Endo/repro pharm

  1. Insulin
    • Short acting: lispro, regular insulin
    • Intermediate: NPH
    • Long acting: glargine
    • Bind insulin receptor, increased glycogen storage in liver and muscle, protein synthesis, K uptake, TG storage
    • Useful in Type I and II, hyperkalemia, hyperglycemia
    • Can cause hypoglycemia, hypophosphatemia, hypersensitivity
  2. Sulfonylureas
    • First generation: tolbutamide
    • Second generation: glipizide
    • Close K channel -> triggers insulin release
    • Only useful in Type II (need beta cells)
    • Disulfiram-like reaction (tolbutamide), hypoglycemia (glipizide)
  3. Metformin
    • Biguanide
    • Decrease gluconeogenesis in liver, insulin sensitizer
    • Can be used in Type I and II
    • Can cause lactiv acidosis
  4. Glitazones/thiazoladinediones
    • Increases insulin sensitivity in peripheral tissue
    • Used in T2DM
    • Can cause weight gain, edema, hepatotoxicity, CV toxicity
  5. Acarbose, miglitol
    • Alpha-glucosidase inhibitors; delayed sugar hydrolysis and glucose absorption -> decreased postprandial hyperglycemia
    • T2DM
    • Can cause GI disturbances
  6. Orlistat
    • Inhibit pancreatic lipases (Orlistat gets rid of fat)
    • Can cause steatorrhea, GI discomfort, reduced absorption of fat-soluble vitamins
  7. Sibutramine
    • Serotonin and NE reuptake inhibitor
    • Obesity management
    • Can cause HTN and tachycardia
  8. Propylthiouracil, methimazole
    • Inhibit organification of iodide and coupling of thyroid hormone synthesis
    • Used in hyperthyroidism
    • Can cause agranulocytosis
  9. Levothyroxine, triiodothyronine
    • Thyroxine replacement
    • Can cause tachycardia, heat intolerance, tremors, arrythmias
  10. GH
    GH deficiency, Turner's syndrome
  11. Octreotide
    • Smoatostatin
    • Used in acromegaly, carcinoid, gastrinoma, glucagonoma
  12. Oxytocin
    • Stimulates labor, uterine contractions, milk let-down
    • Controls uterine hemorrhage
  13. Desmopressin
    • ADH
    • Used in pituitary (central) DI
  14. Demeclocycline
    • ADH antagonist (tetracycline family)
    • Used in SIADH
    • Can cause nephrogenic DI, abnormalities of bone and teeth
  15. Glucocorticoids
    • Decreased production of leukotrienes and prostaglandins by inhibiting phospholipase A2 and expression of COX-2
    • Used in Addison's dz, inflammation, immune suppression, asthma
    • Can cause iatrogenic Cushing's syndrome
    • Increase osteoclastic bone resorption and decreased osteoblastic bone formation
  16. Leuprolide
    • GnRH analog - agonist when pulsatile, antagonist when continuous
    • Infertility (pulsatile), prostate cancer (continuous), uterine fibroids, precocious puberty
    • Antiandrogen, nausea, vomiting
  17. Testosterone
    • Agonist at androgen receptors
    • Used for hypogonadism and promotion of secondary sex characteristics; stimuation of anabolism after burn or injury; treat ER-positive breast cancer
    • Masculinization in females, gonadal atrophy, premature closure of epiphyseal plates
  18. Finasteride
    • 5 alpha-reductase inhibitor - decreases dihydrotestosterone
    • Used in BPH, male-pattern baldness
  19. Flutamide
    • Competitive androgen inhibitor at testosterone receptor
    • Used in prostate carcinoma
  20. Ketoconazole
    • Inhibits steroid synthesis (inhibits desmolase)
    • Used in PCOS to prevent hirsutism
    • can cause gynecomastia and amenorrhea
  21. Spinronolactone
    • Inhibits steroid binding
    • Used in PCOS to prevent hirsutism
    • Can cause geynecomastia and amenorrhea
  22. Estrogens
    • Used in hypogonadism or ovarian failure, menstrual abnormalities, HRT, men with adrogen-dependent prostate cancer
    • Increased risk of endometrial carcinoma, bleeding in postmenopausal women, increased risk of thrombi
    • Don't use in ER + breast cancer, history of DVTs
  23. Clomiphene
    • Partial estrogen agonist
    • Increases release of LH and FSH -> ovulation
    • Used to treat infertility and PCOS
  24. Tamoxifen
    • Estrogen antagonist on breast tissue
    • Used to treat and prevent recurrence of ER + breast cancer
  25. Raloxifene
    • Estrogen agonist on bone
    • Reduces resorption of bone - used to treat osteoporosis
  26. Anastrozole
    Aromatase inhibitor used in postmenopausal women with breast cancer
  27. Progestin
    • Increased vascularization of edometrium
    • Used in OCs, treatment of endometrial cancer and abnormal uterine bleeding
  28. Mifepristone
    • RU-486
    • Competitive inhibitor of progestins
    • Used for termination of pregnancy, administered with misoprostol (PGE1)
    • Can cause heavy bleeding, GI effects, abdominal pain
  29. Dinoprostone
    • PGE2 analog
    • Induces labor
  30. Ritodrine/terbutaline
    • B2 agaonist
    • Relax uterus - reduce premature uterine contractions
    • (Fetus can "return to dreams")
  31. Tamsulosin
    Alpha 1 A,D-antagonist used to treat BPH
  32. Sildenafil, vardenafil
    • Inhibit cGMP phosphodiesterase -> increased cGMP
    • Treatment for erectile dysfunction
    • Can cause headache, flushing, dyspepsia, impaired blue-green color vision; risk of life-threatening hypotension in pts taking nitrates
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Endo/repro pharm
Endo/repro pharm