Exam 9 Pharmacology

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Pituitary
Name a condition associated with aneuploidy for which somatropin may be prescribed 
Somatropin is a formulation of what product of the anterior pituitary? 
BONUS (probably not testable, but a fun fact): What syndrome, for which somatropin may be prescribed, is associated with a compulsive, insatiable craving for food (like, REALLY dramatic)? 
What hormone is commonly injected to test the function of the growth hormone axis? 
When the above-named hormone is injected, should growth hormone levels go up or down (assume normal patient)? 
To investigate possible excess growth hormone (gigantism, acromegaly), what substance would you give a patient to suppress GH release? 
Name a D2 receptor agonist/weak D1 antagonist used to treat gigantism/acromegaly 
Name another hormone, excess secretion of which is treated by the above-named drugs (think: this condition is really awkward for men - gynecomastia) 
If SOMATROPIN stimulates GH secretion, name the endogenous peptide that suppresses/regulates it 
Name a synthetic analogue of the above-named molecule that suppresses GH release in response to all known stimuli 
If you're trying to normalize IGF-1, the product of GH activity in the liver, this PEGylated GH receptor antagonist is your best bet 
Name a synthetic posterior pituitary hormone given to aid in uterine contractions, either in labor or to control postpartum bleeding 
Name a way the above-named synthetic hormone can be given (p.o. is not on the list!) 
Name a V2 receptor agonist that can replace or suppress vasopressin 
Diabetes insipidus, treated by the above-named drug, can be from lack of ADH in the pituitary or insensitivity in the kidney (nephrogenic). Only the pituitary kind, called ______ diabetes insipidus, can be treated with drugs. 
Desmopressin has an added bonus - prevents this childhood problem 
Desmopressin is special - it's a polypeptide that can be taken this way! 
Gonads
Name a GnRH receptor agonist, which shuts down endogeous sex hormone production and GnRH receptors via negative feedback/downregulation 
What is one inital complication of using the above named drugs (it will go away eventually)? 
Somewhat amusingly, agonists of this receptor, used as contraception in females, can treat prostate cancer in males 
Levonogestrel is a drug that acts as an agonist of the progesterone receptor. Taken in two high doses 12 hours apart (or one dose - new!), it is used for this purpose. 
Name another drug that acts as a progesterone receptor agonist, used for (among other things) hormone replacement therapy for women with a uterus 
Name a drug used to treat breast cancer that is not indicated for use in osteoporosis due to its activity as an estrogen receptor agonist in the uterus 
Now name an estrogen receptor agonist/antagonist that IS approved for osteoporosis as well as breast cancer 
Clomiphene is a SERM that acts as an ER partial agonist in the brain. It is used to treat this condition. 
Ulipristal is approved in the US for emergency contraception, but like another progesterone receptor antagonist, mifepristone (RU486) + misoprostol, it can also terminate this condition. 
5-alpha reductase converts testosterone into this much more active form 
Name a drug that inhibits the above-named enzyme, treating BPH and male pattern baldness 
In addition to testosterone patches and gels, two oral preparations are used for infertility, hypogonadism, muscle wasting, erythropoiesis, male HRT, and endometriosis. Name one. 
Name an androgen receptor antagonist that treats prostate cancer but will probably be gone by next year because it also produces seizures and a better drug's coming out 
Because some prostate cancer cells can start producing their own androgen, this drug can be given. It inhibits Cyp 17,20 lyase and stops androgen production. 
When the above-named drug is given, it also stops production of this other type of steriod hormone, so it has to be given exogenously 
Thyroid
(Levo)thyroxine is prescribed for hypothyroidism. It is a supplementation of this form of thyroid hormone 
Liothyronine is used to supplement the other form of thyroid hormone. It is used only in this emergency situation. 
There are two drugs that are used as alternate substrates for thyroperoxidase. Name the one that is bound to protein and safe for use during pregnancy. 
Name the drug for hyperthyroidism that passes through the placenta to an infant and can cause birth defects if used during pregnancy 
The pregnancy-safe hyperthyroid drug has the added bonus of preventing the conversion of what hormone to its more active form? 
In addition to serving as a substrate for thyroperoxidase, drugs for hyperthyroidism also both inhibit two more processes. Name one. 
In the US, we like to destroy our tumors/goiters/whatever. Definitive therapy all the way. What radioactive drug destroys a hyperactive thyroid? 
Again with definitive therapy, if you're preparing a patient for surgery, what drug would treat their hyperthyroidism and reduce the vascularity of the part you're planning to have cut out? 
Amiodarone, an antiarrhythmic, can modulate thyroid function (in either direction) because 37% of its weight consists of this element 
In the event of acute decompensated hyperthyroidism (thyroid storm), what class of drug would you give to treat the resulting tachycardia? 
Pancreas
For insulin-dependent diabetes mellitus, it has been demonstrated that intensive therapy is far superior to conventional (twice daily) therapy. What's the big potential risk, though? 
For type 2 diabetes, sulfonylurea drugs (glybenclamide) and glinides (rapaglinide, neteglinide) both block the KATP channel. The difference is in this property 
Between glybenclamide and rapaglinide (sulfonylurea vs. glinide), which binds to the KATP channel for a longer period of time? 
An advantage of glinides over sulfonylurea drugs is a decreased tendency to cause two major side effects. Name one. 
This GLP-1 receptor agonist potentiates glucose-dependent secretion of insulin (but does nothing if there is not high glucose). 
The action of GLP-1 and GIP can be extended by an inhibitor of this enzyme. 
Name the drug for which you just identified the target. 
Name a drug that is an analogue of amylin - it slows gastric emptying, promotes satiety, and inhibits glucagon secretion. (If it sounds unfamiliar, it wasn't really covered in class but appears on the drug list.) 
Name everybody's favorite Type 2 DM drug, derived from the French lilac, that, among other things, increases GLUT4 transporters in peripheral tissues 
Of the 'flaming wreck' thiazolidinedione drugs, which activate PPAR-gamma to increase glucose utilization (as fat storage), name the one still in use. 
BONUS (probably not testable): Rimonabant almost made it to the market because it really effectively decreased appetite. What side effect kept it from being approved? 
Adrenal
When testing the HPA axis, this glucocorticoid receptor agonist should lower ACTH and cortisol if the negative feedback mechanism is working 
If the feedback mechanism is ACTIVE (that is, the above-named drug suppresses production of ACTH/cortisol), do we suspect Cushing's DISEASE or Cushing's SYNDROME? 
Cushing's syndrome can be the result of paraneoplastic syndrome. What thoracic malignancy is classically associated with this (be specific)? 
Addison's disease, or adrenal insufficiency, is treated with exogenous glucocorticoids and mineralocorticoid receptor agonists. Name an MC receptor agonist. 
What is the most-used anti-inflammatory glucocorticoid receptor agonist? 
Mineralcorticoid receptor antagonists are also a type of potassium-sparing diuretics. Name one. 
We've talked about MC-R antagonists (you just named them above) for CHF and HTN. What liver condition can they also be prescribed for (treat resulting edema)? 

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