S2 Pharm 39-77

Front 1

Drug interaction if given Metyrapone and Aminoglutethimide together

Back 1

Iatrogenic adrenal insufficiency

Front 2

Major side effect in males of spironolactone

Back 2

Gynecomastia; competitive antagonist at androgen receptors (inhibits CYP450 too)

Front 3

Eplerenone MOA

Back 3

Selective aldosterone antagonist (no andorgen receptor antagonism)

Front 4

Alternative use for spironolactone (not hypoeraldosteronism)

Back 4

Treatment for female hirsutism due to androgen receptor antagonism)

Front 5

Phenoxybenzamine MOA

Back 5

Irreversible non-competitive alpha adrenergic receptor inhibitor (blocks catecholamines, reduces HTN in pheochromocytoma)

Front 6

Propranolol MOA

Back 6

Non-selective competitive beta adrenergic antagonist (block catecholamines, reduces tachycardia)

Front 7

Sequence for pheochromocytoma Tx prior to surgery

Back 7

Alpha-adrenergic (phenoxybenzamine) prior to beta-adrenergic (propranolol) antagonist to avoid B2-mediated vasodilation inhibition leading to hypertensive crisis.

Front 8

Test for adrenal insufficiency (not Metyrapone)

Back 8

Cosyntropin; ACTH analogue

Front 9

MIBG

Back 9

Iobenguane (mIGB), radiolabeled molecule like noradrenaline (iodine-123) (specific for pheochromocytoma)

Front 10

Tx for Hypervitaminosis D

Back 10

Decrease Ca2+ / Vit D intake; loop diuretic (furosemide)

Front 11

Effect on thyroid of amiodarone

Back 11

Both hypo and hyperthyroidism

Front 12

1st line Tx- hypothyroidism

Back 12

Levothyroxine (Levo)- T4

Front 13

Drugs reducing conversion T4 -> T3

Back 13

Inhibit 5' deiodinase: propranolol (beta blockers), corticosteroids, aminoglutethemide (comp. selective mineralo), antiarrhythmic amiodarone

Front 14

Liotrix MOA

Back 14

Mix T3/T4 if pt can't convert T4 -> T3

Front 15

Emergency hypothyroid Tx

Back 15

Ex) myxedema coma. Liothyronine- T3, rapid onset, short duration, highly potent (not for long-term use)

Front 16

AE of Liothyronine

Back 16

Cardiotoxicity, increased risk of arrhythmia, insomnia, anxiety

Front 17

Iodine Salt MOA

Back 17

Hyperthyroid- inhibits TH synthesis/release, decreased vascularity of thyroid

Front 18

Thiomide MOA

Back 18

Inhibit peroxidase (organification), inhibit iodotyrosine coupling, inhibit 5'-deiodinase (propylthiouracil/PTU, methimazole)

Front 19

PTU vs. Methimazole

Back 19

PTU (short acting, less potent, rapid acting) vs. Methimazole (10x potent, long duration)

Front 20

Contraindication of PTU in children

Back 20

Hepatotoxicity (hepatocellular necrosis), prefer lower risk Methimazole

Front 21

AE of Thioamides

Back 21

GI, macropapular rash, hypothyroid symptoms, hepatitis (children), lupus-like syndrome, agranulocytosis

Front 22

Tx of Thyroid Storm

Back 22

Propranolol (beta blocker- CV, anxiety, T4->T3 conversion), IV PTU (rapid), hydrocortisone (reduce T4->T3), supportive therapy for fever

Front 23

Postoperative radioablation for thyroid tumor is indicated when:

Back 23

1. distant mets; 2. gross extrathyroidal extension; 3. >4cm tumors

Front 24

DM2 treatment if A1c over 10?

Back 24

Insulin

Front 25

Essure ®

Back 25

Tubal occlusion device placed into fallopian tubes via hysteroscopy

Front 26

Copper T IUD

Back 26

Polyethylene w/ copper causes immune response and hostile environment preventing fertilization

Front 27

Risks of Copper IUD

Back 27

Perforation, expulsion, increased risk of infection during 1st month

Front 28

Levonorgestrel Intrauterine System MOA

Back 28

Thickens cervical mucus (inhibits sperm motility/function), endometrial atrophy prevents fertilization

Front 29

Risks of Levonorgestrel IUS

Back 29

Perforation, expulsion, infection (1st month), unpredictable bleeding, progestin-mediated (breast tenderness, mood, acne, headache), follicular ovarian cysts

Front 30

IUD/IUS Contraindications

Back 30

Pelvic infection, purulent cervicitis, UAB, malignancy, uterine distortion, pelvic TB

Front 31

Implant (Nexplanon) MOA

Back 31

Etonorgestrel, 3 years, bleeding/amenorrhea common

Front 32

Treatment for Premenstrual dysphoric disorder

Back 32

Drospirenone (spironolactone derived), anti-androgenic, exerts progestational and antimineralocorticoid effects by inhibiting and binding androgens to its receptors

Front 33

Progesterone OC MOA

Back 33

Alters fallopian tube peristalsis, cervical mucus thickens, atrophic endometrium

Front 34

OrthoEvra patch MOA

Back 34

Avoids 1st pass, VTE risk

Front 35

NuvaRing MOA

Back 35

Flexible, AE= coital problems, expulsion, vaginal discharge

Front 36

Progestin-Only OC

Back 36

"mini-pill", norethindrone or norgestrel, suppresses ovulation/thickens mucus; CONSISTENT use critical (miss by 3 hrs, use back-up protection)

Front 37

Depo-Provera shot

Back 37

Depot medroxprogesterone acetate (DMPA); convenient; AE= weight gain, irregular bleeding, bone mineral density

Front 38

Risk of frequent spermicide use

Back 38

increased HIV risk

Front 39

Plan B / Ulipristal MOA

Back 39

Inhibit or delay ovulation (causes a lot of nausea)