy in DM2 or combo therapy.
T: hepatotoxicity, heart failure, weight gain, edema, bone fractures
Pramlintide
M: amylin analog, decrease gastric emptying, decrease glucagon. must be injected
C: DM1, DM2
T: hypoglycemia, nausea, diarrhea, delayed drug absorption
Exenatide
Liraglutide
M: GLP-1 analogs. increase insulin, decrease glucagon release. inhibit gastric emptying. must be injected
C: DM2
T: pancreatitis, nausea, vomiting. diarrhea, hypoglycemia
Linagliptin
Sitagliptin
Saxagliptin
M: DPP-4 inhibitors. inhibit incretin degradation, increase insulin, decrease glucagon release. oral drug.
C: DM2
T: respiratory and urinary infections, pancreatitis, HA
Benzoyl Peroxide
M: causes release of oxygen species from neutrophils
C: tx acne. does not lead to resistances; combo with erythromycin and clindamycin
Tretinoin Adapalene Tazaroten Alitretinoin Isotretinoin Bexarotene Acitretin
Retinoids
M: bind RAR and effect gene transcription. useful in many skin conditions by promoting desquamation, collagen synthesis, loosen corneocytes, reduce follicular obstruction, ect.
C: acne, psoriasis, skin aging, skin cancer.
Tretinoin: photochemically unstable, do not use with benzoyl peroxide
Adapalene: tx acne
Tazaroten: psoriasis and mild to mod. acne. teratogen.
alitretinoin: aids related Kaposi’s sarcoma
Isotretinoin: significant teratogen
Bexarotene: cutaneous T-cell lymphoma
Acitretin: psoriasis, severe teratogen. do not combine with ETOH
T: in general, photosensitivity and skin irritancy
Calcipotriene
Vitamin D analog
M: binds vit D receptor which complexes with RXR alpha receptor to regulate gnu transcription.
T: hypercalciuria and hypercalcemia; less with topical use
