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19 Cards in this Set

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Octreotide
Properties - Synthetic somatostatin analog given SQ.
Indications - acromegaly, glucagonoma, insulinoma, GI bleeding, intractable diarrhea
Leuprolide
Properties - GnRH analog that inhibits gonadotropin release when given in continuous doses. Given SQ or IM.
Indications - Prostate cancer, PCOS, uterine fibroids, endometriosis.
Bromocriptine
Properties - Dopamine receptor agonist. Given orally.
Indications - hyperprolactinemia and associated infertility and breast ingorgement, inhibit lacation postpartum. Can also be used with octreotide in acromegaly.
SE, Tox - N/V, arrhythmias, hypotension, paranoia/psychosis.
Oxytocin
Properties - posterior pituitary hormone. Given IV to induce/maintain labor, IM to control postpartum bleeding, as a nasal spray to cause milk secretion.
DDAVP (desmopressin)
Properties - analog of ADH with no V1 effects (so no smooth muscle contraction --> HTN)
Indications - central diabetes insipidus
Menotropins
Properties - partially degraded FSH and LH
Indications - induces ovulation in infertile women when followed by HCG. induces spermatogenesis in infertile men when following HCG.
SE, Tox - overstimulation of ovaries --> multiple pregnancies, ovarian cysts.
Cosyntropin
Properties - a sythetic ACTH analog which is less antigenic.
Indications - Used in the diagnosis of adrenal function (failure to respond indicates primary adrenal disorder).
Levothroxine sodium
Properties - levo isomer of T4 given orally or IV. T4 has halflife of 6-7 days.
Indications - hypothyroidism. preferred drug because cheaper, easier to monitor, and has longer half life than synthetic T3 drug.
Iodine
Properties - 50+mg/d will lead to autoinhibition of thyroid hormone production. Blocks uptake of iodide by the gland and diminishes vascularity. Given as Lugol solution (iodine and potassium iodide). Works within 24 hours.
Indications - given preop to shrink the gland before surgical removal, as tx for thyroid storm. NOT long term.
SE, Tox - dose-related. hypersensitivity, head cold symptoms, gastric irritation, parotitis. long-term use --> sudden disinhibition --> acute hyperparathyroidism.
Propylthiouricil (PTU) and methimazole
Class - Thioamides
Properties - inhibit the peroxidase enyzmes (oxidation of iodide and coupling of iodinated tyrosyl groups) --> decreased hormone synthesis. Also inhibits peripheral T4 --> T3. Onset of action after performed hormones have been metabolized.
Indications - control of hyperthyroidism until surgery, until the effect of radioactive iodide begins, and long-term therapy for mild-moderate cases. PO.
SE, Tox - maculopapular rash, joint pain, headache, nausea, hair loss. Rare, serious agranulocytosis. Can cross placenta and enter breast milk; PTU is more protein-bound therefore less likely to do so.
Radioactive Iodine
Properties - Either PO or IV, it is taken up rapidly by the thyroid --> thyroglobulin. Causes destruciton of the gland by emission of beta particles with minimal damage to surrounding tissue.
Indications - hyperthyroidism
SE, Tox - overdosage --> delayed hypothyroidism.
CI - pregnancy.
Calcitonin
Properties - lowers serum calcium, inhibits bone resorption, blocks Ca, phosphate release from bone
Indications - hypercalcemia, hyperPTH, vitamin D toxicity, Paget disease, bone tumors, osteoporosis.
SE, Tox - hypersensitivity rxns, hypocalcemia
Vitamin D
Indications - hypocalcemia due to rickets, hypoPTH, osteomalacia
SE, Tox - hypercalcemia
Diphosphonates
Properties - analogs of pyrophosphate bind to hydroxyapatite crystals and reduce their formation, growth, and dissolution --> less bone turnover
Indications - hypercalcemia of malignancy, Page disease, osteoporosis, hyperPTH
Sulfonylureas
Examples - Tolbutamide, chlorpropamide, glyburide, glipizide
Properties - stimulates insulin release by closing K channels in βcell membrane --> depol --> Ca influx and insulin release
Indications - NIDDM
SE, Tox - hypoglycemia esp. with long-acting chlorpropamide and high-potency glyburide and glipizide, skin rashes, GI upset, hypothyroidism, disulfiram-like reaction, esp with chlorpropamide
Metformin
Properties - mechanism unknown, possibly inhibits gluconeoneogenesis, increases glycolysis --> decreased serum glucose levels.
Indications - NIDDM, don't need islet function
SE, Tox - NO hypoglycemia, can result in lactic acidosis
Glitazones or Thiazolidinediones (the longest name EVER)
Examples - Pioglitazone, risiglitazone
Properties - increase target cell response to insulin. can be used alone or with other agents.
SE, Tox - weight gain, troglitazone is hepatotoxic
Repaglinide
Properties - sulfonylurea-like, stimulates insulin release
Acorbose
Properties - inhibits α-glucosidase of brush border and prevents asorption of glucose
SE, Tox - GI discomfort