Term
|
Definition
|
|
Term
| What are normal VitD values? |
|
Definition
Normal value is 30ng/ml
Need 1000-1500 units/day |
|
|
Term
| Secretion of calcitonin is stimulated by what? |
|
Definition
|
|
Term
| Hypercalcemia is defined as what? |
|
Definition
|
|
Term
| How is hypercalcemia treated? |
|
Definition
IV fluids
Excretion using loop diuretics w/ Furosemide
Calcitonin -> drug of choice for CHF patients
Long term treatment: Pamidronate, Etidronate, Zoledronate |
|
|
Term
| Hypocalcemia is defined as what? |
|
Definition
|
|
Term
| All Ca++ supplements require what? |
|
Definition
| An acidic environment for absorption except calcium citrate |
|
|
Term
| What is the drug of choice for the treatment of hypocalcemia? |
|
Definition
| Calcium gluconate due to minimal irritation to veins |
|
|
Term
| What are second line treatments for hypocalcemia? |
|
Definition
Calcium chloride
Calcium carbonate and Calcium lactate (Oral only) |
|
|
Term
| What does chronic glucocorticoid treatment do to calcium levels? |
|
Definition
| Down regulates Ca++ binding protein, inhibits Vit D activation, can cause osteoporosis. Give bisphosphonates (alendronate) |
|
|
Term
| How do you treat Paget's disease? |
|
Definition
| Bisphosphonates and calcitonin |
|
|
Term
| What is first line for the treatment of osteoperosis? |
|
Definition
| Bisphosphonates - Alendronate |
|
|
Term
| What is the MoA of bisphosphonates? |
|
Definition
Anti-resorptive action inhibits action on osteoclasts
Changes expression of RANK-L
IV only, poor oral absorption |
|
|
Term
| What are the adverse effects of bisphosphonates? |
|
Definition
| GI bleed, GI irritation, contraindicated in GERD, peptic ulcers, renal dysfunction |
|
|
Term
| What are the bisphosphonates formulations? |
|
Definition
| Alendronate, Ibandronate, Pamidronate, Tiludronate, Risedronate, Etidronate sodium |
|
|
Term
| What are the calcitonen formulations? |
|
Definition
| Gibacalcin (human) and Calcimar (salmon) |
|
|
Term
| What are the adverse effects of Gibacalcin and Calcimar (calcitonen formulations) |
|
Definition
| Headache, weakness, nausea, vomiting, contraindicated with allergy, renal dysfunction |
|
|
Term
| What is the MoA of Plicamycin? |
|
Definition
Cytotoxic antibiotic, inhibits hypercalcemic action of VitD and PTH
Highly toxic, limite duse |
|
|
Term
| What is Plicamycin used for? |
|
Definition
| Hypercalcemia due to advanced neoplasms |
|
|
Term
| Rickets, osteoporosis, and osteomalacia all require what for treatment? |
|
Definition
|
|
Term
| What are the VitD formulations? |
|
Definition
Calcitriol
Ergocalciferol
Doxercalciferol |
|
|
Term
|
Definition
VitD3, activated form of VitD, given for patients with kidney failure
3-5day duration |
|
|
Term
| What are the contraindications for calcitriol use? |
|
Definition
| Hypercalcemia, patients on cardiac glycosides |
|
|
Term
|
Definition
VitD2
Given for hypophosphatemia, osteomalacia, osteoporosis, rickets
2 month duration |
|
|
Term
|
Definition
|
|
Term
| What are the indications for doxercalciferol use? |
|
Definition
| Given for hyperparathyroidism (reduces PTH) |
|
|
Term
| Doxercalciferol is contraindicated in what cases? |
|
Definition
| Pregnancy, hep and renal dysfunction |
|
|
Term
|
Definition
A Calcimimetic, mimics Ca++ at Ca++ receptors of the parathyroid
Increased sensitivity to calcium to reduce PTH
30-40hr half life, long |
|
|
Term
| What is the only drug to shut out the parathyroid hormone release by binding the ionized calcium receptor? |
|
Definition
|
|
Term
|
Definition
|
|
Term
| Patient with osteoporosis has failed bisphosphonates and estrogen modulators, T score is beyond 2.5. What do you use? |
|
Definition
|
|
Term
| Teriparatide therapy beyond 21 months runs the risk of what? |
|
Definition
|
|
Term
|
Definition
| Selective estrogen receptor modulator used in the management of osteoporosis |
|
|
Term
| What are the Growth Hormone agonists? |
|
Definition
|
|
Term
| What is Somatotropin? Uses? |
|
Definition
| Recombinant GH, given for GH deficiency, AIDS wasting |
|
|
Term
|
Definition
| GH with additional methionine at terminus, given for GH def and AIDS wasting |
|
|
Term
|
Definition
| GHRH agonist, somewhat less effective than somatotropin, given for the same reasons |
|
|
Term
| What are the somatostatin agonists? |
|
Definition
|
|
Term
| What are the actions of somatostatin? |
|
Definition
| Inhibitory hormone, inhibits anterior pituitary and GI hormones |
|
|
Term
| What are the actions of Octreotide? |
|
Definition
Similar to somatostatin but longer ½ life
Selectively inhibits growth of prolactin secreting adenomas to somatostatin receptors SSTR2 and SSTR5
Inhibits secretion of GH, serotonin, gastrin, VIP, motilin
Can cause gallstones |
|
|
Term
| What are the actions of Pegvisomant? |
|
Definition
Mutant of GH that binds GH receptor and induces internalization without activating the receptor
Contraindicated in liver dysfunction |
|
|
Term
| What are the dopamine D2 receptor Agonists |
|
Definition
| Bromocriptine, Pergolide, Cabergoline |
|
|
Term
| What are the actions of Bromocriptine, Pergolide, Cabergoline? |
|
Definition
Dopamine D2 receptor agonists
Stops growth of prolactin secreting adenomas
Decreased dopamine release in parkinson’s
Causes postural hypotension due to vasodilation of renal vascular beds |
|
|
Term
| What are the GnRH agonists? |
|
Definition
| Gonadorelin, Gosrelin, Nafarelin (nasal spray) |
|
|
Term
| What affects of Gonadorelin, Gosrelin, Nafarelin (GnRH agonists) on LH and FSH secretion? |
|
Definition
Pulsatile administration = release of FSH and LH
Non-pulsatile administration = FSH and LH “flare” then inhibition after 7 days
Used to either stimulate or (more often) suppress gonadotropin release
Can be given to suppress ovulation, limit 6 months, used for endometriosis
Contraindicated in pregnancy and breast feeding |
|
|
Term
| What are the GnRH antagonists? |
|
Definition
|
|
Term
| Ganirelix and Cetrorelix are used to treat what? |
|
Definition
| Given to delay ovulation in women undergoing fertility treatment, suppress cancer growth |
|
|
Term
| What is the MoA of Ganirelix and Cetrorelix? |
|
Definition
Given via subcutaneous injection
Acts as GnRH antagonist to prevent LH surge during ovarian hyperstimulation
Duration of administration is slower, less negative impact on ovarian response
May cause ovarian hyperstimulation syndrome |
|
|
Term
| What are the FSH agonists? |
|
Definition
Urofollitropin, Follitropin alpha, Follitropin Beta
Extracted from the urine of postmenopausal women |
|
|
Term
|
Definition
| Leuteinizing hormone agonist, all given subQ or IM, is recombinant human LH |
|
|
Term
| Lutropin is only given alongside what drug? |
|
Definition
| Follitropin alpha for stimulation of follicular development in infertile women with profound LH deficiency |
|
|
Term
| What are the hCG agonists? |
|
Definition
| Propasi, Pregnyl, Choriogonadotropin alpha |
|
|
Term
| Oxytocin is given for what purpose? |
|
Definition
| Induce labor and prevent postpartum bleeding, at high concentrations acts as antidiuretic. May cause fetal distress, placental abruption, uterine rupture, fluid retention |
|
|
Term
| What are the actions of Vasopressin? |
|
Definition
Activates receptors in collecting tubules leading to increased water resorption
V2-like receptor activity at extrarenal sites regulates release of coagulation factor VIII and von Willebrand factor |
|
|
Term
|
Definition
| Long acting synthetic analog of Vasopressin, mainly acts at V2 receptor |
|
|
Term
|
Definition
| Vasopressin antagonist used to treat hyponatremia assoc w/ elev. vasopressin |
|
|
Term
| Ghrelin induces the secretion of what? |
|
Definition
|
|
Term
| What is the function of prolactin? |
|
Definition
| Activates JAK-STAT signal pathway to increase casein production for milk production and breast development during pregnancy |
|
|
Term
| What are the Thionamides? |
|
Definition
| Methimazoleb and Porpylthiouracil |
|
|
Term
| What is the function of Methimazoleb and Porpylthiouracil? |
|
Definition
Reduces synthesis of thyroid hormones, inhibits thyroperoxidase to reduce iodination of tyrosyl residues
Antithyroid action delayed days-weeks until existing stores of T3/4 are depleted
Short half lives
May cause arthralgia, fever, rash, fetal goiter, etc |
|
|
Term
| What is the preferred drug for the treatment of fetal thyrotoxicosis? |
|
Definition
|
|
Term
| What is the drug of choice for the treatment of thyroid storm and hyperthyroidism in pregnancy? |
|
Definition
|
|
Term
| Potassium iodide is used for what? |
|
Definition
| Oral solution only, used in treatment of thyroid storm and to prepare hyperthyroid patients for thyroidectomy. Not good long term therapy |
|
|
Term
| What are Iopanoic acid and Lopadate? |
|
Definition
| Iodinated contrast agents that prevent the release of T4 and T3 as well as the conversion of T4 to T3 |
|
|
Term
| What are Iopanoic acid and Lopadate used for? |
|
Definition
| Temporary treatment of highly toxic thyrotoxic patients, used in subacute thyroiditis and patients intolerant to thionamides |
|
|
Term
| First line treatment of Graves disease includes what? |
|
Definition
|
|
Term
|
Definition
| Natural thyroid extract mixture of T4/T3 from animals, unpredictable ratio and effect, possible hypersensitivity |
|
|
Term
| What drug is first line for the treatment of hypothyroidism? |
|
Definition
|
|
Term
| What is Levothyroxine Sodium? |
|
Definition
| Synthetic T3, well absorbed orally, fast onset of action, half dose of T4 needed |
|
|
Term
|
Definition
| T4/T3 mix not preferred, expensive |
|
|
Term
| Testosterone is converted to what? |
|
Definition
| to DHT, a more potent form, via 5alpha-reductase |
|
|
Term
| What is the difference between type I and II 5alpha-reductase? |
|
Definition
Type I 5-alpha-reductase found in non-genital skin, liver, and bone
Type II 5-alpha-reductase found in genita skin |
|
|
Term
| Testosterone is normally bound to what? |
|
Definition
| Androgen binding protein, sex hormone binding globulin (SHBG), and albumin |
|
|
Term
| Histeron and Androderm are used in what? |
|
Definition
| Testosterone patches that bypass first pass metabolism |
|
|
Term
| What are the testosterone esters? |
|
Definition
Testosterone enanthat and Testosterone cypionate
Given via IM, highly lipophilic, given every 2 weeks |
|
|
Term
| What are the 17alpha alkylated androgens aka anabolic steroids? |
|
Definition
Methyltestosterone, Oxandrolone, Stanozolol, Danazol
Causes hepatotoxicity given PO |
|
|
Term
| What is Tetrahydrogestrinoneb |
|
Definition
| newer androgen formulation |
|
|
Term
| What are the uses for testosterone therapy? |
|
Definition
| Male hypogonadism, male andropause, female hypogonadism, improve libido, enhance athletic performance, male contraception, muscle wasting in AIDS, anaplastic anemia |
|
|
Term
| What androgen drug used as adjunctivent for hemolytic anemia and drug induced TTP? |
|
Definition
|
|
Term
| What are the side effects of testosterone treatment? |
|
Definition
| Decreased testicle size, increased RBC production, gynecomastia, decreased HDL, increased LDL, advancement of BPH or prostate cancer |
|
|
Term
| What are the GnRH/LHRH agonists? |
|
Definition
| Buserelin, Leuproreline, Goserelin, Nafarelin |
|
|
Term
| What are the actions of Buserelin, Leuproreline, Goserelin, Nafarelin? |
|
Definition
| GnRH analogs that desensitize the GnRH signaling pathway, inhibiting the release of LH and FSH |
|
|
Term
| Buserelin, Leuproreline, Goserelin, Nafarelin (GnRH agonists) are used for what treatment? |
|
Definition
| BPH and hirsutism treatment |
|
|
Term
|
Definition
GnRH antagonist with extended release used to treat prostate cancer
Significant incidence of hypersensitivity reactions |
|
|
Term
| What are the androgen receptor antagonists? |
|
Definition
| Flutamide, Bicaltamide, Nilutamide, Spironolactone, Cyproterone acetate |
|
|
Term
| What is the MoA of Flutamide, Bicaltamide, Nilutamide, Spironolactone, Cyproterone acetate (androgen receptor antagonists)? |
|
Definition
Limited efficacy when used alone
Blocks negative feedback on HPA axis to increase LH secretion and promote testosterone promotion, takes 6-9 months to reach maximal effect, avoid donating blood
Causes hepatotoxicity and possible gynecomastia (spironolactone) |
|
|
Term
| GnRH analogs are used alongside which to treat metastatic prostate cancer? |
|
Definition
Androgen receptor antagonists:
Flutamide, Bicaltamide, Nilutamide, Spironolactone, Cyproterone acetate |
|
|
Term
| Flutamide, spironolactone, cyproterone acetate are used with estrogen to treat what? |
|
Definition
|
|
Term
| Finasteride (Type I) and Dutasteride (Type I and II) are what type of drugs? |
|
Definition
| 5-alpha reductase inhibitors, blocks the conversion of destosterone to DHT |
|
|
Term
| Finasteride (Type I) and Dutasteride (Type I and II) are used for what? |
|
Definition
5-alpha reductase inhibitors, blocks the conversion of destosterone to DHT
Used for benign prostatic hyperplasia |
|
|
Term
| What is first line for the treatment of BPH? |
|
Definition
Alpha-1 blockers: Terazosin, Doxazosin, Tumulosin, Alfuzosin
Increased urine flow within 48hrs, decreased ejaculation, Alfuzosin prolongs QT interval |
|
|
Term
| Which phase of menstruation is gonadotropin dependent? |
|
Definition
|
|
Term
| Follicles are extremely sensitive and dependent on what hormone during which phase? |
|
Definition
| FSH during the rapid growth phase. Drop of FSH causes atresia with the exception of the dominant follicle |
|
|
Term
| What are estrogen's effects on the liver? |
|
Definition
| Improves lipid profile, increases synthesis of binding proteins SHBG, CBG, and TBH, increases synthesis of coagulation factors |
|
|
Term
| What is estrogen's effect on adipose tissue? |
|
Definition
| Decreases adipose tissue, inhibiting LPL and increasing activity of hormone sensitive lipase |
|
|
Term
| What effect does estrogen have on kidney function? |
|
Definition
| Natriuretic effect on kidneys as a competitive inhibitor of aldosterone |
|
|
Term
| Estrogen from the ovaries induces which phase of menses? |
|
Definition
| Proliferative phase of the endometrium |
|
|
Term
| What is the principal estrogen in circulation? |
|
Definition
Estradiol
Estrone is the main estrogen synthesized by the adrenal gland
Both estradiol and estrone can be converted to estriol |
|
|
Term
| What is the monophasic combined pill? |
|
Definition
|
|
Term
| What is the biphasic combined pill? |
|
Definition
|
|
Term
| What is in the combined pill? |
|
Definition
| Has 3 generations, contains synthetic estrogone: ethinyl estradiol or mestranol and a variety of C-19 progestin steroids: **Norgestrel, Norgestimate, **Desogestrol, Levonorgestrel, Ethynodiol diacetate, Norethindrone acetate |
|
|
Term
|
Definition
| CYP450, beware drug interactions |
|
|
Term
| Contraceptive failure occurs when mixed with what drugs? |
|
Definition
| Rifampin, carbamazepine, phenytoin |
|
|
Term
| What are side effects of the combined pill? |
|
Definition
ACHES = Abdomen Chest Headaches Eye Severe leg pain
Gallstones, blood clots, pancreatitis, stroke, HTN, migraine, occlusion, DVT
Detrimental effects on lipid panel, impairs glucose tolerance, increased risk of breast carcinoma |
|
|
Term
| The combined pill is contraindicated under what risk factors? |
|
Definition
| Heavy smoker, HTN, undiagnosed vaginal bleed, diabetes with vascular complications, DVT or PE, history of stroke, history of thrombosis, history of breast cancer, active viral hepatitis or cirrhosis, breastfeeding, major surgery with immobilization, history of cholestasis with COC use, pregnancy |
|
|
Term
|
Definition
| Long acting progesterone via IM injections, infertility persists for months |
|
|
Term
| Progestin implants use what formulations of progestin? |
|
Definition
| Levonorgestrel or etonorgestrel, cheaper, lasts for months |
|
|
Term
| What are the post-coital contraceptives? |
|
Definition
Ovral, Plan B, Preven
High dose of progesterone, main effect is to make environment inhospitable to sperm |
|
|
Term
| What is the leading cause of death related to menopause? |
|
Definition
|
|
Term
| What are the conjugated Equine Estrogens? |
|
Definition
| Cenestin, Enjuvia, Premarin, Progens |
|
|
Term
| The conjugated Equine Estrogens are used to treat what? |
|
Definition
Primary ovarian failure, menopause symptoms, dose not reduce risk of CHD
Include progestin in women with intact uterus to lower risk of endometrial cancer |
|
|
Term
| What are the esterified estrogens? |
|
Definition
Estratab, Menest, Menrium, Neo-estrone
Given for primary ovarian failure, menopause symptoms, dost not reduce risk of CHD
Include progestin in women with intact uterus to lower risk of endometrial cancer |
|
|
Term
| What is Clonidine used for? |
|
Definition
| Alpha-2 antagonist used to reduce hot flashes |
|
|
Term
| What is Desvenlaflaxine used for? |
|
Definition
| SSRI used to reduce hot flashes |
|
|
Term
| What are the aromatase inhibitors? What are they used for? |
|
Definition
| Anastrozol and Letrozole used to treat endometriosis |
|
|
Term
| What is the MoA of Prochlorperazine? |
|
Definition
A phenothiazine
Blocks dopamine receptors, moderates chemo agents
Causes sedation and extrapyramidal symptoms (parkinsons symptoms) |
|
|
Term
| What is the MoA of Ondansetron, Granisetron, Dolasetron? |
|
Definition
5HT3 inhibitors
5HT3 receptor blockade in the vomiting center and chemoreceptor trigger zone, long duration of action, highly effective, dose adjust in cases of hepatic insufficiency |
|
|
Term
| What is the MoA of Metoclopramide? |
|
Definition
Dopamine antagonist
Elevates CTZ threshold/nausea threshold, used for gastroperesis, prevention of chemo induced emesis, good for GERD
Avoid high dose due to extrapyramidal symptoms, never use long term |
|
|
Term
| What is the MoA of Diphenhydramine, Meclizine, Hyoscine? |
|
Definition
H1 antihistamines
o Used in combo with other antiemetics, prevents motion sickness, limited use by sedation, urinary retention, dizziness |
|
|
Term
| Which H1 antihistamines is approved for use as an anti-emetic used in pregnancy? |
|
Definition
|
|
Term
| What is the MoA of Dronabinol? |
|
Definition
| Cannabinoid, inhibits vomit control mechanism, not often used |
|
|
Term
| What is the MoA of Psyllium? |
|
Definition
A laxative for the small and large intestines, increases bulk and moisture content in stool, stimulates peristalsis
Used to prevent straining during defecation
May cause bowel obstruction if taken with insufficient liquid |
|
|
Term
| What is the MoA of Lactulose, Salin catharitics, Magnesium citrate? |
|
Definition
Acts on colon and small intestine to retain ammonia and produce cholecystokinin, producing osmotic effect to stimulate bowel evacuation
Used in prevention and treatment of portal cystemic encephalopathy, constipation, evacuate colon before exam/surgery, accelerate parasite or poison excretion
May cause electrolyte disturbance |
|
|
Term
| What is the MoA of Senna? |
|
Definition
Stimulates colon interstitial smooth muscles to increase peristalsis, used to facilitate diminished colonic motor response or evacuate colon before exam/surgery
Causes discolored urine, electrolyte depletion |
|
|
Term
| What is the MoA of Docusate? |
|
Definition
A stool softener than lowers surface tension in the intestines, facilitates penetration of fat and water into stool
Used for short term constipation and to evacuate colon before surgery/exam |
|
|
Term
| What are the anti-diarrhea opiods? |
|
Definition
|
|
Term
| What is the MoA of Diphenoxylate? |
|
Definition
Inhibits mucosal peristaltic reflex-reduction of GI motility, metabolized to active metabolite Difenoxin
Maximal anti-diarrheal effects with minimum CNS effects
Combined with atropine to prevent abuse |
|
|
Term
| Diphenoxylate is combined with what when used? |
|
Definition
| Atropine to prevent abuse |
|
|
Term
| What is the MoA of Loperamide? |
|
Definition
Opioid inhibition of GI peristalsis, prolongs transit time of intestinal contents
Indicated for non-specific diarrhea and IBD, has peripheral opiate effects but no CNS effects |
|
|
Term
| What is the MoA of Bismuth subsalicylate aka pepto-bismol? |
|
Definition
Is an anti-secretory, anti-inflammatory, anti-bacterial that coats the GI tract, hydrolyzed in GI to salicylate
Inhibits prostaglandin synthesis and reduces hypermotility and inflammation |
|
|
Term
| What GI medication should be avoid if bacterial enteritis is expected? |
|
Definition
| Opiates Diphenoxylate or Loperamide |
|
|
Term
| What are the Aminosalicylates? |
|
Definition
Sulfasalazine, Olsalazine, Balsalazine
Inhibits synthesis of prostaglandins and inflammatory leukotrienes |
|
|
Term
| What is first line for the treatment of IBD? |
|
Definition
Aminosalicylates:
Sulfasalazine, Olsalazine, Balsalazine |
|
|
Term
| What are the Mesalamine compounds? |
|
Definition
| Pentasa, Asacol, Rowasa, Canasa |
|
|
Term
| What is the MoA Mesalamine compounds Pentasa, Asacol, Rowasa, Canasa? |
|
Definition
Direct salicylates that don’t require break down, modulates inflammatory response, especially leukotrienes, inhibits TNF
Used for IBD, Crohn’s disease, Ulcerative colitis |
|
|
Term
| What are the GI immunosuppressants? |
|
Definition
| Azathioprine, 6-Mercaptopurine, Methotrexate, Cyclosporine, Infliximab |
|
|
Term
| What is the MoA of the Gi immunosuppressants Azathioprine, 6-Mercaptopurine, Methotrexate, Cyclosporine, Infliximab? |
|
Definition
Inhibits purine synthesis, reduces GI inflammation, reduces need for long term corticosteroid use, slow onset
Used to treat IBD |
|
|
Term
| What should you do if aminosalicylates and corticosteid therapy for IBD fails? |
|
Definition
| Increase methotrexate while decreasing corticosteroids |
|
|
Term
| What is used for symptomatic treatment of severe Crohn’s? |
|
Definition
Infliximab and TNF-alpha antagonists
Inhibits induction of proinflammatory cytokines |
|
|
Term
| What are the anti-depressants used to modulate pain effects of neurotransmitters, used for IBS? |
|
Definition
| Amitriptyline and Doxepin |
|
|
Term
| What SSRIs are used for IBS? |
|
Definition
Paroxetine, Fluoxetine, Sertraline
Acts on 5HT1 and 5HT2 receptors to reduce visceral hypersensitivity, less side effects |
|
|
Term
| What is the MoA of Alosetron? |
|
Definition
| Modulates visceral afferent activity from GI, may improve abd pain, not commonly prescribed, only given for extreme conditions of IBS |
|
|
Term
| How is H. pylori diagnosed? |
|
Definition
| Uupper endoscopy, serologic ab detection, urea breath test, or stool antigen tests |
|
|
Term
| What is first line therapy for H. pylori? |
|
Definition
| Omeprazole + Clarithromycin + Amoxicillin/Metronidazole |
|
|
Term
| What is the combination therapy for H. pylori? |
|
Definition
| PPI + Metronidazole or amoxicillin + clarithromycin |
|
|
Term
| What is the bismuth based regiment for H. pylori? |
|
Definition
| Omeprazole + Bismuth subsalicylate + Metronidazole + Tetracycline/Amoxicillin/Clarithromycin |
|
|
Term
| What is given as maintenance therapy H. pylori? |
|
Definition
| Low dose H2 antagonist or PPI |
|
|
Term
| NSAID induced ulcers are best treated with what? |
|
Definition
Omeprazole, Misoprostol is 2nd choice
First stop NSAID, move to COX-2, then Omeprazole |
|
|
Term
| What is the best treatment for GERD? |
|
Definition
| H2 antagonists and PPIs (Omeprazole) |
|
|
Term
| Treat Zollinger-Ellison Syndrome (hypersecretion due to gastrin secreting tumor) with what? |
|
Definition
|
|
Term
| You should avoid taking antacids with what drug? |
|
Definition
| Quinidine, a 1a anti-arrhythmic, causes increased absorption |
|
|
Term
|
Definition
| Al Hydroxide + Mg, Mg hydroxide, Simethicone, Mg carbonate, Ca carbonate, Sodium bicarbonate |
|
|
Term
| What is the order of H2 antagonist potency? |
|
Definition
| Famotidine > Nizatidine > Ranitidine > Cimetidine |
|
|
Term
| What is the MoA of Cimetidine? |
|
Definition
H2 antagonist, suppresses all phases of daytime and nocturnal basal gastric acid secretion, given for PUD
Decreased hepatic metabolism of warfarin, phenobarbital, phenytoin, diazepam, propranolol, very significant |
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Term
| What is the MoA of Rantidine? |
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Definition
H2 antagonist, potential anti-ulcer, reduces gastric acid release in response to food
Short term treatment of active duodenal ulcer, used for maintenance therapy |
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Term
| What is the MoA of Nizatidine? |
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Definition
| H2 antagonist, Inhibits gastric acid secretion, used for active duodenal ulcer and maintenance therapy |
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Term
| What is the MoA of Famotidine? |
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Definition
| Potent competitive inhibitor of histamine at H2 receptor sites, reduces output of HCL |
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Term
| What is the MoA of Omeprazole? |
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Definition
PPI, suppresses gastric acid secretion by inhibiting H/K ATPase
Converted in parietal cell canaliculi to active form, onset within 1hr, lasts for more than 24hrs, better eradication of H. pylori when given in combo with anti-bacterial
Inhibits CYP450, decreased elimination of phenytoin, diazepam, warfarin |
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Term
| What are the PPIs with no drug interactions? |
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Definition
| Lansoprazole, Eesomeprazole, Pantoprazole, Raberprazole |
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Term
| What is the MoA of Lansoprazole? |
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Definition
| PPI, similar to omeprazole, combined with anti-bacterials better |
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Term
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Definition
| Isomer of omeprazole, converted to active form, substantial suppression of acid secretion |
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Term
| What PPIs have no CYP450 interaction? |
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Definition
| Pantoprazole, Raberprazole |
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Term
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Definition
| Binds to Gs FA 294 to increase transport of cholesterol from outer micochondrial membrane to inner to initiate cortisol synthesis |
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Term
| 9alpha-flouro analogs Dexamethasone, Betamethasone, and Triamcinolone are mostly bound to what? |
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Definition
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Term
| How do glucocorticoids cause the death of hypocampal cells? |
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Definition
| Indirectly due to BP and electrolyte changes |
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Term
| Cortisol is converted to inert cortisone at mineralcorticoid receptors by what? |
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Definition
| 11b-hydroxysteroid dehydrogenase |
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Term
| What is the MoA of Ketconazole? |
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Definition
Inhibits all gonadal and adrenal steroid hormone synthesis, used to treat
Potential hypersensitivity and GI reactions |
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Term
| What is the MoA of Metyrapone? |
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Definition
Inhibits 11-beta hydroxylase, increases adrenal androgens and aldosterol
Used to treat pregnant women with Cushings |
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Term
| What is the MoA of Aminoglutethimide? |
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Definition
Inhibits conversion of cholesterol to pregnenolone to prohibit glucocorticoid synthesis
Used to treat Cushings due to adrenal carcinoma, ectopic ACTH producing tumors, adrenal hyperplasia
May cause lethargy, drowsiness, headache |
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Term
| What is the MoA of Spironolactone? |
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Definition
| Antagonist at mineralcorticoid receptor, used to treat hyperaldosteronism |
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Term
| Primary adrenal insufficiency is treated with what? |
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Definition
| Hydrocortisone or fudrocortisone 2/3 in morning, 1/3 in evening |
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Term
| Secondary adrenal insufficiency refers to what? |
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Definition
| Adrenals are working but suppressed due to low ACTH, often due to exogenous cortisol |
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Term
| Fludrocortisone is another name for what? |
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Definition
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Term
| What can given to prevent aromatization of androgens to estrogen? |
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Definition
| Anastazole, Letrazole, Flutamide |
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