Term
|
Definition
| biphosphonate. locks into hydroxyapatite to antagonize PTH. Poor oral absorption. Given IV. CI'd in renal insufficiency. |
|
|
Term
|
Definition
biphosphonate. locks into hydroxyapatite to antagonize PTH. Poor oral absorption. Given IV. CI'd in renal insufficiency.
Main use is for osteoporosis and glucocorticoid prophylaxis. |
|
|
Term
|
Definition
| biphosphonate. locks into hydroxyapatite to antagonize PTH. Poor oral absorption. Given IV. CI'd in renal insufficiency. |
|
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Term
|
Definition
Ca mimetic. Used in hypercalcemia from tumors such as parathyroid tumors. Acts like free Ca to decrease PTH.
Displaces albumin bound verapamil, nsaids, and digoxin |
|
|
Term
|
Definition
| IV elemental calcium. Preferred b/c it doesn't irritate the veins. |
|
|
Term
|
Definition
|
|
Term
|
Definition
|
|
Term
|
Definition
used in pts w/ renal failure.
Treats rickets, osteomalacia, and osteoporosis. CI'd in hypercalcemia or cardiac glycosides (aka digoxin) |
|
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Term
|
Definition
| used in rickets, osteomalacia, osteoporosis. |
|
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Term
|
Definition
| activated in the kidney to calcitriol. highly bound to albumin |
|
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Term
|
Definition
| same as ergocalciferol except that it is contraindicate in renal and hepatic dysfunction. |
|
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Term
|
Definition
antagonizes PTH, inhibits Pagets bone turnover. Used in hypercalcemic emergencies.
SE - headaches, weakness, N/V on first dose |
|
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Term
|
Definition
cytotoxic antibiotic. Inhibits actions of Vit D and PTH on osteoclasts.
Used for hypercalcemia from advanced tumors.
High toxicity. Only used in hospital. |
|
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Term
|
Definition
recombinant PTH.
Only agent that stimulates new bone formation. Used if other treatment is failed.
If used over 21 months --> osteosarcoma |
|
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Term
|
Definition
estrogen receptor agonist.
It is an agonist in the bbone and antagonist in the breast |
|
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Term
|
Definition
| GH mimetic. Mainly used for children SE - idiopathic intracranial HTN. increased incidence of leukemia. Scoliosis, slipped epiphysis.
In adults -> peripheral edema, CTS, arthralgia, myalgia |
|
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Term
|
Definition
Recombinant IGF-1. Used to treat pts with an GH receptor mutation.
SE - hypoglycemia
SE in adults -> peripheral edema, carpal tunnel, myalgia, arthralgia |
|
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Term
|
Definition
similar to SST. Inhibits GH, ST, Gastrin, VIP, and motilin. SE - N/D, bloating, gallstones, high and low blood sugar.
Treats acromegaly or gigantism |
|
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Term
|
Definition
GH receptor antagonist and thus inhibits IGF-1 production too. Causes internalizatin of GH receptor.
SE - liver damage |
|
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Term
|
Definition
Dopamine receptor agonist (D2 specific)
Used to treat prolactinoma.
SE - N/V, headache, postural hypotension. nasal congestion
Gi coupled receptor on lactotrophs. |
|
|
Term
|
Definition
used to treat prolactinoma
Less nausea than bromocriptine.
Gi coupled receptor on lactotrophs. |
|
|
Term
|
Definition
GnRH analog.
controls ovarian hyperstimulation. Suppresses LH surge, endometriosis, reduces T levels in prostate cancer. suppress precocious puberty.
SE - women->headache, menopause symptoms. men -> hot flashes, edema, dec libido, gynecomastia. |
|
|
Term
|
Definition
| GnRH analogs. same as gonadorelin |
|
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Term
|
Definition
| GnRH analogs. available in nasal spray. |
|
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Term
|
Definition
| GnRH receptor antagonist. Prevent LH surge in ovarian hyperstimulation. used in cancers when you want to avoid LH surge such as prostate cancer. |
|
|
Term
|
Definition
| GnRH receptor antagonist. Same as ganirelix. |
|
|
Term
| urofollitropin (follitropin) |
|
Definition
|
|
Term
|
Definition
| LH. Only used with follitropin alpha in infertile females to stimulate follicular development when they are lH deficient. |
|
|
Term
|
Definition
| hCG preparation and is more commonly used then the LH preparation. What is the LH prep name? |
|
|
Term
|
Definition
Gq coupled receptor increasing intracellular Ca -> SM contraction.\
also activates PLC -> prostaglandins.
high doses induces vasopressor effect.
Used to induce labor and prevent post-partum bleeding.
SE - fetal distress, abruption, previa, fluid retention -> HF -> death |
|
|
Term
|
Definition
activates Gq V1 on vasculature and V2 on renal tubules (increased water reabsorption).
SE - abdominal cramping, HTN, arrhythmias, MI, and peripheral ischemia
Uses - esophageal variceal bleeding, polyuria, polydipsia, nocturnal enuresis.
Desmopressin - mainly activates V2 in kidneys. |
|
|
Term
|
Definition
| hog/beef/sheep gland derived TH. Mix of T3 and T4. Unpredictable and possible hypersensitivity. |
|
|
Term
|
Definition
Oral synthetic T4. Stable and is converted to T3 at a predictable rate.
Preferred treatment for hypothyroidism.
Food, Calcium, aluminum, antacids, and cholesterol resins interfere w/ absorption.
Metabolized by CYP3A4 (interferes w/ rifampin, phenytoin and phenobarbitol)
Takes 6-8 weeks for steady state levels.
initiate carefully in elderly pts. May require less.
Low Low doses in CVD.
overdose -> hyperthyroid symptoms and increased bone resorption -> osteoporosis |
|
|
Term
|
Definition
| Oral synthetic T3. Long half life. Fast onset of action. Treatment of choice for myxedemic coma (IV) Used in pts who can't convert T4 to T3. Higher incidence of cardiac side effects |
|
|
Term
|
Definition
Synthetic T3 and T4
not preferred. Expensive |
|
|
Term
|
Definition
TH synthesis inhibitor
Methimazole
Propathiouracil |
|
|
Term
| Iodinated contrast agents |
|
Definition
| anti-thyroid drug. Effective temporary treatment of thyrotoxicosis for those who can't tolerate thionamides. Prevent T4 to T3 and release of TH. |
|
|
Term
|
Definition
causes ablation of the thyroid
Definitive graves treatment for pts w/ CVD, adenoma, and thionamides. Used to treat the ***exopthalmos***
May precipitate thyroid storm so pretreat with thionamide |
|
|
Term
|
Definition
Inhibit release of preformed T3 and T4 via competitive antagonist for iodine uptake.
Used to treat thyroid storm and to prepare hyperthyroid for surgery.
Not for long term.
SE - sore throat, ulcers, rashes, metallic taste |
|
|
Term
|
Definition
a thionamide (TH synthesis inhibitor)
Oral. Inhibits TPO
minimal effect on exophthalmos
No effect on release of preformed TH
less frequent dosing compared to PTU due to longer half life
Hypersensitivity reaction (increase wbc), rash, arthralgia, fever, edema
allergic to this or PTU. not both
Preferred in the treatment of graves due to decreased toxicity |
|
|
Term
|
Definition
Oral. a thionamide (TH synthesis inhibitor)
Inhibits TPO, in addition blocks T4 ->T3 conversion. (thus is preferred in thyroid storm). Preferred in pregnancy
Has no effects on release of preformed TH
minimal effect on exophthalmos
Hypersensitivity rxn, and flu like sxs.
Hepatitis black box warning. Flu like symptoms. allergic to this or methimazole. not both |
|
|
Term
|
Definition
| highly lipophillic. given via injection |
|
|
Term
|
Definition
| Highly lipophillic and given via injection. depo-testosterone |
|
|
Term
|
Definition
| 17a-alyklated testosterone. good for oral absorption but causes hepatotoxicity. |
|
|
Term
|
Definition
| GnRH analog. desensitizes the GnRH signaling pathway via decreasing LH and FSH secretion and testosterone production |
|
|
Term
|
Definition
| GnRH analog. Desinsitizes GnRH pathway via inhibition of LH and FSH and testosterone production. |
|
|
Term
|
Definition
| GnRH competitive antagonist for GnRH receptors in anterior pituitary |
|
|
Term
|
Definition
| GnRH competitive antagonist for GnRH receptors in anterior pituitary |
|
|
Term
|
Definition
Androgen Receptor Antagonist. Used to treat prostate cancer combined w/ GnRH analogs. also used to treat hirsutism in women
also used to treat congenital adrenal hyperplasia b/c steroid synthesis is shifted to androgens.
SE - hepatotoxicity |
|
|
Term
|
Definition
Androgen Receptor Antagonist
Used in prostate cancer and w/ GnRH analogs |
|
|
Term
|
Definition
it is mostly a mineralocorticoid w/ weak anti-androgenic effects.
Treats cushings and hyperaldosteronism
SE - gynecomastia |
|
|
Term
|
Definition
5a-reductase inhibitor. Thus blocks DHT formation -> BPH symptom relief.
Blocks mainly Type II reductase
SE - impotence, decreased libido, and gynecomastia |
|
|
Term
|
Definition
5a-reductase inhibitor. used to reduce DHT formation and treat BPH.
Inhibits type 1 and 2 reductase.
SE - impotence, decreased libido, and gynecomastia. |
|
|
Term
|
Definition
alpha 1 blocker. relaxes smooth muscle around prostate, urethra, and neck of bladder.
First line in BPH pts.
SE - decreased ejaculation |
|
|
Term
|
Definition
alpha 1 blocker. Relaxes prostate, urethra, and neck of bladder.
First line treatment for BPH.
SE - decreased ejaculation |
|
|
Term
|
Definition
alpha 1 blocker. Relaxes smooth muscle around prostate, urethra, and neck of bladder.
SE - decreased ejaculation and prolonged QT interval. |
|
|
Term
|
Definition
| takes effect in 15-30 min and lasts 3-5 hours. They are modified for rapid absorption and dissolution into monomers |
|
|
Term
|
Definition
identical to human insulin. Peaks in 2-3 hours, lasts 5-8 hours.
Forms dimers and hexamers. Take before meals due to slower absorption rates. |
|
|
Term
|
Definition
long lasting peakless insulin.
Soluble in acidic pH and precipitates in neutral pH of subQ tissue. Then slowly dissolves.
Do not mix w/ other insulin preparations |
|
|
Term
|
Definition
| further modified insulin giving it long term affects via increased albumin binding and self-aggregation. |
|
|
Term
|
Definition
sulfonylureas - cause a hypoglycemic effect by stimulating the release of insulin. MOA: bind to SUR1 K channel and cause depolarization.
Uses - type 2 diabetics.
CI - Type 1 DM, pregnant, hepatic/renal insufficiency
SE - hypoglycemia, N/V, aplastic/hemolytic anemia, B-cell burnout, weight gain, sulfa allergy
Displaced by sulfonamides, clofibrate and salicylates. |
|
|
Term
|
Definition
sulfonylureas - cause a hypoglycemic effect by stimulating the release of insulin. MOA: bind to SUR1 K channel and cause depolarization.
Uses - type 2 diabetics.
CI - Type 1 DM, pregnant, hepatic/renal insufficiency
SE - hypoglycemia, N/V, aplastic/hemolytic anemia, B-cell burnout, weight gain, sulfa allergy
Displaced by sulfonamides, clofibrate and salicylates. |
|
|
Term
|
Definition
intermediate acting insulin. Onset 2-5 hours and lasts 4-12 hours.
Usually mixed w/ rapid or short acting. |
|
|
Term
|
Definition
cause hypoglycemia via increase release of insulin via closing K channel.
Absorbed rapidly. Can be used w/ insulin sensitizers, but not sulfonylureas
Less effective at reducing A1c than SUs. |
|
|
Term
|
Definition
Insulin sensitizer. First line drug in Type II DM.
anti-hyperglycemic action via activation of AMP dependent kinase -> increase insulin action in muscle and fat.
SE - anemia (B12 absorption), N/V, abd pain, flatulence, Lactic acidosis.
CI - hepatic/renal insufficiency |
|
|
Term
|
Definition
agonist for PPAR-y -> activates insulin responsive genes causing increased insulin sensitivity.
SE - liver function monitoring, anemia, weight gain, edema, volume expansion, increased fracture risk
CI - nursing mothers. |
|
|
Term
|
Definition
a-glucosidase inhibitor. competitively inhibits enzymes in glucose metabolism in the gut. Slow absorption.
SE - malabsorption, flatulence, diarrhea, abd bloating |
|
|
Term
|
Definition
a-glucosidase inhibitor. inhibits carbohydrate metabolism in gut.
SE - reduce dose if creatinine < 30, malabsorption, diarrhea, flatulence, abd bloating. |
|
|
Term
|
Definition
amylin analog. Delays gastric emptying, inhibits glucagon secretion, and synergistic w/ insulin
SE - hypoglycemia, GI (N/V, anorexia) |
|
|
Term
|
Definition
GLP-1 analog that stimulates the Gs GLP-1 receptor increasing insulin gene expression and beta cell mass.
Actions are glucose dependent -> dose not cause hypoglycemia.
Also an incretin mimetic.
DPP-IV resistant
SE - N/V, hypoglycemia w/ insulin or secretagogues, weight loss, no B-cell burnout |
|
|
Term
|
Definition
GLP-1 analog.
interacts w/ albumin -> increase T1/2 -> once daily dosing.
SE - N/V, hypoglycemia w/ insulin or secretagogues, weight loss, no B-cell burnout |
|
|
Term
|
Definition
DPP-IV inhibitor converted to active metabolite by CYP3A4. excreted unchanged in urine -> reduce in kidney pts.
SE - no GI, and mild hypoglycemia |
|
|
Term
|
Definition
a synthetic vasopressin that mainly activates the V2 receptors in the kidney to increase water reabsorption.
abdominal cramping.
used for nocturnal enuresis. |
|
|
Term
| Drugs that cause hyperthyroidism |
|
Definition
| Iodides, Amiodarone, and Lithium. |
|
|
Term
|
Definition
beta blocker that prevents the sympathetic activation of adrenergic receptors.
also, inhibits 5-deiodinase in peripheral tissue. (The only beta blocker that does this) |
|
|
Term
|
Definition
1st generation antihistamine that is an Anti-emetic. blocks dopamine receptors.
antagonizes chemotherapy effects but limited b/c of sedation and extrapyramidal effects.
Sedation side effect makes it useful for vomiting pts who can't sleep. |
|
|
Term
|
Definition
5HT inhibitor. blocks serotonin in CTZ.
Most efficacious for chemo/radiation/pregnancy emesis. better than metoclopramide.
Dosage needs to be adjusted for hepatic insufficient pts. |
|
|
Term
|
Definition
central dopamine antagonist as well as increases LES pressure. Elevates the CTZ threshold.
Indicated for diabetic gastroperesis and chemo emesis.
Avoid high doses for extrapyramidal effects -> induce parkinson symptoms** |
|
|
Term
|
Definition
h1 antihistamine. don't worry
It's fucking Benadryl. |
|
|
Term
|
Definition
| H1 antihistamines that also has anti-muscarinic effects. prevents motion sickness. But limited by sedation, and anti-muscarinc effects (dry mouth, urinary retention) |
|
|
Term
|
Definition
opiod anti-diarrheal.
inhibits mucosal peristaltic reflex.
Metabolized to active metabolite.
Peripheral and CNS effects. Give to travelers with diarrhea who can't sleep
Formulated w/ atropine to prevent abuse |
|
|
Term
|
Definition
Opiod anti-diarrheal. Inhibits GI peristalsis
Indicated for non-specific diarrhea and IBD.
Used if you need to go to work b/c no CNS effects. |
|
|
Term
|
Definition
| An aminosalicylate. Releases 5-aminosalicylic acid (anti-inflammatory) and sulfaperidine (anti-bacterial) in large intestine. First step to treat IBD |
|
|
Term
|
Definition
AKA Pepto-Bismol
hydrolyzed to salicylate. anti-secretory, anti-inflammatory, and anti-baterial effects. inhibits prostaglandins to reduce hypermotility and inflammation.
cytoprotective adjunct agent used in Peptic Ulcer disease and used to treat diarrhea |
|
|
Term
|
Definition
An aminosalicylate. Releases 5-aminosalicylic acid in large intestine
Treats IBD |
|
|
Term
|
Definition
An aminosalicylate. Releases 5-aminosalicylic acid in large intestine
Treats IBD |
|
|
Term
|
Definition
pentasa, Asacol, Rowasa, and Canasa
used if pts not responding to aminosalicylates
Has an asa in the name
decreases leukotrienes and scavenges free radicals |
|
|
Term
|
Definition
| immunosuppressant that suppresses DHF reductase and production of tetrahydrofolate used in purine/prymidine synthesis. Used to treat IBD by reducing proliferation of inflammatory cells in the GI. |
|
|
Term
|
Definition
TNF-a antagonist.
Used in severe crohns disease.
don't confuse w/ abciximab (IIb/IIIa inhibitor) |
|
|
Term
| Name 2 anti-spasmotic agents used to treat IBS. |
|
Definition
| Scopolamine and dicyclomine |
|
|
Term
| Name an TCA used to treat IBS |
|
Definition
| Amitryptiline or doxeprin |
|
|
Term
Ulcerative Colitis
cytokines? involved bowel? |
|
Definition
IL-1, IL-6, and TNF.
colon and rectum are infiltrated w/ immune cells |
|
|
Term
| Name 3 SSRI's that are used to treat IBS and how they work |
|
Definition
Fluoxetine, sertraline, and paroxetine.
modulation of pain via preventing serotonin reuptake in the synapse. Very effective. |
|
|
Term
| What is the order of treatment for IBD? |
|
Definition
aminosalycylates (sulfasalazine) or mesalamines (pentasa, asacol, rowasa)
Corticosteroids
Immunosuppressive agents (methotrexate, azathioprine, and 6-mercaptopurine)
Monoclonal antibodies (infliximab)
Surgery (indicated if fistulas, adhesions, and obstructions |
|
|
Term
|
Definition
| Anti-sposmotic agent that treats symptoms of IBS |
|
|
Term
|
Definition
| An H2 receptor antagonist. Blocks acid secretion by the parietal cells in stomach to treat GERD decreases hepatic metabolism of warfarin, phenobarbital, phenytoin, diazepam, and propanolol because it is a potent inhibitor of the cytp450 system |
|
|
Term
|
Definition
stimulates Gi coupled prostaglandin receptor on stomach parietal cell to treat GERD
Not used in cardiac patients |
|
|
Term
exomeprazole
Uses? side effects? |
|
Definition
used in Peptic ulcer disease and GERD.
Inhibits p450 -> decreased elimination of phenytoin, diazepam, and warfarin. |
|
|
Term
|
Definition
Direct irreversible PPI, Most effective in treating GERD and PPI. its a prodrug. converted in parietal cell to active form.
Inhibits 3A4 -> buildup of phenytoin, diazepam, and warfarin
fast onset. |
|
|
Term
| How do you diagnose H. Pylori infection |
|
Definition
MC is urea breath test b/c pylori is urease positive.
can also do endoscopy, and serology |
|
|
Term
|
Definition
systemic alkalosis
diarrhea
magnesium antacids should be avoided in pts w/ renal impairment
Interferes w/ digoxin, ketoconazole, and INH absorption. |
|
|
Term
|
Definition
| anti-ulcer drug. binds and inhibits H2 receptor. H2 receptor blocker. Doesn't mess w/ CytP450 system. |
|
|
Term
| A pt is on phenytoin, a drug metabolized by the p45o system, and develops a peptic ulcer, which PPI is preferred? |
|
Definition
|
|
Term
|
Definition
PPI aka prevacid. FDA approved for infants
PPI.
May interfere w/ absorption of digoxin, ketoconazole and isoniazid |
|
|
Term
|
Definition
PPI. aka nexium.
May interfere w/ absorption of digoxin, ketoconazole and isoniazid.
Inhibits 3A4 -> buildup of phenytoin, diazepam, and warfarin |
|
|
Term
| What is the first line therapy three drug protocol for H. Pylori induced peptic ulcer? |
|
Definition
omeprazole
clarithromycin
amoxicillin/metronidazole |
|
|
Term
|
Definition
Treats Cushings via antagonist at glucocorticoid receptor (no effect on cortisol)
Used for hyperglycemia from hypercortisolism and for pts failed surgery or not surgery candidates.
SE - endometrial proliferation and vaginal bleeding b/c progesterone receptor antagonist. (Estrogen goes cray)
CI - pregnancy, C3A4 drugs (statins, corticosteroid therapy, women w/ endometrial issues.
QT prolongation, hypokalemia, and hypocortisolism. |
|
|
Term
|
Definition
inhibits gonadal and adrenal steroid hormone release.
Unlabeled use in cushings.
SE - hypersensitivity and GI disturbance |
|
|
Term
|
Definition
inhibits 11b-hydroxylase -> increased 11 deoxycorticosteroids and androgens.
Treats ectopic ACTH syndrome, and used for pregnant women w/ cushings.
SE - salt/water retention, hirsutism, transient dizziness |
|
|
Term
|
Definition
inhibits conversion of CH -> pregnenolone.
Treats - cushings from adrenal carcinoma, ACTH producing tumors, adrenal hyperplasia.
SE - lethargy, drowsiness, headache, N/V |
|
|
Term
| Spironolactone (adrenal use) |
|
Definition
antagonist of mineralocorticoid receptor and androgen receptors.
SE-gynecomastia |
|
|
Term
|
Definition
agonist at somatastatin receptor 5. Inhibits ACTH release.
treats adults w/ cushings who can't have surgery.
SE - hypocortisolism (lower dose), hyperglycemia and DM (significant via inhibition of insulin), QT prolongation, cholelithiasis (just like octreotide) |
|
|
Term
|
Definition
| synthetic ACTH. Used to detect addisons. |
|
|
Term
|
Definition
| aromatase inhibitor. Used in treatment of congenital adrenal hyperplasia and endometriosis |
|
|
Term
|
Definition
| aromatase inhibitor. Used in treatment of congenital adrenal hyperplasia and endometriosis |
|
|
Term
|
Definition
increase glucose dependent insulin secretion, decrease glucagon secretion, decrease appetite.
This is a good molecule to have in diabetes.
Degraded by dipeptidal peptidase IV (DPP-IV) |
|
|
Term
Chrohns Disease
cytokines? Bowel involved? Sxs and signs? |
|
Definition
IL-1,6, and 12. TNF and IFN-a.
macrophages, neutrophils and leukocytes infiltrate.
Affects the entire GI tract.
abd tenderness, frequency, bloody stool, low fever, high CRP. |
|
|
Term
|
Definition
| combination patch. High risk of DVT. |
|
|
Term
|
Definition
| a combination contraceptive. Ethinyl estradiol/etonogestrel. Less effective than the pill |
|
|
Term
|
Definition
| The hormone contained in the progestin implants and in nuvaring. Cheap. Lasts for years. Fertility rapidly returns. |
|
|
Term
| Depot-medroxyprogesterone acetate |
|
Definition
| a long acting progestin only contraceptive. IM injection every three months. almost 100% effective. Infertility persists after discontinuation |
|
|
Term
|
Definition
| Progesterone w/ mineralocortocoid antagonistic action. Causes increase in serum K in pts that are on ACEs or K sparing diuretics. |
|
|
Term
|
Definition
| contain a high dose of progesterone to prevent the implantation of the possibly fertilized egg. |
|
|
Term
|
Definition
| the typical estrogen component of birth control. |
|
|
Term
| Conjugated equine estrogens |
|
Definition
Used for HRT. has a short acting estrogen mixture of conjugated estrogens in order to successfully get by first pass metabolism
Used in women who have had a hysterectomy |
|
|
Term
|
Definition
| Synthetic estrogens used for HRT. hydrolyzed by the gut enzymes to get across the membrane |
|
|
Term
|
Definition
| specifically used to treat the hot flashes in menopause via central a2 agonist |
|
|
Term
|
Definition
| SSRI used to treat hot flashes in menopause |
|
|
Term
| what drugs when administered with contraceptives will induce contraceptive failure |
|
Definition
| drugs that induce p450 metabolism such as rifampin, carbamezepine, and phenytoin |
|
|
Term
|
Definition
| a GnRH analog used to suppress gonadotropin secretion and eliminate estrogen production to treat endometriosis. |
|
|
Term
| physiological actions of progestins |
|
Definition
| increase adipose tissue via inhibition of hormone sensitive lipase. Natriuretic peptide, elevates body temp, promotes healthy skin, increase insulin sensitivity. Raises the LDL and decreases the HDL |
|
|
Term
| adrogenic effects of progestins excess? Name 5 |
|
Definition
| increased appetite, weight gain, tired/fatigue, acne, oily scalp, hair loss, hirsuitism, breast regression, depression, yeast infections |
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|
