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Endocrine Pharmacology > WK2 > Flashcards

WK2 Flashcards

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1
Q

Ketaconazole does what?

A

Inhibits Side-Chain cleavage and other CYP enzymes (Anti-fungal)

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2
Q

Metyrapone does what?

A

Inhibits 11-b-hydroxylase

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3
Q

Etomidate does what?

A

Inhibits 11-b-hydroxylase

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4
Q

Ketaconazole is used for what in endocrine?

A

Decrease Cortisol in Cushing Disease

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5
Q

Metyrapone and Etomidate are used for what?

A

DecreaseCortisol levels in Cushing Disease

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6
Q

Which drug can be used when waiting for definitive diagnosis of Cushing Disease?

A

Metyrapone

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7
Q

Toxicity of Ketaconazole

A

LIVER TOX

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8
Q

Treatments for Cushing disease that decrease ACTH release?

A 
DA agonist (Cabergoline)
SST analog (Pasireotide)
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9
Q

Mifepristone does what?

A

Anatagonist of Glucocorticoid Receptor

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10
Q

Mifepristone is used for what? (2)

A

Inoperable disease

Ectopic ACTH tumors that have failed other treatments

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11
Q

Mitotane is what?

A

a DDT insecticide with adrenal toxicity

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12
Q

SE of Mitotane?

A

Adrenal Carcinoma

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13
Q

Symptoms of Cushing Syndrome

A 
Truncal Obesity
Moon Facies
HTN
Wt Gain
Hyperglycemia
Glucose intolerance
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14
Q

Symptoms of Addison’s Disease?

A

Hypoglycemia
Metabolic Acidosis
Hyperpigmentation
Hypotension

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15
Q

Symptomatic difference between primary adrenal insufficiency (Addisons) and secondary?

A

Secondary = Decreased ACTH

  • Normal Aldosterone = NO HYPOTENSION
  • Low ACTH = NO HYPOPIGMENTATION
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16
Q

Glucocorticoid toxicity in heart?

A 
Positive ionotrope (Tachycardia)
HTN
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17
Q

Glucocorticoid toxicity in in CNS?

A

Lowered seizure threshold (hypokalemia)

Behavior changes

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18
Q

Glucocorticoid toxicity in GI?

A 
Increased HCl (Peptic Ulcer)
Antagonizes VitDR = decreased Ca and PO4 absorption
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19
Q

Glucocorticoid toxicity in in bones?

A

DIRECT osteoblast inhibition

Decreased Ca –> Increased PTH increased osteoclast action

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20
Q

Glucocorticoid toxicity in muscles?

A

Hypokalemia (cramps, myopathy)

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21
Q

How are specific blood cells affected?

A

Decreased Lymphocytes, Eosinophils and Basophils
Increased RBC and Neutrophils
Leukocyte extravasation inhibited

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22
Q

Anti-inflammatory effects of glucocorticoids (5)?

A 
Decreased AA conc
Reduced COX-2
Decreased peripheral leukocytes
Stabilized lysosomal membranes
Reduction of vasoactive factors
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23
Q

What enzyme activates Prednisone?

A

11-b-hydroxylase-2 (inhibits cortisol)

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24
Q

Hydrocortisone GC, MC, and duration of action?

A

1, 1, 8hrs

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25
Prednisolone GC, MC, and duration of action?
4, 0.8, 16-36 hrs
26
Dexamethasone GC, MC, and duration of action?
25-80 0 36-54 hrs
27
Betamethasone GC, MC, and duration of action?
25-30 0 36-54
28
Fludocortisone GC, MC, and duration of action?
15 200 24 hrs
29
Which glucocorticoid agonizes the minerocorticoid receptor the most?
Fludocortisone
30
What enzyme does licorice inhibit?
11-b-hydroxylase
31
Metformin (Biguanides) acts how?
Activates AMPK Inhibits gluconeogenesis Increased skeletal and adipocyte glucose uptake
32
Metformin is used for what?
Type II DM (Insulin independent)
33
SE of metformin? What isn't a SE of metformin, but is of other diabetes drugs?
GI distress, lactic acidosis Hypoglycemia
34
Chlorpropramide is what?
1st gen sulfonylurea
35
Tolbutamide is what?
1st gen sulfonylurea
36
Tolazamide is what?
1st gen sulfonylurea
37
Glyburide is what?
2nd gen sulfonylurea
38
Glipizide is what?
2nd gen sulfonylurea
39
Glimepride is what?
2nd gen sulfonylurea
40
Sulfonylurea MOA?
Bind ATP dep K channels and close them, increasing intracellular Ca, causing Insulin release
41
SE of sulfonylureas?
Hypoglycemia | Wt Gain
42
Sulfonylurea in pregnancy? Why?
NOT IN PREG | Cross the placenta and cause hypoglycemia
43
Why are 2nd gen sulfonylureas better than 1st?
2nd gen have shorter half life and more potency
44
Lispro onset, max, and duration?
15 min - 1 hr - 4 hrs
45
Regular Insulin onset, max, duration?
30 mins - 2 hr - 8 hrs
46
NPH Insulin onset, max, duration?
2 hrs - 10 hrs - 20 hrs
47
Insulin Glargine inset, max, duration?
2 hrs - no peak - 24 hrs
48
Who needs supplemental Insulin?
Type I (insulin-dependent)
49
SE of insulin supplementation?
Hypoglycemia | Wt gain
50
GLP-1 analog MOA?
GLP-1 = glucagon like hormone secreted by intestinal epithelial cells Stimulates Insulin Decreased Glucagon Induces Saiety
51
Exenatide is what?
GLP-1 Analog (INJECTED)
52
SE of GLP-1 analog?
Wt loss hypoglycemia PANCREATITIS
53
Sitagliptin is what?
DPP-4 inhibitior
54
Sitagliptin MOA?
Inhibits dipeptidyl peptidase-4, which usually metabolizes GLP-1 Increases GLP-1 half-life
55
Meglitinites (Repeglinitide, nateglinitide) are what?
Insulin secretagogues
56
Meglitinites MOA?
bind different binding site on K channels, increasing Insulin release
57
SE of Sitagliptin?
Nausea and vomiting | No hypoglycemia or wt changes
58
SE of Megltinites?
Wt gain | Hypoglycemia
59
Acarbose is what?
a-glucosidase inhibitor
60
Miglitol is what?
a-glucosidase inhibitor
61
Acarbose and Miglitol MOA?
Inhibit a-glucosidase in brush border intestinal cells, decreasing glucose intake with meals
62
SE of a-glucosidase inhibitors?
Flatulence | Diarrhea
63
Pramlintide is what?
Amylin analog
64
Pramlintide MOA?
Binds Amylin receptor Decreases glucagon synthesis Delays gastric emptying Increases Saiety
65
Pramlintide SE?
GI distress
66
Rosiglitazone, pioglitazone, troglitazone is hwat?
Thiazolidinediones
67
Thazolidinediones MOA?
Binds PPARy upregulates genes to increase skeletal and adipocyte glucose uptake decrease insulin resistance
68
SE of thazolidines?
Hypoglycemia Edema (HF?) Liver Tox

Endocrine Pharmacology (5 decks)

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