pharm 1 liner- endocrine

Question 1

recombinant growth hormone used in growth hormone deficiency

Answer 1

somatropin

Question 2

somatostatin analog used for acromegaly, carcinoid, glucagonoma and other growth hormone producing pituitary tumors

Answer 2

octreotide

Question 3

gonadotropin-releasing hormone (GnRH) analog used for infertility (agents with pulsatile admin), or uterine fibroids and endometriosis (antagonist with continuous admin to suppress gonadotropin production and down regulate GnRH receptor in pituitary)

Answer 3

leuprolide

Question 4

competitive antagonists at gonadotropin releasing hormone receptors used to prevent LH surge during controlled ovarian hyper stimulation

Answer 4

ganirelix

Question 5

Ergot dopamine agonist inhibits lactotroph cell growth and prolactin secretion that can be used to treat prolactinoma

Answer 5

bromocriptine

Question 6

Synthetic human corticotropin used for diagnosis of adrenal insufficiency

Answer 6

cosyntropin

Question 7

Agent used to stimulate uterine contraction and labor, milk letdowns, and control postpartum bleeding

Answer 7

oxytocin

Question 8

Agent of choice for the treatment of hypothyroidism

Answer 8

levothyroxine (T4)

Question 9

Mechanism of Levothyroxine

Answer 9

L-isomer of T4

Question 10

Adverse effects of Levothyroxine

Answer 10

palpitations, arythmies, excessive sweating, heat intolerance

Question 11

An isomer of T3 which may be used in myxedema coma

Answer 11

liothyronine (T3)

Question 12

Thioamide agents used in hyperthyroidism

Answer 12

methimazole and propylthiouracil (PTU)

Question 13

Thioamide extensively protein bound, less likely to cross placenta, inhibits peripheral conversion of T4 to T3 in high doses, and indicated for pregnant women in 1st trimester

Answer 13

propylthiouracil

Question 14

Propylthiouracil (PTU) mechanism of action

Answer 14

inhibits thread peroxidase; blocks peripheral T4 to T3 conversion

Question 15

A severe adverse effect of thioamide

Answer 15

agranulocytosis

Question 16

Can be effective for short term therapy of thyroid storm, but after several weeks of therapy causes an exacerbation of hyperthyroidism

Answer 16

iodide salts (potassium iodide)

Question 17

Permanently cures thyrotoxicosis, patients will need thyroid replacement therapy thereafter. Contraindicated in pregnancy

Answer 17

radioactive iodine

Question 18

Used for the symptomatic treatment of thyrotoxicosis by blocking cardiac adverse effects as well as blocking peripheral T4 to T3 conversion

Answer 18

beta blockers such as propranolol and esmolol

Question 19

Used for Addison’s disease, congenital adrenal hyperplasia inflammation, immune suppression, and asthma

Answer 19

glucocorticoids

Question 20

Two short-acting glucocorticoids

Answer 20

hydrocortisone (cortisol), cortisone

Question 21

Four intermediate-acting glucocorticoids

Answer 21

prednisone, predisolone, methylprednisolone, triamcinolone

Question 22

Two long-acting glucocorticoids

Answer 22

betamethasone, dexamethasone

Question 23

Two glucocorticoids with mineralocorticoid action

Answer 23

fludrocortisone, deoxycortisterone

Question 24

Side effects of corticosteroids

Answer 24

Iatrogenic Cushing’s syndrome, hyperglycemia, impaired wound healing, osteoporosis, peptic ulcers, myopathy, adrenal suppression (> 2 week treatment)

Question 25

Inhibits conversion of cholesterol to pregnenolone therefore inhibiting corticosteroid synthesis

Answer 25

aminoglutethimide

Question 26

antigfungal agent used to inhibit adrenal and gonadal sterior synthesis

Answer 26

ketoconazole

Question 27

selective inhibitor of 11-hydroxylation and interferes with cortisol and corticosterone synthesis; used for adrenal function tests and is the only adrenal-inhibiting medication that can be admin to pregnant women with bushings syndrome

Answer 27

metyrapone

Question 28

Progesterone receptor antagonist used to induce abortion blocks glucocorticoid receptor at higher concentration

Answer 28

mifepristone (RU486)

Question 29

Three rapid-acting insulin used for postprandial glycemia

Answer 29

aspart, lidpro, glulisine

Question 30

Short-acting insulin used intravenously for ketoacidosis

Answer 30

regular insulin

Question 31

Intermediate-acting insulin with variable pharmacokinetics; use is mostly replaced by long-acting insulin

Answer 31

neutral protamine hagedorn (NPH) insulin

Question 32

Two long-acting insulin preparations that provide basal glycemia control

Answer 32

glargine, determir

Question 33

Major side effect of insulin

Answer 33

insulin

Question 34

Insulin receptor has

Answer 34

tyrosine kinase activity

Question 35

first generation sulfonylurea that is relatively safe for elderly diabetics and patients with renal impairment due to its short half-life

Answer 35

tolbutamide

Question 36

First generation sulfonylurea contraindicated in elderly diabetics because of prolonged long half-life

Answer 36

chloropropamide

Question 37

Three second generation sulfonylureas

Answer 37

glyburide, glipizide, glimepiride

Question 38

mechanism of action of sulfonylureas

Answer 38

Close K+ channels in beta cell membrane, depolarize cell, open voltage-gated Ca2+ channels, influx of Ca2+ release preformed insulin

Question 39

Side effect specific to first generation sulfonylureas

Answer 39

disulfiram-like reactions with alcohol use

Question 40

Second generation sulfonylureas is more potent than 1st generation and can eaily cause

Answer 40

hypoglycemia

Question 41

Both first and second generation of sulonylureas can cause

Answer 41

allergy (sulfa)

Question 42

How do Sulfonylureas affect body weight that is mediated by the insulin effects on adipose tissue

Answer 42

weight gain

Question 43

A meglitinide insulin secretagogue that has no sulfur in its structure and may be used in type 2 diabetics with sulfonylurea allergy

Answer 43

repaglinide

Question 44

A D-phenylalanine derivative insulin secretagogue that is useful for type 2 diabetics with very reduced renal function or elderly patients

Answer 44

nateglinide

Question 45

mechanism of action of repaglinide and nateglinide

Answer 45

Close K+ channels, depolarize cell, open voltage-gated Ca2+ channels, release preformed insulin

Question 46

First line drug for the treatment of type 2 diabetes mellitus

Answer 46

metformin

Question 47

Mechanism of action of metformin

Answer 47

gluconeogenesis, peripheral glucose uptake; increase insulin sensitivity

Question 48

Most serious side effect of metformin

Answer 48

lactic acidosis

Question 49

Metformin is contradindicated in

Answer 49

renal insufficiency

Question 50

The most common side effect of metformin is

Answer 50

GI distress/upset

Question 51

Two thiazolidinediones

Answer 51

pioglitazone, rosiglitazone

Question 52

Mechanism of action of thiazolidinediones

Answer 52

Activate PPAR-ɣ, ­ transcription of insulin-responsive genes, ­ GLUT4 glucose transporter, ­ insulin sensitivity

Question 53

Side effect of thiazolidinediones

Answer 53

Weight gain, edema, heart failure,macular edema, hepatotoxicity

Question 54

Two alpha-glucosidase inhibitors

Answer 54

acarbose, miglitol

Question 55

mechanism of a action of alpha-glucosidase inhibitors

Answer 55

Act on intestinal brush boder α-glucosidase, delay digestion and absorption of glucose, ↓post-prandial blood glucose

Question 56

α-glucosidase inhibitors are contraindicated in

Answer 56

inflammatory bowel disease

Question 57

Side effect of alpha-glucosidase inhibitors

Answer 57

flatulence, diarrhea, abdominal cramps

Question 58

Four glucagon-like polypeptide-1 (GLP-1) analogs that increase insulin secretion and suppress postprandial glucagon release

Answer 58

eventide, liraglutide, albiglutide, dulaglutide

Question 59

The most common side effect of GLP-1 analogs

Answer 59

nausea, vomiting

Question 60

Three dipeptidyl peptidase-4 (DPP-4) inhibitors that reduce breakdown of glucagon-like polypeptide-1, resulting in increased insulin secretion and suppress postprandial glucagon release

Answer 60

citagliptin, saxagliptin, linagliptin

Question 61

Oral antidiabetic drugs can increse the risk of UTI and respiratory infection

Answer 61

DPP-4 inhibitors

Question 62

Amylin analog that delays gastric emptying and suppresses glucagon release

Answer 62

pramlinitide

Question 63

Three sodium-glucose transporter 2 (SGLT2) inhibitors

Answer 63

canagliflozin, dapagliflozin, empagliflozin

Question 64

Mechanism of action of sodium-glucose transporter 2 (SGLT2) inhibitors

Answer 64

inhibit SGLT2 and decrease glucose resorption in proximal collecting tubules

Question 65

Main side effects of SGLT2 inhibitors

Answer 65

glycosuria, genital infections, UTI

Question 66

SGLT2 inhibitors causes orthostatic hypothension due to

Answer 66

diuresis by glucose leading to dehydration

Question 67

bisphosphonates

Answer 67

alendronate and -dronates

Question 68

mechanism of action of bisphosphonates

Answer 68

inhibitors osteoclast activity and prevent bone resorption

Question 69

uses of bisphosphonates

Answer 69

osteoporosis, parents disease, hypercalcemia

Question 70

major side effects of bisphosphonates

Answer 70

corrosive esophagitis, osteonecrosis of jaw

Question 71

first generation bisphosphonate when used long term causes osteomalacia

Answer 71

etidronate

Question 72

may be used intranasal to decrease bone resorption

Answer 72

calcitonin (salmon prep)

Question 73

vitamin given with calcium to ensure proper absorption (bone)

Answer 73

vitamin D