Endocrine Drugs

Front 1

Patient with prolactinoma is given this drug? What are its side effects?

Back 1

Bromocriptine
SE: Hypotension & Nausea
*cabergoline (another dopamine agonist - SE: Nausea & headache)

Front 2

What type of medications stimulate prolactin secretion?

Back 2

Dopamine antagonists - antipsychotics & estrogens (OCP & pregnancy)

Front 3

A male patient has hesitancy when urinating and after treatment he now has increased hair growth. What is the medication?

Back 3

Finasteride = 5 alpha reductase
*used to treat benign prostatic hypertrophy and male patterned baldness
SE:
- rash
-decreased libido
- breast tenderness enlargement
- decrease volume of ejaculation
-impotence

Front 4

If a patient had an overactive thyroid and you wanted to decrease the amount to T4/T3 made by competitive inhibition? What drug would you use?

Back 4

Perchlorate/ pertechnetate - these drugs block iodine absorption

Front 5

What drug would you use if you were trying to block both peroxidase and 5' - deiodinase in the thyroid? What is the major side effect of this drug?

Back 5

Propylthiouracil
Major SE: hepatotoxicity & agranulocytosis (rare)

Front 6

What if you had a patient with an over active thyroid, and you were only trying to block oxidation of iodine (by inhibiting peroxidase)?

Back 6

You would tx with Methimazole
SE: possible teratogen & agranulocytosis (rare)

Front 7

How do Beta Blockers aid hyperthyroid patients?

Back 7

Beta blockers decrease the symptoms associated with hyperthyroid and they also decrease the peripheral conversion of T4 to T3

Front 8

What is the therapeutic treatment for Conn's disease?

Back 8

Spironolactone - K+ sparing diuretic that works by acting as an aldosterone antagonist

Front 9

A patient with Hypotension and hyperkalemia presents to the ER, what drug should be administered right away?

Back 9

Corticosteriods (aldosterone and cortisol)
* This patient most likely has Adrenal Insufficiency

Front 10

You have a patient with episodic HTN, Headache, and tachycardia. What is the treatment of choice?

Back 10

This patient has a pheochromocytoma- Tx: alpha- antagonist = PHENOXYBENZAMINE - irreversible alpha blocker

this treatment should be followed by surgery to remove the tumor

Front 11

What would be the side effects of the drug given to patients with hypothyroidism/

Back 11

Levothyroxine
SE:Tachycardia, heat intolerance, tremors, arrhythmias
*also used for myxedema

Front 12

Your patient has Grave's disease, what is the treatment?

Back 12

B-blockers (decrease symptoms and decrease peripheral conversion to T3)

Thionamides (methimazole & Propylthiouracil)

Front 13

You have a patient that just underwent surgery for the following symptoms: increase size in feet, hands, and head. He also had insulin resistance.What medication should be started after surgery?

Back 13

Octreotide
SE: Gallbladder problems
Dysglycemia - disruption in blood sugar regulation
Hypothyroidism
Bradycardia

Front 14

What is desmopressin's role in diagnosing DI?

Back 14

Response to Desmopressin (synthetic ADH) distinguishes between central and nephrogenic diabetes insipidus

Front 15

What is the treatment for central DI?

Back 15

intra nasal desmopressin
SE: headache

Front 16

What is the treatment for nephrogenic DI (kidneys don't respond to ADH)?

Back 16

1. Hydrochorothiazide
2. amiloride
3. Indomethacin - increase water absorption by decreasing prosteglandin synthesis

Front 17

What is the treatment for SIADH?

Back 17

demeclocycline OR h2o restriction

SE: photosensitivity,discoloration of teeth, glossitis, nausea

*this is off label use

Front 18

What are the clinical uses of GH?

Back 18

GH deficiency and Turners syndrome

Front 19

What are the clinical uses of somatostatin (octreotide)?

Back 19

Acromegaly
Carcinoid
gastrinoma
glucagonoma

Front 20

What are the clinical uses for Oxytocin?

Back 20

Stimulates labor, uterine contractions, milk let down, and controls uterine hemorrhage

Front 21

What is the clinical use for ADH (desmopressin)?

Back 21

Pituitary (central) DI

Front 22

When would one use Demeclocycline?

Back 22

For SIADH - ADh antagonist
* member of tetracycline family
SE: Nephrogenic DI, photosensitivity, abnormalities of bone and teeth

Front 23

Name some glucocorticoids?

Back 23

1) Hydrocortisone
2) prednisone
3) triamcinolone
4) dexamethasone
5) beclomethasone

Front 24

What are some clinical uses for glucocorticoids?

Back 24

1) Addison's disease
2) Inflammation
* like the extraoccular muscles in Grave's disease
3) immune suppression
4) asthma

Front 25

What are the side effects to glucocorticoids?

Back 25

1) Cushing's like syndrome
2) when the drugs are stopped abruptly - can create adrenal insufficiency

Front 26

What is a corticosteriod?

Back 26

This term refers to both glucocorticoids (cortisol) and mineralcorticoids (aldosterone)

Front 27

What are the different types of insulin?

Back 27

1) Lispro (rapid-acting)
2) Aspart ( rapid)
3) Glulisine (rapid)
4) Regular insulin (short acting)
5) NPH (intermediate)
6) Glargine (long lasting - 24h)
7) Detemir (long lasting -12 h)

Front 28

What is the mechanism of action of Insulin?

Back 28

Bine insulin receptor (tyrosine kinase activity)
* liver = increase glycogenolysis
*muscle = increase glycogen and protein
* fat = aids in TG storage

Front 29

What are the side effects associated with insulin?

Back 29

Hypoglycemia
hypersensitivity reaction (very rare)

Front 30

What is the first line therapy for someone who is in DKA?

Back 30

regular insulin

Front 31

How do the sulgonylureas work?
1st gen: Tolbutamide & Chloropropamide
2nd gen: Glyburide, Glimepriride, Glipizide

Back 31

Close the K+ channel in Beta cells - triggering cell membrane depolarization - releasing Ca - releasing insulin
*these drugs require some islet function

Front 32

What are the major side effects to the sulfonylureas?

Back 32

1st gen: disulfiram-like rxn
2nd gen: hypoglycemia

Front 33

What drug has a similar MOA as the sulfonylureas but isn't used as much anymore?

Back 33

Meglitinides (nateglinide)
SE: hypoglycemia & wt. gain

Front 34

What is the MOA for sitagliptin?

Back 34

It is a DPP4 inhibitor = inhibits the breakdown of GLP-1
SE: Nausea
*wt. neutral

Front 35

What are the major SE for Exenatide (GLP-1 agonist)?

Back 35

N/V; pancreatitis
* MOA: increase insulin and decrease glucagon release; increases somatostatin - slows gastric emptying - slows the blood sugar increase
*wt. loss

Front 36

What are the major SE for thiazolidinediones?

Back 36

(Pioglitazone & Rosiglitazone)
* increase insulin sensitivity in peripheral tissues - binds PPAR- gamma (transcription regulator)
SE: wt. gain, edema, HEPATOXICITY, HEART failure

Front 37

What are the SE for the Alpha-glucosidase inhibitors?

Back 37

(Acarbose & Miglitol)
SE: Gi disturbances (flatulence and diarrhea)
MOA: inhibits the intestinal brush border alpha glucosidease
- delaying sugar hydrolysis and glucose absorption
- needs 3x/day dosing

Front 38

What are the SE to Metformin (Biguanide)?

Back 38

SE: GI upset - gets better over time if you titrate up to the dose you need & lactic acidosis
MOA: decrease hepatic production of glucose
* no hypoglycemia risk
* wt. neutral to loss