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Block 3 > review for Pharm Block 3 Quiz (up to Diabetes) > Flashcards

review for Pharm Block 3 Quiz (up to Diabetes) Flashcards

0
Q

purpose of LH in males

A

in Leydigs cells–> regulates testosterone synthesis

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1
Q

purpose of FSH in males (Sertoli cells)

A

promote Spermatogenesis in Seminiferous tubules

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2
Q

step that produces testosterone

A

androstenedione–> testosterone

via 17 beta hydrosteroid dehydrogenase*****

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3
Q

most circulating testosterone is bound to…

A

SHBG= sex hormone binding globulin( which has hepatic origin)

testosterone weakly binds to albumin and testosterone bound to albumin is considered unbound testosterone

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4
Q

what is the active form of testosterone and what is the enzyme that produces the

A

testosterone–> DHT= dihydrotestosterone

via 5 alpha reductase–>
1= non genital skin and liver
2= urogenital skin and genital skin of both sexes

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5
Q

what is the purpose of androgens in males?

A

development of the male phenotype

  • growth of penis
  • thicker oily skin
  • increase height and musculature
  • axillary hair
  • growth of larynx
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6
Q

why is testosterone not given orally

A

LARGE 1ST PASS EFFECT METABOLISM VIA LIVER–> inactivated via 1st pass effect

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7
Q

what are the therapeutic androgens

A
  1. testosterone aqueous= short acting
  2. testosteronr cypionate= depot–> last longer and has anabolic effects
  3. testosterone gel
  4. Fluoxymesterone–> most effects are anabolic
  5. DANAZOLE= weak androgenic and interacts with progesterone and androgen receptors–> PANCREATITIS
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8
Q

describe the androgenic vs anabolic effects

A

androgenic= used for those with inadequate androgen secretion
–> for development and maintenance of masculine characteristics

anabolic= for senile osteoporosis and severe burns–> speeds up recovery from surgery
–> promotes cell growth

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9
Q

adverse affects of androgens in females

A
  1. masculinization with acne
  2. facial hair
  3. deep voice
  4. male pattern baldness
  5. menstrual irregularities
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10
Q

adverse effects of androgens in males

A
  1. priaprism= boner for longer than 4 hrs
  2. impotence= cant get/keep it up
  3. decrease in spermatogenesis
  4. gynecomastia= MOOBS
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11
Q

effects of androgens in kids

A

growth disturbances–> promote pre-mature closing of epiphyseal plates

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12
Q

general adverse effect of androgens

A
  1. increase LDL–> increases risk for pre-mature coronary heart disease
  2. fluid retention–> edema
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13
Q

4 anti-androgens

A
  1. spiro-no-lactone
  2. flutamide
  3. ketoconazole
  4. cimetidine
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14
Q

which antiandrogen is used to treat hirsutism= excessive hairiness in women

A

spironolactone–> have to give at high doses

–> in men it causes impotence

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15
Q

drug that competitively inhibits the binding of DHT to androgen receptor

and what is it used for

A

flutamide–> used for

1. prostatic cancer when combined with GnRH blockade or estrogen

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16
Q

SE of flutamide

A
  1. hepatitis

2. anemias

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17
Q

ketoconazole inhibits…. and is used for…

A
  • 17 alpha-hydroxylase

used to treat prostatic cancer= HEPATOTOXIC

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18
Q

at high doses what does cimetidine do

A

competes for androgen receptors–> used for hirsutism

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19
Q

what is the only 5 alpha reductase inhibitor

A

FINASTERIDE= competitive inhibitor for both enzymes (prefers 5 alpha reductase 2)

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20
Q

used of FINASTERIDE= 5 alpha reductase inhibitor

A

in high doses= PROSCAR–> for prostatic hyperplasia
in low doses= PROPECIA–> for male pattern baldness

CAUSES IMPOTENCY

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21
Q

what 3 drugs can you use for impotence

A
  1. sil-denafil
  2. var-denafil
  3. tada-lafil= weekender–> single dose can last 36 hrs
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22
Q

MOA of impotence drugs

A

NO–> + guanylyl cyclase–> increase cGMP–> smooth muscle relaxation of corpus cavernosum–> increase blood flow–> boner

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23
Q

what is AN ABSOLUTE CONTRAINDICATION for taking impotence medication

A

CONCURRENT NITRATE USE

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24
Q

describe the 2 things where you see an increase in GH

A

in kids= gigantism–> due to open long bone epiphyses
in adults= acromegaly= abnormal growth of tissue esp. CT
–> leads to metabolic abnormalities and cardiac dysfunction

25
Q

what are the 2 groups of hypothalamic hormones

A
  1. GnRH agonists

2. GnRH antagonists

26
Q

what are the GnRH agonists

A
  1. leuprolide

2. -relins

27
Q

what are the 2 ways you can administer a GnRH agonist

A
  1. pulsatile= for replacement therapy–> for infertility or delayed puberty
  2. continuous= for suppression–>
    - endometriosis
    - uterine fibroid
    - prostate cancer
    - early puberty
28
Q

what do you see when you administer a GnRH agonist

A

FLARE UP
1st 7-10 days= agonist effect
2nd= flare up= increase in gonadal hormone
3rd= desensitization/inhibitory effect–> decrease in gonadal hormone

29
Q

what is the bonus of using a GnRH antagonist

A
  1. no flare up

2. rapid onset of effects

30
Q

what are the GnRH antagonists

A
  • relix
    1. gani-relix
    2. ceto-relix
    3. aba-relix
    4. dega-relix
31
Q

the anterior pituitary secretes what 3 hormones

A
  1. GH
  2. FSH/LH
  3. Prolactin
32
Q

what is the GH agonist

A

somatropin

33
Q

what is the GH antagonist

A

somatotropin

  1. octreotide
  2. lanreotide
34
Q

GH antagonists lower which hormones and how does this affect their uses?

A
  1. GH
  2. glucagon
  3. insulin
  4. gastrin

can be used for hormone secreting tumor or BLEEDING ESOPHAGEAL VARICES

35
Q

Name the FSH/LH hormones

A 
mixed= menotropin
FSH= uroFollitropin
LH= Lutropin= recombinant form--> almost identical to hcG

***first 2= used for infertility

36
Q

what 2 hormones does the posterior pituitary release

A
  1. oxytocin–> alters transmembrane ion channels–> induces labor
  2. Vasopressin/ADH
37
Q

the purpose of ADH agonists and what they target

A
  1. 8-L-arginine vasopression= V1 blocker (blood vessels)–> BLEEDING ESOPHAGEAL VARICES
  2. Desmopressin= V2 blocker (primary cells/ principal cells of collecting ducts–> DOC for central diabetes insipidus
38
Q

what is the DOC for central diabetes insipidus (ADH insufficiency)

A

ADH agonist= retain H20 and constricts blood vessels

39
Q

what are the ADH/vasopressin antagonists

A
  1. conivaptan–> V1 and V2
  2. Tolvaptan–> V2 blocker
    - for euvolemic and hypervolemic hyponatremia
    - SIADH
40
Q

side effects of GH antagonists

A
  1. biliary sludge and gallstones
  2. sinus bradycardia

alt for acromegaly= PEGVISOMANT

41
Q

prolactin is the primary hormone responsible for lactation and is inhibited by

A

hypothalamus releases DOPAMINE–> inhibits prolactin

42
Q

a prolactin antagonist=

A

dopamine agonist=

  1. bromocriptine–> for acromegaly
  2. cabergoline–> for hyper-prolactinemia
43
Q

what causes hyperprolactinemia

A
  1. antipsychotics which are dopamine receptor blockers–> they inhibit dopamine= no inhibition of prolactin production
  2. benign prolactinoma
44
Q

SE of hyperprolactinemia

A

females–> - ovulations= menstrual irregularities

  • amenorrhea= no periods
  • galactorrhea= leaky nipples

men

  • decreased libido
  • gynecomastia= man boobs
45
Q

what blocks oxytocin

A
  1. Beta blockers
  2. magnesium sulfate
  3. inhaled anesthetics
46
Q

what enzyme is used to produce T4 and T3 in thryoglobulins

A

thyroid peroxidase

47
Q

purpose of TH in kids and adults

A

kids–> normal development–> esp CNS

adults–> maintain metabolic homeostasis

48
Q

which TH is more active

A

T3

T4–> T3 via deiodinase enzymes

49
Q

T3 and T4 are highly bound to

A

thyroxine binding globulin

if bound–> they are not active

50
Q

high concentrations of iodide can prevent

A

TH release

51
Q

what is a thyroid storm and how do you treat it

A

life-threatening complication of hyperthyroidism

give PTU (propylthiouracil) +iodates in high doses 
control tachyarrhythmia with B blockes or Ca channel blockers
supportive therapy= dexamethasone (long acting corticosteroid)
52
Q

radioactive iodine= DOC

A

for Graves Disease

cannot give in pregnant women or younger patients

53
Q

adenohypophysis releases

A

TSH= thyrotropin stimulating hormone–> causes the TRH from the thyroid gland

54
Q

what do you give for hypothyroidism

A
  1. desicated thyroid= T3 and T4
  2. levothyroxine= T4= DOC for hypothyroidism
  3. Livothyronine= T3
55
Q

what is the DOC for hypothyroidism

A

levothyroxine= T4–> low cost and long T1/2

56
Q

treatment for hyperthyroidism

A
  1. remove thyroid gland
  2. local radiation with radioactive iodine–> DOC for Graves’ disease
  3. antithyroid agent
57
Q

what is the DOC for Graves’ disease (diffuse toxic goiter)

A

radioactive iodine

58
Q

what are the 2 anti-thyroid agents

A
  1. PTU=propyl-thio-uracil–> DOC for thyroid storm

2. methimazole

59
Q

what are the side effects of the anti-thyroid agents

A
  1. agranulocytosis= low WBC
  2. BM aplasia

can cross placenta and get secreted in mothers milk

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