Pharmacology Winter Exam 3 Flash Cards

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Title:	Pharmacology Winter Exam 3
Description:	Bolded Drugs
Number of Cards:	165
Save Count:	0
Author:	shumwaybrad9
Created:	2012-02-06
Tags:	pharmacology
Private	No

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- Question
- Answer
- Side 3

- Bromocriptine (Parlodel)
- Dopamine Agonist-->inhibition of prolactin release (dopamine is major regulator for prolactin secretion)
- Cabergoline
- Dopamine Agonist-->inhibition of prolactin release (dopamine is major regulator for prolactin secretion)
  
  More effective and better tolerance than Bromocriptine. DOC for inhibiting prolactin release.
- Somatropin (Humatrope)
- GH Agonist (same as Somatrem)
  
  Indications: Treating growth failure due to GH deficiency (main one)..mostly in kids
  Adverse effects: Fluid retention and edema (reduces w/ treatment time); Musculoskeletal pain, stiffness; Hyperglycemia, hypothyroidism.
  CIs: Used cautiously pts w/ DM; Hypothyroidism
- Somatrem (Protropin)
- GH Agonist (same as Somatropin)
  
  Indications: Treating grow failure due to GH deficiency (main one)..mostly in kids
  Adverse effects: Fluid retention and edema (reduces w/ treatment time); Musculoskeletal pain, stiffness; Hyperglycemia, hypothyroidism.
  CIs: Used cautiously pts w/ DM; Hypothyroidism
- Mescasermin (Increnelex)
- IGF-1 Agonist
  
  recombinant human IGF-1 (rhIGF-1)
  Not as effective as GH therapy
  Indications: Pts who are unresponsive to GH therapy, such as those with IGF-1 deletion/mutation, GH receptor mutation, or GH antibodies.
- Octreotide (Sandostatin)
- Somatostatin Analog-->in order to antagonize GH
  
  Indications: Treating GH excess (e.g. acromegaly); Can reduce tumor size/growth; Treating excessive diarrhea.
  Adverse Effects: GI effects (in up to 50%), but subside; Gallstones and gallbladder sludge (25%).
- Pegvisomant (Somavert)
- GH Antagonist (GH receptor antagonist)
  
  Indications: GH excess; Return to normal IGF-1 levels in 97% of pts
  Adverse Effects: Growth of GH-secreting tumor (lack of negative feedback)
- Gonadorelin
- Short acting GnRH agonist.
  
  Not available in US anymore (administration very inconvenient)
  Used for treating infertility
- Leuprolide
- Long acting GnRH agonist (same as Goserelin)
  Continuous administration causes an initial surge and then an ultimate INHIBITION of gonadotropin release.
  Indications: breast or prostate cancer (steroid dependent). Treating precocious puberty.
  Adverse effects: Menopausal symptroms (women), testicular atrophy, bone pain and neuralgia in men w/ metastatic prostate tumors.
- Goserelin (Zoladex)
- Long acting GnRH agonist (same as Leuprolide)
  Continuous administration causes an initial surge and then an ultimate INHIBITION of gonadotropin release.
  Indications: breast or prostate cancer (steroid dependent). Treating precocious puberty.
  Adverse effects: Menopausal symptroms (women), testicular atrophy, bone pain and neuralgia in men w/ metastatic prostate tumors.
- Cetrorelix (Cetrotide)
- Competitive GnRH Receptor Antagonist (so no initial surge of gonadotropins like the long acting agonists)
  Indications: Suppress endogenous LH and FSH for Assisted Reproductive Technologies (ART)
- hMG, Menopur
- Human menopausal gonadotropin
  Contains both FSH and LH, but used as an FSH drug
- human Chorionic Gonadotropin (hCG, Follutein, Pregnyl)
- LH agonist (similar structure and binds to LH receptor)
  Longer half-life than LH
  Indications: Correcting hypogonadism, INFERTILITY (induce spermatogenesis in men; FSH then dose of LH to induce ovulation in women [ART])
- Ethinyl estradiol
- Synthetic estrogen found in oral contraceptives
- Mestranol
- Synthetic estrogen found in oral contraceptives
- Conjugated equine estrogens (Premarin)
- Conjugated estrogens used for hormone replacement therapy
- Synthetic conjugated estrogens (Cenestin)
- Synthetic conjugated estrogens used for hormone replacement therapy
- Esterified estrogens (Estratab, Menest)
- Conjugated estrogens used for hormone replacement therapy
- Diethylstilbestrol (DES)
- Non-steroidal estrogen with estrogenic activity (not used much anymore)
- Tamoxifen (Novaldex)
- Selective estrogen receptor modulator (SERM)
  Agonist in uterus and bone (prevents bone loss)
  Antagonist in breast
  Indications: DOC for estrogen-dependent breast cancer
  Does not relieve hot flashes
  Adverse effects: Increased risk of uterine cancer (stimulates estrogen receptors in the uterus)
- Raloxifene (Evista)
- Selective estrogen receptor modulator (SERM)
  Antagonist in both breast and uterus (less uterine cancer risks)
  Agonist in bone
  Indications: prevention of postmenopausal osteoporosis
- Clomiphene (Clomid)
- Selective estrogen receptor modulator (SERM)
  Antagonist in hypothalamus
  Indications: Infertility (DOC when HPG axis intact)-used to stimulate secretion of LH and FSH (inhibits neg. feedback)
  Adverse effects: Multiple pregnancies
- Fulvestrant (Faslodex)
- Full estrogen receptor antagonist
  
  Adverse: menopausal symptoms
- Anastrozole (Arimidex)
- Aromatase inhibitor (does not inhibit adrenal steroid synthesis)
  Indications: Treatment of advanced breast cancer in postmenopausal women or in patients whose disease progressed during tamoxifen therapy.
  Adverse: Menopausal symptoms
- Progesterone (generic)
- A Pregane (progesterone derivative)
  Acts on nuclear receptors
  Secretory state in Uterus. Also effects on endocervical glands, breasts, and a thermogenic action.
  Indications: Oral contraceptives (often combined with estrogen); Prevention of endometrial hyperplasia in HRT
- Medroxyprogesterone (Provera)
- A Pregane (progesterone derivative)
  *the rest is the same as Progesterone.
  Acts on nuclear receptors
  Secretory state in Uterus. Also effects on endocervical glands, breasts, and a thermogenic action.
  Indications: Oral contraceptives (often combined with estrogen); Prevention of endometrial hyperplasia in HRT
- Norethindrone acetate (Aygestin)
- An Estrane (19-nortestosterone)
  *the rest is the same as Progesterone.
  Acts on nuclear receptors
  Secretory state in Uterus. Also effects on endocervical glands, breasts, and a thermogenic action.
  Indications: Oral contraceptives (often combined with estrogen); Prevention of endometrial hyperplasia in HRT
- Norgestrel (Ovrette)
- A Gonane (13-ethyl derivative of norethindrone)
  *the rest is the same as Progesterone.
  Acts on nuclear receptors
  Secretory state in Uterus. Also effects on endocervical glands, breasts, and a thermogenic action.
  Indications: Oral contraceptives (often combined with estrogen); Prevention of endometrial hyperplasia in HRT
- Mifepristone (RU 486, Mifeprex)
- An Antiprogestin
  Blocks progestin binding to the progesterone receptor.
  Indications: Pregnancy termination; Also antagonizes glucocorticoid receptor (can be used in Cushings). (can also be used within 72 postcoitally to prevent implantation)
  Contraindications: Pregnancy or breastfeeding.
- Danazol (Danocrine)
- Weak progestin (acts as antiprogestin in women), androgen and glucocorticoid that suppresses ovarian function.
  *****Used to treat endometriosis!*****
  Contraindications: Pregnancy or breast feeding
- Drospirenone/ethinyl estradiol (Yasmin, Yaz)
- Contraceptive pill.
  Uses estrogen and a spronolactone derivative (*mineralocorticoid antagonist*...this makes it unique) that has progesterone agonist effects.
  Has the ability to reduce water retention, thus it is the only combination pill that is FDA approved for reducing PMDD symptoms.
- Testosterone (generic, Testoderm transdermal)
- An androgen *same info as methyltestosterone
  Indications: Men: Testicular deficiency, Aging and Impotence (not anymore because of incidence of prostate cancer in this group), Anemia (now likely treated with erythropoietin instead).
  Women: Female hypopituitarism (Methyltestosterone with diethylstillbesterol)
  Both: hypoproteinemia of nephrosis; debilitated patients (have negative nitrogen balance)
  Adverse: Decreased testosterone production and spermatogenesis in men; masculinization in women, pseudohermaphroditism (of fetus from use in mom)
  Both: Oily skin, acne, decreased HDL, psychological changes ("roid rage")
- Methyltestosterone (generic)
- An androgen *same info as testosterone
  Indications: Men: Testicular deficiency, Aging and Impotence (not anymore because of incidence of prostate cancer in this group), Anemia (now likely treated with erythropoietin instead).
  Women: Female hypopituitarism (Methyltestosterone with diethylstillbesterol)
  Both: hypoproteinemia of nephrosis; debilitated patients (have negative nitrogen balance)
  Adverse: Decreased testosterone production and spermatogenesis in men; masculinization in women, pseudohermaphroditism (of fetus from use in mom)
  Both: Oily skin, acne, decreased HDL, psychological changes ("roid rage")
- Flutamide (generic)
- A nonsteroidal androgen receptor antagonist.
  Indications: Prostate cancer; topically for hirsutism and male pattern baldness. Give in combination with long-acting GnRH agonist.
- Finasteride (Proscar, Propecia)
- 5alpha-reductase inhibitor (the enzyme converting testosterone to DHT) *same as Dustasteride
  Indications: Treating benign prostatic hyperplasia; Treating male-pattern baldness.
  Contraindications: Teratogenic!
- Dustasteride (Avodart)
- 5alpha-reductase inhibitor (the enzyme converting testosterone to DHT) *same as Finasteride
  Indications: Treating benign prostatic hyperplasia; Treating male-pattern baldness.
  Contraindications: Teratogenic!
- What are the rapid-acting insulin preparations?
- lispro, aspart, glulisine
- What are the intermediate insulin preparations?
- NPH or Isophane
- What are the long-acting insulin preparations?
- Insulin detemir
  Insulin glargine
- Sulfonylureas (general info)
- Stimulate insulin release from pancreatic beta cells.
  Indirectly potentiate insulin action on target tissues.
  Adverse: Can cause hypoglycemia, weight gain
  Contraind: Sulfa allergies
- Tolbutamide (Orinase)
- A first generation sulfonylurea (so not prescribed much anymore)
  Infrequent hypoglycemia
  Safest in the elderly for 1st gen. (because not much hypoglycemia)
- Glyburide (Micronase)
- 2nd generation sulfonylurea (more potent)
  Effect lasts 24 hours
  May cause hypoglycemia
- Glipizide (Glucotrol)
- 2nd generation sulfonylurea (more potent)
  Half-life 2-4 hours
  least hypoglycemic effect
- Glimepiride (Amaryl)
- 2nd generation sulfonylurea (more potent)
  once a day dosing
  has little hypoglycemic effect
- Repaglinide (Prandin)
- *same info as Nateglinide
  A Meglitinide
  Same mechanism as sulfonylureas (action on K channels)
  No issues w/ sulfa allergies (not sulfonamides)
  Rapid, short action, mimics insulin better
  Not much effect on weight
- Nateglinide (Starlix)
- *same info as Repaglinide
  A Meglitinide
  Same mechanism as sulfonylureas (action on K channels)
  No issues w/ sulfa allergies (not sulfonamides)
  Rapid, short action, mimics insulin better
  Not much effect on weight
- Metformin (Glucophage)*
  Mechanism?
- A Biguanide (only one in notes)
  Mech: Glucose removal from blood increased, absorption from GI decreased. Reduced glucagon levels, reduced gluconeogenesis.
- Metformin (Glucophage)*
  Indications?
- Indications: Reduction of glucose to euglycemic state. Safe for use in children>10 years old.
  **DOC for type II DM + lifestyle changes because it: 1. Does not increase body weight. 2. Reduces macrovascular events.**
- Metformin (Glucophage)*
  Adverse effects?
  Contraindications?****question on this*****
- Adverse: Lactic acidosis (rare, but dangerous); Diarrhea (one of "top five" diarrhea drugs)
  **CI's: Lactic acidosis conditions (Eg. due to renal dz, hepatic dz, alcoholism, and dz's predisposing to tissue hypoxia like CHF and COPD)
- Pioglitazone (Actos)
- A Thiazolidinedione (aka glitizones, Tzds)
  *same info as Rosiglitazone
  Post-receptor insulin-mimetic action
  Indications: Lowers insulin resistance; Reducing the development of type 2 DM (and prophylactic in pre DM II)
  Adverse: Edema (bad for CHF)
  CI's: ***CHF!!!!***
  caution when pts have hepatic dz
- Rosiglitazone (Avandia)
- A Thiazolidinedione (aka glitizones, Tzds)
  *same info as Pioglitazone (Actos)
  Post-receptor insulin-mimetic action
  Indications: Lowers insulin resistance; Reducing the development of type 2 DM (and prophylactic in pre DM II)
  Adverse: Edema (bad for CHF)
  CI's: ***CHF!!!!***
  caution when pts have hepatic dz
- Acarbose (Precose)
- *same info as Miglitol
  Alpha-glucosidase inhibitor
  Which results in delayed carbohydrate digestion and absorption.
  Has no significant effects on weight.
  Adverse: flatulence
- Miglitol (Glyset)
- *same info as Acarbose
  Alpha-glucosidase inhibitor
  Which results in delayed carbohydrate digestion and absorption.
  Has no significant effects on weight.
  Adverse: flatulence
- Exenatide (Byetta)
- An Incretin Mimetic
  GLP-1 agonist that is resistant to enzymatic degradation by DPP-IV->to lower glucose levels.
  Potential increased beta cell number and function.
  Causes some weight loss.
  Pharm: S.C. injections 60min before 2 main meals.
  Adverse: May cause acute pancreatitis, increase risk of pancreatic and thyroid cancer.
- Sitagliptin (Januvia)
- DPP-IV inhibitor->potentiating the effects of the incretin hormones.
  Has no significant effects on weight.
  Administered orally
  Adverse: may be associated w/ acute pancreatitis and pancreatic cancer
- Pramlintide (Symlin)
- Only used as an adjunct to insulin therapy in DM (can be used for both type I and II***)
  Synthetic analog of amylin (which regulates postparandial glucose conc.)
  Weight loss can occur.
- Bromocriptine (Cycloset) (2nd effect in this unit)
- Dopamine agonist
  Somehow results in reduction in postmeal plasma glucose levels due to enhanced suppression of hepatic glucose production.
  Indications: Reduces fasting and postmeal plasma free fatty acid and triglyceride levels. Potentially reduces CV end point problems in DM.
- Glucagon
- hyperglycemic agent (also produced by alpha cells)
  Mobilizes hepatic glycogen when it is available (so more useful in adults w/ stable DM).
- Diazoxide (Proglycem)
- Non-diuretic thiazide, vasodilator and hyperglycemic
  Used in patients with insulinoma. (long term use)
- Oxytocin (Pitocin, Syntocinon)
- (normally stored in post. pituitary)-contracts uterus
  DOC to induce labor at term if indicated.
  **Prevention of hemorrhage**
  Adverse: Water intoxication (ADH like effects); Uterine rupture; Sinus bradycardia of fetus (All of the above are with high doses); Anaphylaxis
  Pharm: IV, IM or by nasal route
- Ergonovine maleate (Ergotrate)
- An Ergot alkaloid
  Contracts uterine smooth muscle
  Indications: **Used AFTER completion of labor and the delivery of the placenta to contract uterus and decrease uterine bleeding**
  Contraindications: Ergot alkaloids should NEVER be used to induce labor (too strong); Hepatic or renal disease; Obliterative vascular or coronary art. dz
- Dinoprostone (Prostin E2)
- A Prostaglandin (synthetic prostaglandin E2)
  Indications: Uterine contractions to expel uterine contents (fetal death, abortion, elective abortion); Cervical ripening prior to delivery at term.
  Adverse: GI disturbances, vomiting, ***DIARRHEA***(one of top 5 diarrhea drugs..can be very serious..black box warning)
  Contraindications: For abortions, should not be used in pts w/: acute cardiac, pulmonary, renal or hepatic dz; asthma, HTN, anemia, jaundice, or epilepsy
- Magnesium Sulfate (MgSO4)
- A Tocolytic agent
  Direct effect on uterine cells (unknown mech.)
  Not FDA approved for premature labor tx (but used as a 1st line drug)
  Is FDA approved for pre-eclampsia/eclampsia
  *IV (only hospital use)*
- Nifedipine (Procardia)
- A Tocolytic agent
  Calcium channel blocker (uterine smooth mm use calicum influx for contraction).
  Not FDA approved for premature labor tx.
  Starting to be used as 1st line drug (less side effects than magnesium)
- Indomethacin (Indocin)
- A Tocolytic agent
  Not FDA approved for premature labor tx.
  The NSAID Indomethacin is investigated for delaying preterm labor.
  Reduction of prostaglandin synth. (they usually lead to uterine contractions)
  *May cause partial closure of the fetal ductus arteriosus*
- Progesterone
- Not FDA approved, but recommended by Amer. Coll. of OBs and GYNs for prophylactically maintaining length of pregnancy in high risk women w/ history of spontaneous birth at <37 wks.
- Nitroglycerin
- Emergency use only to relax uterus for emergency C-section (like in uterine rupture)
- Ethanol
- Is used (often in rural areas) for treatment of premature labor (Not FDA approved).
  Direct relaxant effect on the myometrium and inhibition of oxytocin release.
- Fludrocortisone (Florinef, 9alpha-Flurocortisol)
- Synthetic adrenocortical steroid (w/ similar actions to those of aldosterone).
  Given w/ a glucocorticoid for replacement therapy in adrenocortical insufficiency.
  Given *as needed* after 1st trying just glucocorticoids (and if they are hyponatremic, hyperkalemic, or have arrhythmias)
- Dexamethasone (Decadron)
- High anti-inflammatory effects w/ no salt-retaining effects.
  Preferred glucocorticoid for cerebral edema because of ability to enter the CNS.
  Also used for diagnosis of Cushing's dz (dexamethasone suppression test)
- Hydrocortisone (Cortef)
- aka Cortisol
  Replacement/Weak anti-inflammatory drug
  **Preferred for replacement therapy in patients with adrenal insufficiency because exhibits equal mineralocorticoid and glucocorticoid properties**
- Cortisone (Cortone)
- Same uses as hydrocortisone
  Replacement/Weak anti-inflammatory drug
  It must be converted to hydrocortisone in the liver to be active (less potency than hydrocortisone)
- Prednisone (Meticorten)
- *same as Prednisolone
  More anti-inflammatory than salt-retaining (more glucocorticoid effects than mineralocorticoid)
  Prednisone must first be converted to prednisolone in the liver in order to be active.
  Most commonly prescribed oral glucocorticoid.
- Prednisolone (Delta-Cortef)
- *same as Prednisone
  More anti-inflammatory than salt-retaining (more glucocorticoid effects than mineralocorticoid)
- Triamcinolone (Aristocort, Kenalog)
- *same as Methylprednisolone
  High anti-inflammatory/no salt-retaining (high glucocorticoid effect/no mineralocorticoid effect).