Pharma

Question 1

Somatotropin side effects

Answer 1

Myalgia arthralgia
Perpheral edema

Question 2

Mescarmine

Answer 2

Recombinant IGF1

Side effects : hypoglycaemia, IC HTN, Increased liver enzymes

Question 3

Octreotide, lanreotide

Answer 3

Somatostatin receptor agonist

Question 4

Octreotide side effects

Answer 4

GI disturbance
Gall stones
Bradycardia
Cardiac conduction anomalies

Question 5

Pegvisomant

Answer 5

GH receptor antagonist

ACROMEGALY

Increased liver enzymes

Question 6

Agonist of Vasopressin V2 receptors

Answer 6

Desmopressin

Uses: pituitary diabetes insipidus , haemophilia A nd vWBF
Side effect: hyponatremia

Vasopressin: DI plus esophageal varices

Question 7

Conivaptan

Answer 7

Vasopressin receptor antagonists: V1a and V2 for hyponatremia

Tolvaptan: selective for V2(hepatotoxic if more than 30 days)

Question 8

Atosiban

Answer 8

Antagonist of oxytocin receptor

Question 9

Levothroxine T4
Liothyronine T3

Answer 9

Treatment for hypothyroidism
T4 more suitable

Toxicity= thyrotoxicosis, elderly, heart patients, ones wd long-standing myxedema (give lower doses)

Question 10

Methimazole
Propyluracil(okay to give in pregnancy)

Answer 10

Inhibit peroxidase, iodination, coupling and peripheral conversion of T3 and T4.
Slow onset as will effect future formation

Question 11

Agranulocytosis and hepatitis

Answer 11

Methimazol
PTU

Question 12

What to give in thyroid storm and for surgical resection of hyperactive thyroid

Answer 12

Lugol solutions : iodine and KI
Saturated solution of KI

Question 13

Iodide salts

Answer 13

Reduce release of thyroid
Inhibit iodination of tyrosine

Rapid onset
Escape= transient

Metallic taste, bleeding disorder

Question 14

131 IODINE

Answer 14

Permanent cure to thyrotoxicosis

Wdout harm to other tissues
Contraindications in pregnancy

Question 15

Inhibitors of iodide uptake

Answer 15

SCN -
CLO4- (aplastic anemia)

Question 16

Thyrotoxicosis

Answer 16

I 131
B blockers : prpranolol (also inhibit periphery conversion of T4)

Question 17

Amiodarone (anti arrhythmic) associated hypothyroidism

Answer 17

Give thyroid hormones

Question 18

Amiodarone associated hypothyroidism

Answer 18

Thioamides like methimazole or PTU

Question 19

Inhibitors of perpheral conversion of T4 to T3

Answer 19

Thioamides
Propranolol
Amiodarone

Iodinated radiocontrast media=
Oral diatrizoate
IV iohexol

Question 20

Parenteraltreatment of osteoporosis

Answer 20

Teriparatide analog of PTH

Question 21

Inhibitors of vitamin D

Answer 21

Phosphate
Fibroblast growth factor 23
Vit D metabolites

+PTH

Question 22

Uses of Vitamin D, its metabolites

Answer 22

Nutritional deficiency
Intestinal dystrophy
CKD
Liver disease
Hypo parathyroidism
Nephrotic syndrome

With Ca supplements: osteoporosis

Psoriasis

Question 23

Calcitriol active form

Answer 23

It is given in condition where Vit D activation is impaired e.g CKD, liver disease, hypoparathyroidism
Secondary hyperparathyroidism

Question 24

Secondary hyperparathyroidism

Answer 24

Calcitriol is given but it increases hypercalcemia and hypercalciuria.
So we give
DOXERCALCIFEROL: converted in liver to 1,25 D
PARICALCITOL: 19-nor 1,25D2
CALCIPOTRIENE:

Question 25

Calcitonin (injection/nasal spray)

Answer 25

When acute reduction of serum Ca is needed ✅paget disease ✅hypercalcemia ✅ osteoporosis

Question 26

Raloxifene

Answer 26

Estrogen and SERM Prevents and prevents bone loss in postmenopausal women ⚠️ hot flashes Thromboembolism

Question 27

Bisphosphonates

Answer 27

Inhibit osteoclasts (farnesyl pyrophosphate synthase) Reduce both resorption and formation Paget disease Osteoporosis malignancy hyperCa Diff dosages ⚠️gastric and esophageal irritation Renal damage and osteonecrosis of jaw Take water alot

Question 28

Denosumab

Answer 28

- RANKL -osteoclasts ✅menopause osteoporosis SC inj. Every 6 months

Question 29

Cinacalet

Answer 29

Activate Ca sensing receptors in parathyroid and reduce PTH Secondary hyperparathyroidism in CKD ⚠️hypoCa

Question 30

Toxicity of oestrogen

Answer 30

Endometrial cancer, breasr cancer MI Thromboembolism Migraine Oral gives more hepatic effects

Question 31

Toxicity of progesterone

Answer 31

High BP DECREASE HDL Decreased bone density

Question 32

Toxicity of OCPS

Answer 32

Thromboembolism Breast cancer Nausea, breast tenderness, headache, skin pigmentation, depression

Question 33

Older progestins have an androgenic effect

Answer 33

L- norgestrel Norethinedrone Newer are. Norgestimate, desogestrel.

Question 34

Tamoxifen

Answer 34

SERM Antagonist: breast cancer✅, hot flushes, Agonist: endometrial hyperplasia, venous thrombosis ,bone

Question 35

Raloxifene

Answer 35

Osteoporosis in post menopause: partial agonist effect, venous thrombosis Antagonist: breast CA, hot flushes, No effect on endometrial lining

Question 36

Clomiphene

Answer 36

Partial agonist Induces ovulation who are trying Block est receptors in pitutary, reduces negative feed back so FAH and LH increase : ovulation

Question 37

To give in menopause

Answer 37

Bazedoxfene

Question 38

What if breast cancer is resistant to tamoxifen

Answer 38

Fulvestrant : pure receptor antagonist

Question 39

Aromatase inhibitors

Answer 39

Anastrozole Exemestane

Question 40

Danazol

Answer 40

Weak partial agonist of progestin, androgen glucocorticoids Inhibit p450 cytochrome enzymes Treats endometriosis, fibrocystic disease of breast

Question 41

Leuprolide

Answer 41

GnRH agonist: supresses gonadotropin secretion Inhibit ovarian production of est and prog Treat fibroids, endometriosis (<6 months) precociously puberty Ganirelix,cetrorelix: controlled ovarian hyperstimulation.