Term
| What are the 1st generation sulfonylureas? |
|
Definition
Chlorpropamide
Tolbutamide
Tolazamide |
|
|
Term
| What are the 2nd generation sulfonylureas? |
|
Definition
|
|
Term
| What are the 3rd generation sulfonylureas? |
|
Definition
|
|
Term
| What are the 3 mechanisms of actions of the sulfonylureas? |
|
Definition
1) stimulate - insulin release from B-cells of the pancreas
2) Prolong Binding - of insulin to target tissue receptors
3) Reduce glucose - levels in the serum through indirect inhibition |
|
|
Term
| Can sulfonylureas be used in pregnancy? |
|
Definition
| NO! They can cross the placenta and cause insulin depletion in the fetal pancreas |
|
|
Term
| What is the major SE of sulfonylureas? |
|
Definition
|
|
Term
| What is the SE caution if a pt is on chlorpropamide? |
|
Definition
| disulfiram rxtn with alcohol use |
|
|
Term
| What is the MOA of Metformin? (3) |
|
Definition
1) inhibits hepatic gluconeogenesis
2) decreases glucose absorption from GI tract
3) Increases peripheral utilization of glucose |
|
|
Term
| What diabetic drug can be used in the treatment of PCOS? |
|
Definition
|
|
Term
| What class of drugs does Metformin belong to? |
|
Definition
|
|
Term
| What are the major SE of Metformin? |
|
Definition
Lactic Acidosis
GI upset
DOES NOT CAUSE HYPOGLYCEMIA!!! |
|
|
Term
| In which pts should Metformin use be avoided? |
|
Definition
| Pt with renal insufficiency |
|
|
Term
| In which pts should sulfonylureas be used with caution? |
|
Definition
| pts with renal and hepatic insufficiency |
|
|
Term
| Which class of drugs works by binding PPAR-Y, which results in the upregulation of multiple genes, which has an end result of a decrease in insulin resistance? |
|
Definition
| Thiazolidinediones - Pioglitazone and Troglitazone and Rosiglitazone |
|
|
Term
| What drug class has SE including hypoglycemia, edema and liver damage (with one particular drug in the class, that is now off the market)? |
|
Definition
| Thiazolidinediones - Pioglitazone and Troglitazone and Rosiglitazone |
|
|
Term
| What must be monitored closely while using Rosiglitazone or Pioglitazone? |
|
Definition
|
|
Term
| Which diabetes meds inhibit a-glucosidase, which causes a decrease in the absorption of postprandial carbs, thus lowering postprandial glucose? |
|
Definition
|
|
Term
| Which med has major GI SE including flatulence and diarrhea? |
|
Definition
|
|
Term
| What drug is a GLP-1 analog that increases insulin secretion and decreases glucagon secretion? |
|
Definition
|
|
Term
| Which meds are DPP-4 inhibitors? |
|
Definition
| Sitagliptin, Vildagliptin |
|
|
Term
| Which meds work by degrading GLP-1 which acts to increase insulin secretion and to decrease glucagon secretion? |
|
Definition
| Dipeptidyl peptidase- 4 (DPP-4) Inhibitors = Sitagliptan and Vildagliptan |
|
|
Term
| Which class of drugs binds to K channels of the pancreatic B-cell thus stimulating the release of insulin from the pancreas? Which drug class are these similar to? |
|
Definition
| Meglitinides; Similar to sulfonylureas |
|
|
Term
| What meds are Meglitinides? |
|
Definition
| Repaglinide and Nateglinide |
|
|
Term
| Which diabetes med has SE including pancreatitis and hypoglycemia? |
|
Definition
|
|
Term
| Which diabetes med causes nausea? |
|
Definition
| DPP-4 Inhibitors (Sitagliptin and Vildagliptin) |
|
|
Term
| Which diabetes med causes weight gain and hypoglycemia? |
|
Definition
| Meglitinides (Repaglinide and Nateglinide) |
|
|
Term
| Which class of drugs inhibits HMG-CoA reductase, thus inhibiting cholesterol biosynthesis in the liver, as well as causing an increase in the concentration of LDL receptors on hepatocytes, thereby decreasing the LDL and VLDL? |
|
Definition
| HMG-CoA reductase inhibitors - Atorvastatin, Pravastatin, lovastatin, rosuvastatin, simvastatin, and fluvastatin |
|
|
Term
| Which drug's MAJOR effect is to decrease total cholesterol levels and LDL levels? |
|
Definition
| Atorvastatin (also Simvastatin, Pravastatin, Lovastatin, Rosuvastatin, Fluvastatin) |
|
|
Term
| Which lipid-lowering agent can cause SE including myopathy, abnormal LFTs and is teratogenic? |
|
Definition
| Atorvastatin (also Simvastatin, Pravastatin, Lovastatin, Rosuvastatin, Fluvastatin) |
|
|
Term
| What cholesterol-lowering med acts by decreasing cholesterol absorption in the GI tract and mainly results in a decrease in LDL levels? |
|
Definition
|
|
Term
| Are drugs like Atorvastatin effective in familial hypercholesterolemia? |
|
Definition
| No, b/c these pts lack LDL receptors |
|
|
Term
| Which lipid lowering med works by inhibiting the reabsorption of bile acids in the jejunum and ileum, resulting in an increased conversion of cholesterol to bile acids, leading to lower levels of cholesterol, overall resulting in a lowering of LDL? |
|
Definition
| Bile Acid Resins: Cholestyramine, Colestipol and Colesevelam |
|
|
Term
| Which med is used to lower LDL levels, has no effect on HDL and can also be used to treat pruritis associated with liver failure and diarrhea after gallbladder removal? |
|
Definition
| Cholestyramine (also Colestipol and colesevelam) |
|
|
Term
| What med has SE including GI upset, bad taste to the med, decreased absorption of fat soluble vitamins (A,D,E,K)? |
|
Definition
| Cholestyramine (also Colestipol and colesevelam) |
|
|
Term
| ARe bile acid resins effective in individuals with familial hypercholesteroemia? |
|
Definition
| No, b/c they lack LDL receptors |
|
|
Term
| Which class of drugs stimulates lipoprotein lipase which is the enzyme responsible for breaking down trigs into VLDL and chylomicrons which are then removed from circulation? |
|
Definition
|
|
Term
| Which drugs are considered fibrates? |
|
Definition
| Gemfibrozil, ciprofibrate, bezafibrate and fenofibrate |
|
|
Term
| What drug’s main effect is decreases trig levels, but may also decrease LDL and mildly increase HDL? |
|
Definition
| Fibrates: Gemfibrozil, ciprofibrate, bezafibrate and fenofibrate |
|
|
Term
| Which lipid lowering meds have SE including increased incidence of of gallstone formation , GI upset, myositis and abnormal LFT? |
|
Definition
| Fibrates: Gemfibrozil, ciprofibrate, bezafibrate and fenofibrate |
|
|
Term
| What happens to Warfarin’s effects when that pt is put on fibrates? |
|
Definition
| Effects of Warfarin are increased |
|
|
Term
| What drug is used primarily to increase HDL levels and to decrease LDL levels by decreasing lipolysis in adipose tissue? |
|
Definition
|
|
Term
| What is the MC SE of Niacin? |
|
Definition
|
|
Term
| Which med decreases osteoclastic bone reabsorption by inhibiting osteoclastic activity and increasing osteoclastic cell death? |
|
Definition
| Bisphosphonates: Alendronate, Etidronate, Ibrandronate, Zoledronate, Pamidronate, and Risedronate |
|
|
Term
| What are the Bisphosphonates? |
|
Definition
| Alendronate, Etidronate, Ibrandronate, Zoledronate, Pamidronate, and Risedronate |
|
|
Term
| What drug is used in the treatment of osteoporosis, padget’s disease of the bone, bone metastasis with associated hypercalcemia and MM? |
|
Definition
| Bisphosphonates: Alendronate, Etidronate, Ibrandronate, Zoledronate, Pamidronate, and Risedronate |
|
|
Term
| Which med has SE of esophageal erosions (GI upset), and rarely osteonecrosis of the jaw? |
|
Definition
| Bisphosphonates: Alendronate, Etidronate, Ibrandronate, Zoledronate, Pamidronate, and Risedronate |
|
|
Term
| Which drugs inhibit thyroid peroxidase, resulting in the inhibition of thyroid hormone synthesis, also inhibits peripheral conversion of T4 to T3? |
|
Definition
| Propylthiouracil and Methimazole |
|
|
Term
| What drug is used in the treatment of hyperthyroidism in pregnant women? |
|
Definition
|
|
Term
| Which med can cause SE including Maculopapular skin rash, agranulocytosis, and arthralgias? |
|
Definition
| Propylthiouracil and Methimazole |
|
|
Term
| What med is used in the treatment of hypothyroidism? |
|
Definition
|
|
Term
| What med is the synthetic form of T4 (thyroid hormone)? |
|
Definition
|
|
Term
| Which agent induces microtubular depolymerization by binding tubulin, thereby leading to decreased migration of leukocytes to the affected site? |
|
Definition
|
|
Term
| Which med decreases the reabsorption of uric acid in the proximal tubule of the kidney by blocking active transport of uric acid? |
|
Definition
|
|
Term
| What med inhibits xanthine oxidase, an enzyme in the purine degradation pathway that is responsible for converting xanthine to uric acid? |
|
Definition
|
|
Term
| What med is used during an acute gouty attack? |
|
Definition
|
|
Term
| Which med is used to treat Behcet dx and scleroderma? |
|
Definition
|
|
Term
| What meds are used in the prevention of further gouty attacks and the prevention and treatment of hyperuricemia (eg tumor lysis syndrome)? |
|
Definition
| Probenecid and Allopurinol |
|
|
Term
| What gout med has SE including diarrhea and bone marrow suppression? |
|
Definition
|
|
Term
| What gout med has SE including GI upset and inhibition of renal excretion of PCN and NSAIDs? |
|
Definition
|
|
Term
| What gout med has SE including GI upset, hypersensitivity reactions and decreased metabolism of 6-mercaptopurine and azothioprine? |
|
Definition
|
|
Term
| When allopurinol treatment is begun, what meds should be used in conjunction with the treatment and why? |
|
Definition
| Colchicine and NSAIDS; to prevent acute gouty attacks that are common in the first few weeks of treatment with Allopurinol |
|
|
Term
| What are the synthetic corticosteroids? |
|
Definition
| Prednisone, hydrocortisone, cortisone, prednisone, methylprednisolone, bethmethasone, dexmethasone |
|
|
Term
| What class of drugs mimics the actions of endogenous glucocorticoids? |
|
Definition
| Synthetic Corticosteroids: Prednisone, hydrocortisone, cortisone, prednisone, methylprednisolone, bethmethasone, dexmethasone |
|
|
Term
| Which med is used in the diagnosis of cushings syndrome? |
|
Definition
| Dexmethasone suppression test |
|
|
Term
| What med class has such actions as vasoconstriction, stimulation of hepatic gluconeogenesis and protein catabolism, decreases circulating leukocytes, stimulation of gastric acid and pepsin production, the inhibition of prostaglandin and leukotriene formation? |
|
Definition
| Synthetic Corticosteroids: Prednisone, hydrocortisone, cortisone, methylprednisolone, bethmethasone, dexmethasone |
|
|
Term
| What med is used for the treatment of adrenocortical insufficiency? |
|
Definition
| Synthetic Corticosteroid: Prednisone, hydrocortisone, cortisone, methylprednisolone, bethmethasone, dexmethasone |
|
|
Term
| What med can be used in the treatment of collagen-vascular d/o (eg SLE, RA, polymyositis)? |
|
Definition
| Synthetic Corticosteroids: Prednisone, hydrocortisone, cortisone, prednisone, methylprednisolone, bethmethasone, dexmethasone |
|
|
Term
| What med is used to treat inflammatory bowel disease due to its action of stimulating gastric acid and pepsin production? |
|
Definition
| Synthetic Corticosteroids: Prednisone, hydrocortisone, cortisone, methylprednisolone, bethmethasone, dexmethasone |
|
|
Term
| Which med is used in the treatment of spinal cord compression, ITP, arthritis, MS, and nephrotic syndrome? |
|
Definition
| Synthetic Corticosteroids: Prednisone, hydrocortisone, cortisone, methylprednisolone, bethmethasone, dexmethasone |
|
|
Term
| What med can cause SE central obesity, buffalo hump, "moon facies", thinning of skin with the development of striae, impaired wound healing, peptic ulcer dx and edema? |
|
Definition
| Synthetic Corticosteroids: Prednisone, hydrocortisone, cortisone, methylprednisolone, bethmethasone, dexmethasone |
|
|
Term
| Which med can be used to stimulate fetal lung development? |
|
Definition
|
|
Term
| Which med is used as immunosuppression in organ transplant recipients? |
|
Definition
| Synthetic Corticosteroids: Prednisone, hydrocortisone, cortisone, methylprednisolone, bethmethasone, dexmethasone |
|
|
Term
| What inhaled corticosteroid is used in the treatment of asthma? |
|
Definition
|
|
Term
| What type of agents are Orlistat and sibutramine? |
|
Definition
|
|
Term
| Which drug inhibits the pancreatic enzyme, lipase, thereby reducing intestinal fat absorption? |
|
Definition
|
|
Term
| Which drug acts as a neurotransmitter (serotonin, NE, Dopamine) re-uptake inhibitor at the synaptic cleft? |
|
Definition
|
|
Term
| Why was Fen-Phen withdrawn from the US market? |
|
Definition
| Risk of valvular disease and Pulmonary HTN |
|
|
Term
| Which drug used in weight control that is a combo of phentermine and fenfluramine? |
|
Definition
|
|
Term
| What med is used in the treatment of prostate CA? |
|
Definition
|
|
Term
| What med is the competitive antagonist at the androgen receptor, thereby decreasing the growth effects of testosterone on the prostate? |
|
Definition
|
|
Term
| What med used to treat prostate CA can cause gynectomastia, GI upset and abnormal LFTs? |
|
Definition
|
|
Term
| What med acts as a mild agonist at androgen and progesterone receptors, thereby resulting in the decrease of LH and FSH secretion and is therefore used to treat endometriosis and fibrocystic disease of the breast? |
|
Definition
|
|
Term
| What drug inhibits 5 A-reductase? What does this do? |
|
Definition
| Finasteride - inhibits the conversion of testosterone to dinydrotestosterone which limits the growth of the prostate in BPH |
|
|
Term
| What med can be used in the treatment of BPH, prostate CA and male pattern baldness? |
|
Definition
|
|
Term
| What are the SE of finasteride? |
|
Definition
|
|
Term
| What med acts to inhibit aromatase, the enzyme that converts androgens into estrogens and is used in the tx of estrogen-receptor positive breast CA? |
|
Definition
|
|
Term
| What drugs are GnRH agonists? |
|
Definition
| Leuprolide, Naferelin and Goserelin |
|
|
Term
| What med works by binding to the GnRH receptors in the pituitary causing an initial release of LH and FSH, however with continued administration leads to the desensitization and downregulation of the GnRH receptors thereby eventually causing a decrease in LH and FSH release and consequentially a decrease in estrogen and testosterone levels? |
|
Definition
|
|
Term
| What med is used in the treatment of metastatic prostate CA, leiomyomas and endometriosis when administered in a continuous fashion? |
|
Definition
| Leuprolide (Nafrelin and gosrelin) |
|
|
Term
| What med is used to treat infertility when administered in an intermittent fashion? |
|
Definition
| Leuprolide (Nafrelin and gosrelin) |
|
|
Term
| What med can cause SE including impotence, hot flashes and GI upset? |
|
Definition
| Leuprolide (Nafrelin and gosrelin) |
|
|
Term
| What med acts as a partial agonist at the estrogen receptors in the pituitary, thereby increasing the release of gonadotropins and is used to treat infertility? |
|
Definition
|
|
Term
| What are the common SE of Clomiphene? |
|
Definition
| hot flashes and multiple pregnancies |
|
|
Term
| What synthetic hormone acts to decrease GnRH release and subsequently decreases FSH and LH? |
|
Definition
|
|
Term
| What synthetic hormone acts to decrease FSH release and also do not provide enough positive feedback to stimulate LH release? |
|
Definition
| low level synthetic estrogen |
|
|
Term
| What does the decrease in FSH levels cause? |
|
Definition
| inhibition of follicular development |
|
|
Term
| What does the decrease in LH levels cause? |
|
Definition
|
|
Term
| What med can be used to treat DUB, PCOS, Endometriosis and dysmenorrhea? |
|
Definition
|
|
Term
|
Definition
| Breast fullness, N/V, HA, increased risk of thromboembolism especially in women > 35y/o who also smoke |
|
|
Term
| Which type of BCs are not associated with an increased risk of thromboembolism? |
|
Definition
|
|
Term
| How long after unprotected intercourse can Emergency Contraception be taken effectively to prevent pregnancy? |
|
Definition
|
|
Term
| What med contains HIGH dose synthetic progestins? |
|
Definition
| Emergency Contraception Pill |
|
|
Term
| What med is a steroid compound that acts as a competitive receptor antagonist at the progesterone receptor and at high doses acts as an abortifacient by causing a breakdown of the endometrial lining and cervical dilation? |
|
Definition
|
|
Term
| What med is a synthetic analog of the hormone somatostatin? |
|
Definition
|
|
Term
| What hormone acts to inhibit the release of secretin, gastrin, TSH, VIP and GH? What are the effects of this hormone? |
|
Definition
| Somatostatin; Effects are reduction in GI motility and Vasoconstriction |
|
|
Term
| What med is used to treat esophageal varices associated with cirrhosis induced portal HTN? |
|
Definition
| Octreotide (synthetic analog of somatostatin) |
|
|
Term
| What med is used in the tx of diarrhea associated with VIP-producing tumors, acromegaly and tx of Zollinger-Ellison Syndrome? |
|
Definition
| Octreotide (synthetic analog of somatostatin) |
|
|
Term
| What are the SE of Octreotide? |
|
Definition
| Cardiac arrhythmias and GI upset |
|
|
Term
| What med that is a naturally occurring hormone causes vasoconstriction, an increase in the permeability of the collecting ducts to water and an increase in factor VIII activity? |
|
Definition
|
|
Term
| What med is used in the tx of central DI? |
|
Definition
| Vasopressin (or Desmopressin, a similar drug) |
|
|
Term
| What med is used in the treatment of septic shock and cardiac arrest? |
|
Definition
| Vasopressin (or Desmopressin, a similar drug) |
|
|
Term
| What electrolyte imbalance does Vasopressin cause as a SE? |
|
Definition
|
|
Term
| What med is given to pts with mild hemophilia A or Von Willebrand dx before minor surgical procedures to decrease the risk of uncontrollable bleeding? |
|
Definition
|
|
Term
| What hormone can be given to cause uterine contractions as well as the contraction of the myoepithelial cells in the breast? |
|
Definition
|
|
Term
| What med can stimulate milk "let down"? |
|
Definition
|
|
Term
| What med can induce labor? |
|
Definition
|
|
Term
| When should Metformin be temporarily stopped? Why? |
|
Definition
| temporarily stopped in patients undergoing radiology studies requiring iodinated contrast, as this may lead to renal dysfunction and subsequently, increased levels of metformin in the body |
|
|
Term
| What do Meglitinides end in? |
|
Definition
|
|
Term
| What do DPP-4 inhibitors end in? |
|
Definition
|
|
Term
| Which two meds cause a decrease in the absorption of fat-soluable vitamins? |
|
Definition
| Bile Acid sequestrants (like Cholestyramine) and Orlistat |
|
|
Term
| What are the fat soluble vitamins? |
|
Definition
|
|
Term
| What condition is described as acute, life-threatening emergency caused by lack of adrenocorticoids? |
|
Definition
|
|
Term
| What is the major glucocorticoid in humans? |
|
Definition
|
|
Term
| Where is most cortisol in humans found? |
|
Definition
| 95% bound to circulating proteins in plasma (corticosteroid-binding globulin, albumin) |
|
|
Term
| What does synthetic cortisol preferably bind to? |
|
Definition
|
|
Term
| When is the majority of Cortisol produced? What are the normal levels? |
|
Definition
| Daily cortisol production is 10-20 mg (majority between 5 & 9 am & after meals) |
|
|
Term
| In stressful situations, what can cortisol levels rise to? |
|
Definition
|
|
Term
| What is our endogenous mineralcorticoid? |
|
Definition
|
|
Term
| What are the actions of aldosterone? |
|
Definition
Holds sodium—and with it, water—in the body
Causes the excretion of potassium by acting on the renal tubule |
|
|
Term
| What stimulates aldosterone release? |
|
Definition
1) low renal perfusion pressure stimulates renin production→ angiotensin I→ angiotensin II→ aldosterone secretion
2) Elevated extracellular K concentration
3) ACTH |
|
|
Term
| What is the unlabeled use of fludrocortisone? |
|
Definition
|
|
Term
| What med acts to Increases sodium reabsorption in the renal tubules & increases potassium excretion, leading to water & sodium retention? |
|
Definition
|
|
Term
| What electrolyte imbalances does Addison's disease cause? |
|
Definition
|
|
Term
| What condition is described as lack of both cortisol & aldosterone in most cases with an increase in ACTH? |
|
Definition
| Primary Adrenal Insufficiency (Addison's dz) |
|
|
Term
| What test is used to dx Addison's? What med is used? |
|
Definition
| Cortrosyn Stimlation Test - Cortrosyn (a synthetic analog of ACTH) |
|
|
Term
| Which dz has sx including reduced CO, decreased vascular tone, Hypovolemia leads to secretion of vasopressin, which leads to water retention & hyponatremia, Hyperpigmentation, & Hyperkalemia? |
|
Definition
|
|
Term
| What test is used to dx secondary adrenal insufficiency? What is a pos test? |
|
Definition
| Metyrapone test; Positive test is if no ACTH is produced in response to the lowered cortisol levels |
|
|
Term
| What is the Gold standard to test hypothalamic pituitary response to hypoglycemia? What is a pos test? |
|
Definition
| Insulin tolerance test (ITT); Positive test is if ACTH level does not rise due to the lowered glucose levels in the body |
|
|
Term
| What is the tx for primary adrenal insufficiency? |
|
Definition
Glucocorticoid replacement (for ↓ cortisol) = hydrocortisone
Mineralocorticoid replacement (for ↓ aldosterone) = fludrocortisone |
|
|
Term
| What is the treatment for secondary adrenal insufficiency? |
|
Definition
| Glucocorticoid replacement (for ↓ ACTH) = Hydrocortisone |
|
|
Term
| What is the mandatory part of treatment for pts with primary or secondary glucocorticoid insufficiency? |
|
Definition
| ID and IM glucocorticoid injection for ER use (usually dexmethasone) |
|
|
Term
| What meds are used for Hyperaldosteronism? |
|
Definition
Aldactone (spironolactone)
Inspra (eplerenone)
Midamor (amiloride) |
|
|
Term
| Pt presents with Cushings, feminization, HTN, hyperaldosteronism, cystic acne, and temporal balding. Labs show elevated adrenal sex steroids, urinary free cortisol & 17-ketosteroids. What condition might you suspect? What is the tx? |
|
Definition
| Adrenal Carcinoma; surgical resection |
|
|
Term
| Pt presents with abdominal pain, palpable abdominal mass, metastases, fever, fatigue, weight loss. Labs show elevated adrenal sex steroids, urinary free cortisol & 17-ketosteroids. What condition might you suspect? What is the tx? |
|
Definition
| Adrenal Carcinoma; surgical resection |
|
|
Term
| What are the 6 P's of the sx of a Pheochromocytoma? |
|
Definition
Paroxysms – “spells”
Pressure – sudden increase in BP
Pain – abrupt throbbing headache, chest, abd pain
Perspiration – generalized diffuse diaphoresis
Palpitations – tachycardia with panic or anxiety
Pallor – from vasoconstriction |
|
|
Term
| What is the lab eval for the dx of a pheochromocytoma? |
|
Definition
| 24 hr urine for catecholamines |
|
|
Term
| What condition is described as syndrome of excess cortisol? |
|
Definition
|
|
Term
| What test is used to evaluate and dx Cushing's? |
|
Definition
| Dexamethasone suppression test |
|
|
Term
| What med can be used to treat Cushings by causing a chemical adrenalectomy? |
|
Definition
|
|
Term
| Which med is a non-surgical treatment used in Cushing's if all other tx have failed, and works by causing generalized glucocorticoid resistance? |
|
Definition
| Mifepristone (Mifeprex or AKA: RU 486) |
|
|
Term
| What meds are used in the treatment of Cushings if surgery is not an option and work by blocking steroid synthesis? |
|
Definition
| ketoconazole, metyrapone & aminoglutethimide |
|
|
Term
| What electrolyte imbalance is caused by estrogen? |
|
Definition
|
|
Term
| What med is limited to treatment of inoperable breast or prostate cancer and is a non-steroidal estrogen? |
|
Definition
|
|
Term
| What hormone can lead to HTN, thromboembolism, Endometrial carcinoma (if unopposed), gallbladder dz and dementia? |
|
Definition
|
|
Term
| What hormone is used to Suppress ovarian function which treats Dysmenorrhea, Endometriosis, & Uterine bleeding? |
|
Definition
|
|
Term
| What HRT is Used in post menopausal women with uterus? |
|
Definition
|
|
Term
| What HRT is used Only if pt had a hysterectomy? |
|
Definition
| Estrogen alone (unopposed) |
|
|
Term
| What are estrogens effects on lipids? progesterones? |
|
Definition
Estrogenn: ↓ LDL. ↑ HDL
Progestins:↑ LDL, ↓ HDL |
|
|
Term
| Describe the cyclic Estrogen/Progestin HRT? |
|
Definition
Estrogen for 25 days
Progestin last 10-13 days of estrogen treatment
No therapy given for 5-6 days |
|
|
Term
| Describe the continuous HRT of Estrogen and Progestin? |
|
Definition
Estrogen daily
Progestin for first 10-13 days of each month |
|
|
Term
| What anti-estrogen is used to treat anovulatory infertility (including PCOS)? |
|
Definition
|
|
Term
| What anti-estrogen is used to treat & prevent breast CA in ER(+) cases? |
|
Definition
|
|
Term
| What anti-estrogen is used to treat osteoporosis & breast cancer? |
|
Definition
|
|
Term
| What med produces a "chemical castration"? |
|
Definition
|
|
Term
| What meds (2) are indicated for the uses of Wt gain after surgery, infection or trauma, Decreased protein catabolism associated with prolonged corticosteroid use and Relief of bone pain in osteoporosis? |
|
Definition
| Fluoxymesterone & oxandrolone |
|
|
Term
| Which androgen receptor antagonist has an unlabeled use of the treatment of female hirsutism? |
|
Definition
|
|
Term
| What are the serious warning signs of OC SE? (ACHES) |
|
Definition
A -abdominal pain
C -chest pain or shortness of breath
H –headache (throbbing)
E -eye problems (flashing lights or vision disturbance
S -severe leg pains |
|
|
Term
| What drugs decrease the effectiveness of OCs? |
|
Definition
Anti-convulsants - Barbiturates, Phenytoin, Carbamazepine, Toprimate, Vigabatin
Anti-Infectives - Rifampin, Griseofulvin, Sulfonamides
Anti-biotics - Tetracyclines etc |
|
|
Term
| What is the formulation of plan b? |
|
Definition
| Progestin only in HIGH dose |
|
|
Term
| If pt takes plan B and then vomits after 1 hour, what must you do to prevent pregnancy? |
|
Definition
|
|
Term
| What is Prempro used for? |
|
Definition
| HRT (Combo Estrogen/Progestin) |
|
|
Term
| What can excess estrogen cause? |
|
Definition
|
|
Term
| Does the minipill contain estrogen or progestin or both? Who is normally prescribed this OC? |
|
Definition
| No estrogen, progestin only; prescribed to breastfeeding mothers |
|
|
Term
| RW calls your clinic because she has missed 2 doses of her OC while on vacation. It was during week 2 of the pack, what are your instructions to her? |
|
Definition
Take 1 extra pill ASAP, continue as usual & then skip placebo before next pack
She does not need a backup method of contraception since it was missed in week 2 (or 3) |
|
|
Term
| What is the leading COD for men and women in the US? |
|
Definition
|
|
Term
| What are the risk factors for atherosclerosis? If pt has 2 or more, what risk assessment should you perform? What does that calculate |
|
Definition
Smoking
HTN (or on HTN med)
Low HDL (<40)
Family history premature CHD (male <55, female <65)
Age (male >45, female >55)
If 2+ perform Framingham Risk which calcs the % risk of having a coronary event in the next 10 yrs |
|
|
Term
| Which anti-lipid drug is pregnancy category X? |
|
Definition
|
|
Term
| In which conditions is the use of Niacin absolutely contraindicated? |
|
Definition
| chronic liver disease, severe gout |
|
|
Term
| When should statins be taken? Why? |
|
Definition
| at bedtime; as cholesterol synthesis occurs predominantly at night |
|
|
Term
| Which statin has the least drug-drug interactions? |
|
Definition
|
|
Term
| When should bile acid sequestrants be taken? |
|
Definition
Must be taken with meals
2-3 times daily (mix with water or juice) |
|
|
Term
| What is the most effective drug at lowering LDL? What is the 2nd most effective drug? |
|
Definition
1st - Statins
2nd - Bile Acid Sequestrants (good option for pregnant women) |
|
|
Term
| What is the standard-of-care treatment for gout? |
|
Definition
|
|
Term
| What med is commonly used in initial treatment of gout instead of colchicine? |
|
Definition
|
|
Term
| What first new drug approved for gout in over 40 years, may be used in overproduction or underexcretion of uric acid and is used as a prophylactic treatment with colchicine or NSAIDs during initiation of treatment to avoid gouty attacks? |
|
Definition
|
|
Term
| What are the Uricosuric Agents used to treat gout? |
|
Definition
| Probenecid, sulfinpyrazone |
|
|
Term
| Which gout meds cause a Decrease urate in pts with tophaceous gout or frequent gouty attacks by decreasing uric acid reabsorption in the proximal tubule? |
|
Definition
| Probenecid, sulfinpyrazone |
|
|
Term
| What med is a Growth Hormone antagonist? |
|
Definition
|
|
Term
| What med causes AE including Nausea, vomiting, abdominal cramps, flatulence, steatorrhea with bulky bowel movements, pain at injection site, biliary sludge & gallstones (after 6 months) but yearly incidence of gallstones is 1%, sinus bradycardia, conduction disturbances and B12 deficiency with long-term use? |
|
Definition
|
|
Term
| What are the contraindications for GnRH agonists? |
|
Definition
| Contraindications include pregnancy & breast feeding |
|
|
Term
| What is the principle hormone responsible for lactation? |
|
Definition
|
|
Term
| What is the standard treatment for hyperprolactinemia? |
|
Definition
| Dopamine agonist - Bromocriptine, cabergoline & pergolide ergot derivatives |
|
|
Term
| What is the MC cause of elevated PRL levels? |
|
Definition
| Due to prolactin-secreting adenomas |
|
|
Term
| What hormone imbalance causes sx including, syndrome of amenorrhea & galactorrhea in women, loss of libido & infertility in men, and is associated with inhibition of GnRH release? |
|
Definition
|
|
Term
| When is the stimulation of uterine contraction by using oxytocin contraindicated? |
|
Definition
|
|
Term
| What electrolyte imbalance can Vasopressin use cause? |
|
Definition
| hyponatremia and consequent seizures |
|
|
Term
| What type of meds have an off-label use of hyponatremia and acute heart failure? |
|
Definition
|
|
Term
| What is the drug therapy for Graves dz? |
|
Definition
| Methimazole or propylthiouracil |
|
|
Term
| What is the preferred treatment for hyperthyroidism? How should you start the doses? |
|
Definition
| Methimazole; Start with divided doses |
|
|
Term
| Pt is on Methimazole and they have c/o sore throat & fever, what serious AE might this be a sign of? |
|
Definition
|
|
Term
| What is the treatment of choice for very large glands or multinodular goiters? |
|
Definition
|
|
Term
| What can you give prior to thyroidectomy to diminish vascularity of gland & simplify the surgery? |
|
Definition
| Saturated solution of potassium iodide 10-14 days prior to surgery |
|
|
Term
| Who does a Toxic Uninodular Goiter commonly occur in? |
|
Definition
| Often occur in older women with nodular goiters |
|
|
Term
| What is a Toxic multinodular goiter usually associated with? |
|
Definition
|
|
Term
| During Thyroid storm, what should be given to pts to control the severe cardiovascular manifestations? When is it contraindicated? |
|
Definition
| Propranolol - Contraindicated in HF and asthma pts |
|
|
Term
| If asthmatic pt is going through thyroid crisis, what med do you give to control the severe cardiovascular manifestations? |
|
Definition
|
|
Term
| During thyroid storm, what can aid in reducing the release of thyroid hormones? |
|
Definition
| Saturated solution of potassium iodine |
|
|
Term
| During thyroid storm, what med should be given to protect against shock? |
|
Definition
|
|
Term
| What cardiac toxicity can be caused by hyperthyroidism? |
|
Definition
|
|
Term
| What is the MC cause of hyperthyroidism worldwide? in the U.S? |
|
Definition
Worldwide: iodide deficiency
US: Hashimoto’s thyroiditis |
|
|
