Term
| Nafarelin acetate (Synarel Nasal solution) |
|
Definition
| endometriosis; agonist of GnRH; spray in morn and even b/w days 2 and 4 of menstrual cycle; sneezing dec bioavailability |
|
|
Term
|
Definition
| prostate CA, endometriosis, kids c precocious puberty; inhibits gonadotropin secretion by desensitizing LHRH receptors; causes edema, hot flashes, impotence, dec libido |
|
|
Term
| Somatropin (Humatrope, Serostim, Genotropin) |
|
Definition
| cachexia in AIDS, and kids c growth failure sec to lacking endogenous GH; IM or SC injection; may induce insulin resistance, hypothyroidism, inhibit growht promoting effect |
|
|
Term
|
Definition
| cachexia in AIDS and kids c growth failure sec to lacking endo GH; IM or SC; may induce insulin resistance, inhibit growth promotion, hypothyroidism |
|
|
Term
|
Definition
| hyposecretion of TSH resulting in atrophy and dec secretory activity of thyroid --> myxedema in adults and cretinism in kids |
|
|
Term
|
Definition
| diff b/w primary and sec hypothyroidism; IM or SC; can cause facial flushing, N/V, HA |
|
|
Term
| what are purified gonadotropin products used for |
|
Definition
| to induce ovulation and PG in infertile women |
|
|
Term
| Human chorionic gonadotropin (hCG)(APL, Pregnyl, Profast) |
|
Definition
| PG test obtained from urine of PG women and induces ovulation only after pre-test c menotropins; same activity as LH with some FSH activity; IM ONLY; may have multiple births when on this drug |
|
|
Term
| Menotropins (Pergonal, Repronex) |
|
Definition
| induction of ovulation and PG in anovulatory infertile women; produce ovarian follicular growth in women s primary ovarian failure; IM c hCG; |
|
|
Term
| Clomiphene (Clomid, Serophene) |
|
Definition
| infertility in women c norm ovarian and pituitary fxn but s normal hypothalamic stimulus; promotes pituitary release of FSH and LH; PO; |
|
|
Term
| Vasopressin (ADH) (Pitressin) |
|
Definition
| post op abd distention, bleeding esophageal varices (unlabeled use), V fib/pulseless V tach cardiac arrest (unlabeled), DI (limited); acts on V1 and V2 receptors and released in response to changes in blood osmolality; IV or intraarterial injection- parenterally; may cause facial pallor, N, belching, abd cramps, bronchial constriction; caution in pts c vascular disease, epilepsy, migraines, asthma, or heart failure |
|
|
Term
|
Definition
| DOC for DI, pediatric enuresis, and adult enuresis; synthetic analog of ADH; intranasal sln BID or PO injection for enuresis; induce V1 receptor SE including antidiuretic effects, abd cramping, angina, HTN |
|
|
Term
|
Definition
| induction of labor, abortion (unlabeled), control PP bleeding; released in response to hormonal changes at term PG; IV; may cause PCVs, harm or death to mom or infant; CI in CPD and unfavorable fetal position |
|
|
Term
|
Definition
| cause GI and vascular smooth muscle contraction |
|
|
Term
|
Definition
| cause water conservation and release of blood coagulation facotrs |
|
|
Term
| What is full blown hypothyroid syndrome called in adults? |
|
Definition
| myxedema coma (cold intolerance, wt gain, constipation, lethargy, thick dry skin, and puffy appearance |
|
|
Term
| what is full blown hypothyroid syndrome called in children? |
|
Definition
| cretinism- development of abnormalities, short body, mental retardation |
|
|
Term
| Levothyroxine (Sythroid, Levoxyl) |
|
Definition
| DOC for hypothyroidism; synthetic levothyroxine; PO daily; may cause hyperthyroidism if dosage is too high, angina and a fib in elderly; cholestyramine and orlistat may interfere c absorption; thyroxine inc anticoag effect of warfarin |
|
|
Term
|
Definition
| hypothyroidism; synthetic form of T3; short duration of activity; used in "augmentation therapy" with antidepressants |
|
|
Term
| signs and symptoms of hyperthyroidism |
|
Definition
| wt loss in setting of hyperphagia, tremor, nervousness, and atrial tachycardias |
|
|
Term
|
Definition
| DOC for hyperthyroidism in PG and during breastfeeding; also used for life-threatening thyroid storm; interfere with incorporation of iodine into tyrosine residues of thyroglobulin; PO but effect may take weeks; may cause hepatotoxicity, agranulocytosis; PG category D |
|
|
Term
|
Definition
| preferred to PTU due to fewer SE; used for hyperthyroidism; interferes with incorporation of iodine into tyrosine residues of thyroglobulin; PO; skin rash, leukopenia |
|
|
Term
|
Definition
| hyperthyroidism; emission of beta rays destroys the thyroid cells; supplement with T4 replacement |
|
|
Term
| sodium etidronate, alendronate (Fosamax), risedronate (Actonel) |
|
Definition
| first line for Paget's disease, also prevention of osteoporosis; bind irreversibly to bone and resists action of osteoclasts; pt should remain sitting up for 30 min after taking the drug; causes gastric irritation; |
|
|
Term
|
Definition
| calcitonin for osteoporosis and Paget's disease; inhibits bone resoroption and enhances bone formation; causes hypocalcemia, nausea |
|
|
Term
|
Definition
| for long-term control of hypocalcemia; recommends 1000-1500 mg/d Ca and 400 IU vitamin D to dec bone loss during aging |
|
|
Term
| Teriparatide injection (Forteo; Fortco) |
|
Definition
| treatment of osteoporosis in postmenopausal women and men at risk; first agent approved for osteoporosis that stimulates new bone formation |
|
|
Term
| Cypionate (Depo-Testosterone) |
|
Definition
| testosterone deficiency (dec sex drive, impotence, dec bone density); promotes development and maintenance of male sex organs and secondary sex characteristics and inhibit spermatogenesis; IM as oily solutions but not effective PO; PG women should NOT touch, metabolized to DHT and CI in men with breast or prostate CA |
|
|
Term
| Nandrolone decanoate (Deca-Durabolin) |
|
Definition
| replacement therapy in primary or secondary hypogonadism; schedule IV; work as endo androgens; high dose produces androgenic effects; causes sodium and water retention, gynecomastia, acne, sterility; CI pts c cancer of prostate or male breast, nephrosis or PG; BB Warn peliosis hepatitis, liver, cell tumors and blood lipid changes |
|
|
Term
| Oxymetholone (Anadrol-50) |
|
Definition
| anabolic steroids; dysmenorrheal, dec menopausal sx, dec PP breast engorgement, provide sx relief in breast CA; schedule IV; sodium and water retention, gynecomastia, acne; BB Warn peliosis hepatitis, liver cell tumors and blood lipid changes; CI in pts with prostate or male breast CA, nephrosis or PG |
|
|
Term
|
Definition
| anti-androgens; first line for advanced prostate cancer (combo with LHRH); inhibits action of androgens by binding androgen receptors; causes hot flashes and diarrhea |
|
|
Term
| Finasteride (Propecia, proscar) |
|
Definition
| anti-androgens; proscar for BPH and propecia for hair loss; 5-alpha-reductase inhibitor (prevents conversion of testoterone to potent DHT); may cause impotency, dec libido, breast tenderness; PG X and women should not handle tablets |
|
|
Term
|
Definition
| anti-androgen; symptomatic BPH; inhibits conversion of testosterone to DHT; subject to enzyme inhibition and PG X so don't handle tabs |
|
|
Term
| estrogen (estradiol is most potent), estrone & estriol |
|
Definition
| PG mare urine is natural source; for menopausal/postmenopausal women, ovulation and prevent PP breast discomfort and dec bone resorption & conservation of calcium; weakly anabolic so dec plt adhesiveness, inc serum clot factors, dec lactation PP, inc levels of thyroxin and cortisol and dec beta lipoproteins/cholesterol; made in liver with complete absorption; inc in incidence of breast CA and DVT; CI in women with undx genital bleeding, estrogen dependent CA, thromboembolism hx or PG |
|
|
Term
| Premarin or ethinyl estradiol |
|
Definition
| relieve menopausal hot flashes with no CV benefit, prevents vulvovaginal atrophy; use lowest dose possible; risk for ischemic stroke |
|
|
Term
|
Definition
| non-steroidal benzothiophene SERM; prevention of postmenopausal osteoporosis, dec risk of breast CA, inc bone mineral density and lowers LDL; agonist in some estrogen receptors and antagonist at others; inc risk of thromboembolism, hot flashes and leg cramps; fewer GI SE and drug interactions than Fosamax and not associated c SE of estrogen therapy |
|
|
Term
| What is first line therapy for postmenopausal osteoporosis? |
|
Definition
|
|
Term
|
Definition
| bisphosphonate; for osteoporosis in postmenopausal women; take 30 min before anything c plain water only and avoid laying down for 30 min; may cause esophagitis |
|
|
Term
|
Definition
| anti-estrogen; SERM drug; agonist on endometrial proliferation, bone resorption & lipoproteins anti-estrogen on breast CA; inc endometrial thickness and risk of CA and inc venous thromboemboli events |
|
|
Term
|
Definition
| transforms proliferative endometrium into secretory endometrium and influences spontaneous contractile activity of the uterus and dec GnRH release sustains PG and reduces incidence of endometrial hyperplasia |
|
|
Term
|
Definition
| progestin-only for tx of AUB, amenorrhea and endometriosis; long acting is for OCP |
|
|
Term
|
Definition
| produced by corpus luteum, testes, adrenal glands and placenta during PG |
|
|
Term
|
Definition
| GI upset, H/A, dizziness, N/V, thromboemboli, cholestatic jaundice and depression |
|
|
Term
|
Definition
| CI in pt c PMH of thromboembolic disease, breast CA or genital organs CA or impaired liver function |
|
|
Term
| progesterone in oil (progestaject) IM (progesterone vag gel), |
|
Definition
|
|
Term
| medroxyprogesteron acetate (Provera tablets) |
|
Definition
|
|
Term
| hydroxyprogesteron caproate in oil (Hylutin) |
|
Definition
|
|
Term
| norethindrone acetate (aygestin tabs) |
|
Definition
|
|
Term
| megestrol acetate (Megace tabs and PO suspension) |
|
Definition
|
|
Term
|
Definition
| N, V, wt gain, cramping; warning of thromboembolism and HTN; PG cat X |
|
|
Term
| progesterone only Micronor, Nor-QD |
|
Definition
| for women who can't stand estrogen; OC of choice in SLE pt; taken QD c no pill-free interval and changes endometrial and cercial mucous environment; take at exactly the same time daily; may cause breakthrough bleeding, ectopic PG risk and inc need for compliance |
|
|
Term
| combination pill = combo of estrogen and progestin |
|
Definition
| taken daily for 21 d then a 7 d pill free interval; others have 81 d dosage c only 4 menses/yr; 1 prep is a year- long dosage schedule |
|
|
Term
|
Definition
| worse in first 3 mo- N, dizziness, edema, and abd cramping; constant SE- H/A thromboembolic sm, dec libido; worse over time- h/a and hirusitism |
|
|
Term
| combination pill CI and warnings |
|
Definition
| enzyme induces dec OCP effectiveness; use second method of contraception; CI in thrombophlebitics, CVA, ischemic artery disease, PG, smokers > 35 y/o; severe h/a, migraine, HTN |
|
|
Term
|
Definition
| contraceptive progestin-containing IUD; recommended for women who have had at least 1 child and pt taking anticonvulsants; lasts 5 yrs; |
|
|
Term
|
Definition
| long-acting injectable progestins; administered every 3 mo; long acting injectable and used to tx endometrial and renal carcinoma; prevents follicular maturation and ovulation; PP for women breastfeeding; causes amenorrhea, wt gain and inc risk osteoporosis; BB warn dec BMD and not used more than 2 yrs |
|
|
Term
|
Definition
| contains progestin etonogestrel; single rod inserted subdermally in upper arm for 3 yrs; may cause irregular bleeding and amenorrhea, h/a, wt gain, breast and abd pain |
|
|
Term
|
Definition
| estonogestrel/ethinyl vaginal ring indicated for prevention of PG; release estrogen and progestin over three weeks then removed for one week; may cause vaginitis, h/a, UTI, N, wt gain |
|
|
Term
|
Definition
| provides 60% more estrogen than typical OCP; applied to area where it won't be rubbed off; worn for 1 week at a time for 3 consecutive weeks and wk 4 is patch free; BB Warn of cigarettemokg and risk of CV adverse effects |
|
|
Term
|
Definition
| for emergency contraception; 2 tabs w/in 72 hrs of unprotected intercourse and 2 tabs 12 hrs later; doses are much higher than in OCP; combo levonorgestrel and ethinyl estradiol |
|
|
Term
|
Definition
| emergency contraception; progestogen prep w/ 1 tab w/in 72 hr of unprotected intercourse and 2nd tab 12 hrs later; contraceptive not an abortifactant and acts by preventing ovulation and may prevent implantation |
|
|
Term
|
Definition
| nonoxynol 9 & octoxynol; apply 10 min but not > 1 hr before intercourse and apply high in vagina prior to intercourse; |
|
|
Term
| Clomiphene Citrate (Clomid, Serophene) |
|
Definition
| nonsteroidal ovulatory stimulant and fertility drug; 80% of women become PG; inc output of GnRH and pituitary gonadotropin; CI hepatic dysfunction, abnormal bleeding |
|
|
Term
|
Definition
| vasoconstrictor used PP oxytocins to prolong intense contractions of uterus for hemostasis; PO or IM; uterine cramping, N/V/D; CI in eclampsia, CVA, limb ischemia |
|
|
Term
|
Definition
| produced from arachidonic acid; used as abortifactant for cervical ripening; regulate sperm motility, stimulate anterior pituitary release of LH, inhibit activity of corpus luteum and control smooth muscle tone; most serious SE = uterine rupture or cervical perforation, drowsyness, HTN, dyspnea |
|
|
Term
|
Definition
| abortifacient and unlabeled use as "vaginal ripening" at term; 2 tabs inserted vaginally or PO; |
|
|
Term
|
Definition
| beta 2 agonist that suppresses labor; SC administration; unapproved use |
|
|
Term
|
Definition
| inhibits myometrial contractility and tx eclampsia; IV; lacks FDA approval |
|
|
Term
| What is the insulin of choice? |
|
Definition
| rapid acting insulins lispro or aspart |
|
|
Term
|
Definition
| facilitate transport of glucose across cell membranes & to enhance phosphorylation of glucose within cells |
|
|
Term
| what is the most serious SE of insulin? |
|
Definition
|
|
Term
| treatment of severe hypoglycemia |
|
Definition
| treated with 50% glucose solution or glucagon IV |
|
|
Term
| insulin drug interactions |
|
Definition
| ACTH, glucocorticoids, thyroid, thiazides, estrogens inc blood sugar; epi inhibits secretion of insulin; BB, NSAIDs, ethanol, salicylates, lithium with hypoglycemic effects; OCAs, beta-2 agonists, CCB, phenytoin with hyperglycemic effects |
|
|
Term
| insulin lispro (LYS-Pro Humalog) |
|
Definition
| rapid or immediate onset short acting; 15 min ac or immediately pc; peak 1 hr; |
|
|
Term
|
Definition
| insulin of choice for use in insulin pumps; faster absorption, onset of action and shorter duration of action than regular insulin; |
|
|
Term
| Glulisine insulin (Apidra) |
|
Definition
| approved for use with insulin pump; administered 15 min ac or 20 min pc and faster onset and shorter duration of action than reg insulin; |
|
|
Term
| Insulin injection (regular insulin) |
|
Definition
| insulin of choice for tx of abrupt onset hyperglycemia or ketoacidosis; short acting; IV and SC: |
|
|
Term
|
Definition
| intermediate prep c insulin conjugated c protamine; peaks 4-12 hrs and take bid; used in insulin mixtures |
|
|
Term
| Detemir Insulin (Levemir) |
|
Definition
| as effective as NPH c same incidence of hypoglycemia; once or twice-daily SC use and can be used as monotherapy or added to PO antidiabetic agents or rapid-acting insulin; provides up to 24 hr duration of action; |
|
|
Term
|
Definition
| lower incidence of nocturnal hypoglycemia than NPH; more dense crystal structure; SC once daily with flat insulin profile for 24 hrs; should not be admin IV and not diluted or mixed with other insulin or solution |
|
|
Term
|
Definition
| suppresses glucagon secretion and slows gastric emptying; contributes to glucose control during post prandial period |
|
|
Term
|
Definition
| synthetic analog of amylin approved in pts c type 1 or 2 diabetes who inject insulin at mealtimes and have failed to acheive glucose control; ac to dec post-prandial plasma glucose and dec short-acting insulin required; N/V and inc risk of severe hypoglycemia when given c insulin; do not mix insulin in same syringe |
|
|
Term
|
Definition
| sec gen sulfonylurea; PO hypoglycemic; stimulate pancreatic cells to secrete insulin; initial dose with first main meal; may cause hypoglycemic coma and GI upset; PG cat C |
|
|
Term
|
Definition
| chloramphenicol, MAOI, salicylates and sulfonamides inc risk of hypoglycemia; NSAIDs and salicylates affect prostaglandin activity which regulates glucose |
|
|
Term
| Glipizide (Glucotrol; Glucotrol XL) |
|
Definition
| sec gen sulfonylurea that stimulates pancreatic beta cells to secrete insulin; take 30 min ac; may cause hypoglycemic coma or GI upset; PG cat C |
|
|
Term
|
Definition
| meglitinides; PO hypoglycemic that stimulates the release of insulin from the pancreas; PO within 15 min of meal; hypoglycemia |
|
|
Term
|
Definition
| meglitinides; lower blood glucose or HgbA1C; sensitizes beta cells to glucose c rapid onset and short duration of action; take 1 to 30 min ac; |
|
|
Term
| Metformin (Glucophage) general info |
|
Definition
| biguanide anti-hyperglycemic; monotherapy first line or when used in combo may have syngergistic effect |
|
|
Term
| Metformin (Glucophage) actions and MOA |
|
Definition
| anti-hyperglycemic that lowers LDL and inc HDLs; do not stimulate pancreatic insulin secretion; dec glucose production by liver by dec gluconeogenesis inc glucose oxidation; dec glucose absorption |
|
|
Term
| Metformin (Glucophage) kinetics |
|
Definition
| food dec extend and delays absorption however it should be given c the morning and evening meals to dec gastric upset |
|
|
Term
| Metformin (Glucophage) SE and CI |
|
Definition
| GI distress and less hypoglycemia or wt gain; CI in pts with renal dysfunction or metabolic acidosis; cimetidine causes inc in concentration and AUC; BB warn lactic acidosis |
|
|
Term
| Rosiglitazone (Avandia), Pioglitazone (Actos) |
|
Definition
| combination therapy c sulfonylureas, diet and exercise in pts with type 2 diabetes; inc glucose uptake, dec insulin resistance, and inc sensitivity of insulin receptors; once daily; fluid retention that may lead to heart failure; inc risk of hypoglycemia when given c insulin |
|
|
Term
| Acarbose (Precose) Miglitol (Glyset) |
|
Definition
| alpha-glucosidase inhibitors; used to dec postprandial plasma glucose & potentiate the hypoglycemic effect of insulin & sulfonylureas; reversibly bind to & inhibit alpha-glycosidase at brush borders of the small intesine; take at first bite of each meal; GI symptoms; |
|
|
Term
| Sitagliptin (Januvia) and Saxagliptin (Onglyza) |
|
Definition
| dipeptidyl peptidase-4 inhibitors; tx type 2 diabetes and do not cause hypoglycemia or wt loss; inc availability of GLP-1; |
|
|
Term
|
Definition
| polypeptide hormone produced by alpha cells of pancreatic islets for tx of severe hypoglycemia; stimulates glycogenolysis and produces neoglucogenesis; IV c glucose in tx of acute hypoglycemic rxn |
|
|
Term
| Indications for corticosteroids |
|
Definition
| Deficiency states (i.e Addison's dx), cerebral edema, lumbar disc dz, organ transplant, asthma, arthritis, collagen dx, ocular inflammation, cutaneous d/o, UC, MG, leukemia, allergic rhinits, URI |
|
|
Term
|
Definition
| gluconeogenesis, protein catabolism, fatty acid metabolism, anti-inflammatory effects, lymphoid tissue and immune response suppression, sex hormone regulation |
|
|
Term
|
Definition
| aldosterone evokes distal renal tubular reabsorp of Na in exchange for K |
|
|
Term
|
Definition
| cortisol influences glucose, fat, and protein metabolism and produces anti-inflammatory response |
|
|
Term
| corticosteroid withdrawal SE |
|
Definition
| fever, myalgia, arthralgias, malaise |
|
|
Term
| long term corticosteroid use in large doses SE |
|
Definition
| pituitary adrenal suppression, fluid/lytes imbalance, hyperglycemia, PU, inc susceptibility to infection, osteoporosis, myopathy, cataracts, arrest of growth, cushing habitus |
|
|
Term
| hydrocortisone (Cortef, hydrocortone) |
|
Definition
| chronic adrenal insufficiency, UC; cortisol secreted by adrenal cortex regulated by ACTH from ant pit; causes sodium and water retention; antacids interfere with PO absorption, enzyme inducers |
|
|
Term
|
Definition
| more potent corticosteroid than hydrocortisone; DOC for long-term EOD tx to dec suppression of HPA axis and for autoimmune diseases; analog of cortisol; converted to prednisolone in gut; taper drugs! may cause adrenal insufficiency |
|
|
Term
|
Definition
| tx for certain types of cerebral edema; fluorinated derivative with anti-inflammatory effects; suppresses HPA axis and not likely to cause Na and H2O retention; |
|
|
Term
| Fludrocortisone (Florinef) |
|
Definition
| mineralocorticoid for deficiency states such as addison's disease; glucocorticoid c potent mineralocorticoid properties; sodium and water retention |
|
|
