Neuroendocrine pharmacology Flashcards Preview

D&T 4 exam 1 > Neuroendocrine pharmacology > Flashcards

Flashcards in Neuroendocrine pharmacology Deck (66):
1

How is hypothalamic dwarfism treated

GH replacement

2

when can you not use GH replacement for hypothalamic dwarfism

- closed epiphysis
- 15 years and older
- cannot make IGF1
- active malignancy

3

usually GH replacement is given with what hormone

sex steroids

4

name a GH replacement drug? when is it administered

Somatropin
evening

5

name a synthetic GHRH ?

Sermorelin

6

early in GH treatment what are some side effects

- increased intracranial pressure
- anti-insulin actions, decreases glucose utilization

7

What is human recombinant IGF-1 used to treat?

growth deficiency due to low levels of IGF-1
- Laron Dwarfism

8

What is Laron Dwarfism

mutations in GH receptor

9

what are adverse effects of human recombinant IFG-1

hypoglycemia
lipohypertrophy

10

what is used to treat acromegaly in adults and gigantism in children

somatostatin analogs
Pegvisomant

11

name somatostatin analogs

Octerotide
Lanreotide

12

what is the difference between Octerotide and Lanreotide

Octreotide shorter half life

13

what are adverse effects of Somatostatin analogs

GI: diarrhea, nausea, abdominal pain
- gallstones
- reduce levels of thyrotopin secretion

14

MOA for Pegvisomant

competitive GH receptor antagonist
reduces levels of IGF-1

15

what is second line therapy for acromegaly

Pegvisomant

16

adverse effects of Pegvisomant

Lipohypertrophy at injection site

17

Symptoms for hyperprolactinemia

- amenorrhea, galactorrhea, infertility in women and impotence
- galactorrhea, infertility in men

18

what is used to treat hyperprolactinemia

dopamine receptor agonists

19

name 2 dopamine receptor agonists

Cabergoline
Bromocriptine

20

MOA for Cabergoline and Bromocriptine

stimulate D2 receptor

21

difference between Cabergoline and Bromocriptine

Cabergoline has longer half life and greater selectivity for D2 receptor

22

Bromocriptine is FDA approved to treat what

Acromegaly and hyperporlactinemia

23

What are adverse affects for D receptor agonists

- cabergoline has lower nausea
-- hypotension and dizziness
-- linked with valvular disease, attribute to ergot activity

24

what drug is used to treat hypothyroidism

Protirelin

25

MOA for Protirelin

synthetic TRH
- stimulates release of TSH

26

How is Protirelin used to diagnose hypothyroidism

- TSH, T3, T4 levels are normal: hypothalamic defect
- TSH, T3, T4 not increased: pituitary failure
- TSH increased, T3, T4 not increased: thyroid gland problem

27

What is used as a diagnostic drug for ACTH

Cosyntropin

28

How is GnRH released from the hypothalamus

pulses

29

hCG mimics the action of what hormone

LH

30

what is hCG FDA indicated for

- stimulation of ovulation in anovulatory women
- treat male infertility and cryptorchidism

31

What does Menotropins contain

equal amounts of partially degraded FSH and LH

32

what is Menotropins FDA indicated for

- female infertility in order to stimulate the development of ovarian follicles
- promotes spermatogenesis in males

33

what is in Urofollitropin

mostly FSH

34

what is in Follitropin beta and alpha

recombinant human FSH

35

What is in Choriogonadotropin alpha

recombinant human LH

36

What are side effects of Gonadotropin mimic drugs

- women risk of multiple births
- ovarian hyperstimulation
- gynecomastia in men

37

MOA for Clomiphene

- increases levels of LH and FSH
- inhibiting estrogen negative feedback at level of hypothalamus

38

FDA indications for Clomiphene

female infertility due to polycystic ovary syndrome

39

what are side effects of Clomiphene

multiple births
ovarian cysts

40

Name the anti-estrogen and anti-androgen drugs

Leuprolide
Goserelin
Nafarelin
Histrelin

41

What is the mechanism of action of anti-estrogen and anti-androgen drugs ( long acting)

- synthetic GnRH agonists ( or analogs) have longer half-lives than endogenous GnRH
- improves receptor binding affinity
- down-regulate the GnRH receptor and inhibit gonadotropin secretion

42

what are anti-estrogen and anti-androgen drugs ( long acting) used for

endometriosis
uterine fibriods
advanced prostate cancer
central precocious puberty

43

Adverse effects of anti-estrogen and anti-androgen drugs ( long acting)

hot flashes
vaginal atrophy
erectile dysfunction

44

Name 2 androgen receptor antagonists

Flutamide
Bicalutamide

45

Flutamide and Bicalutamide are usually given with what other drug and why

- long-acting GnRH analog
- not given alone b/c increase LH synthesis

46

What is the black box warning for Flutamide and Bicalutamide

reversible liver damage
- liver function should be assayed prior and during treatment

47

Name a 5alpha-reductase inhibitor

Finasteride

48

MOA of Finasteride

blocks conversion of testosterone to DHT

49

What is 5alpha-reductase used to treat

benign prostatic hyperplasia
male pattern baldness

50

What are 2 types of diabetes insipidus

central and nephrogenic

51

What are symptoms of diabetes insipidus

polyuria
polydipsia
dilute urine

52

how do you treat central Diabetes inspidius

Desmopressin

53

what are the effects of Desmopressin

- reduced vasopressor activity
- enhanced antidiuretic activity compared with vasopressin
- stimulate VIII and von Willebrand factor

54

What is Desmopressin FDA indicated for

von-Willebrand disease type I
Primary nocturnal enuresis

55

What are adverse effects of vasopressor activity

facial pallor
nausea, cramps
more prominent in vasopressor activity than in Desmopressin

56

Overstimulation of V2 in tubules can cause what

water intoxication

57

Chlorpropamide and Carbamazepine will cause what drug interactions with diabetes insipidus drugs

- increase sensitivity of collecting duct to vasopressin

58

What drug interaction inhibits the action of vasopressin on collecting duct within kidney

Lithium and Demeclocycline with Diabetes insipidus drugs

59

As many as 3 patients taking lithium will develop what

nephrogenic DI

60

how do you treat nephrogenic DI

thiazide diuretics
amiloride

61

What is SIADH

impaired H2O excretion

62

what is treatment for SIADH

fluid restriction
Demeclocycline and Tetracylcine

63

what is FDA approved for euvolemic or hypervolemic hyponatremia associated with SIADH

Conivaptan
Tolvaptan

64

what is oxytocin used for

aborption
adjunct, induction of labor
postpartum hemorrhage
induction of lactation

65

how is oxytocin administered

IV - induce labor
Im control post-abortion hemorrhage

66

adverse effects of overstimulation of oxytocin

trauma to mother or fetus
uterine rupture
water intoxication
allergic reactions