Reading...
Play button
Play button
Use LEFT and RIGHT arrow keys to navigate between flashcards;
Use UP and DOWN arrow keys to flip the card;
H to show hint;
A reads text to speech;
41 Cards in this Set
- Front
- Back
|
Calcitonin
|
opposite of PTH
suppress bone resorption produced by parafollicular cells act via GPCR regulated by Ca and PTH can treat hypercalcemia, osteoporosis, paget disease |
|
|
treatment for hyperthyroidism
|
thionamides
radioactive iodine surgery (then L thyroxine for resultant hypothyroidism) |
|
|
Thionamides
|
inhibit thyroid peroxidase-mediated iodination of thyroglobulin
methimazole propylthiouracil |
|
|
Methimazole
|
thionamide
better choice if 1 treatment chosen |
|
|
propylthiouracil
|
blocks peripheral conversion of T4 to T3
treat thyrotoxic crisis |
|
|
thionamide tox
|
methimazole can cause cholestatic jaundice
both can cause rash, arthritis, rarely-agranulocytosis |
|
|
5 alpha reductase inhibitors
|
treat BPH/MPB
block conversion of testosterone to dihydrotestosterone |
|
|
bisphosphonates
|
tx osteoporosis, osteopenia, paget's
MOA- antiresorptive, inhibit osteoclasts by blocking farnesyl pyrophosphate synthesis |
|
|
Alendronate
|
most potent bisphosphonate
|
|
|
Etidronate
|
bisphosphonate
give cyclically |
|
|
bisphosphonates tox
|
erosive esophagitis
must take on empty stomach, full glass water, remain upright |
|
|
Glucocorticoids effect on bone
|
antagonize vit D-mediated absorption of Ca++ and PO4
partially block reabsorption of Ca and PO4 in kidney may enhance PTH-mediated bone resorption |
|
|
Estrogens effect on bone
|
adsorb to bone crystals and render them resistant to enzymatic hydrolysis
|
|
|
Calcitriol
|
regulate gene txn
dec PTH stimulate Ca and PO4 absorption from GI stimulates FGF23 release from bone (inhibits VitD production) |
|
|
RANKL + MCSF
|
differentiation and activation of osteoclasts
|
|
|
FGF23 excess
|
osteomalacia
(inhibits calcitriol production and dec phosphate levels) |
|
|
Ganirelix
|
GnRH antagonist, tx prostate ca
|
|
|
flutamine
bicalutamine nilutamide |
treat hirsuitism
|
|
|
Sulfonylureas
|
Glipizide
Glyburide Glimepiride inc intracellular Ca= release insulin can cause hypoglycemia |
|
|
Biguanides
|
metformin
enhances insulin's suppression of gluconeogenesis enhance glucose uptake by skeletal mm dec TG and LDL no hypoglycemia |
|
|
Thiazolidinediones TZDs
|
Pioglitazine
Rosiglitazone reduce insulin's resistance inc glucose utilization in muscle reduce TG, inc HDL no hypoglycemia |
|
|
Glinides
|
type 2 DM tx
repaglinide exenatides GLP-1 analog |
|
|
Dipeptidylpeptidase 4 inhibitor (DPP4)
|
type 2 DM tx
Sitagliptin Saxagliptin |
|
|
alpha glucosidase inhibitors
|
acarbose
miglitol bind jejunal brush border cleave oligo and monsaccharides |
|
|
Insulins
|
fast acting: Apart, Lispro, Glulisine
NPH (neutral protamine hagedorn) Glargine- no peak Detemir-no peak |
|
|
Maximum effect on A1C
|
metformin>glipizide>glimepiride
|
|
|
SERMs
|
tamoxifen
nonsteroidal estrogen receptor ligand agonist in bone and endometrium antagonist in breast (dec stimulatory GF like TNFalpha and inc inhibitory like TNF beta) |
|
|
tamoxifen metabolism
|
CYP2D6 transforms it to endoxifen (100x more potent)
SSRIs dec conc of endoxifen |
|
|
Aromatase MOA and indication
|
convert androgens to estrogens
treat locally advanced or metastatic breast ca (not for premenopausal women) |
|
|
premenopausal treatment for breast ca
|
premenopause = surg, chemo, then tamoxifen (NEVER chemo+hormonal)
ovarian ablation |
|
|
postmenopausal treatment for breast ca
|
surgery
tamoxifen chemo if necessary selective aromatase inhibitor progestins |
|
|
GnRH agonist
|
LHRH agonist
treat prostate cancer tumor flare- surge tesosterone before feedback loop inhibits (bone pain, neuropathy, hematuria, urinary obstruction) |
|
|
abiraterone
|
treat castration-resistant prostate ca (pts previously treated with docetaxel)
|
|
|
combined androgen blockade
|
GnRH agonist + anti androgenic
|
|
|
hormones manipulated in oral contraception
|
GnRH stimulates FSH and LH
FSH stimulates estradiol secretion and stimulates follicles progesterone is more dominant hormone in 2nd 1/2 of cycle |
|
|
why estrogen in contraceptives?
|
negative feedback to pituitary = inhibit FSH and ovulation
|
|
|
why progestins in contraceptives?
|
negative feedback to pituitary= inhibit ovulation (<estrogen)
endometrial atrophy thicken cervical mucus |
|
|
Anastrozole
Exemestane Letrozole |
aromatase inhibitors
prevent conversion to estradiol |
|
|
Goserelin
Leuprolide |
Gonadotropin releasing hormone agonists
suppress FSH and LH to treat ca |
|
|
Bicalutamide
Flutamide Nilutamide Abiraterone |
anti-androgenic agents
nonsteroidal ligands |
|
|
MOA of insulin
|
binds tyrosine kinase transmembrane receptor
phosphorylates tissue specific substrates (IRS1, SH2) change gene expression to upregulate lipoprotein lipase, fatty acid synthase, glucokinase |
