Endocrinology and Toxicology - Drugs Overview Flashcards Preview

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Flashcards in Endocrinology and Toxicology - Drugs Overview Deck (90)
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1
Q

Cyanide Poisoning:

What are the possible drugs for treatment?(3)

A

1) Amyl nitrite (inhaled antidote)
2) Sodium nitrite (IV antidote)
3) Sodium thiosulfate (IV antidote)

2
Q

Cyanide Poisoning:
Treatment Mechanism of Amyl nitrite (inhaled antidote)
and Sodium nitrite (IV antidote)

A

Nitrites oxidize some of the hemoglobin’s iron
(ferrous → ferric), converting Hgb into methemoglobin.
Cyanide binds to methemoglobin, forming
cyanmethemoglobin, thus releasing cyanide from
cytochrome oxidase

3
Q

Cyanide Poisoning:
Treatment Mechanism of Sodium thiosulfate
(IV antidote)

A

Induces a metabolising enzyme, producing sodium

thiocyanate, which is excreted in urine

4
Q

Cholinesterase inhibitors poisoning:

What are the possible drugs for treatment?(2)

A

Atropine and Pralidoxime

5
Q

Cholinesterase inhibitors poisoning:

Treatment Mechanism of Atropine

A

Muscarinic receptor antagonist

6
Q

Cholinesterase inhibitors poisoning:

Treatment Mechanism of Pralidoxime

A

Reactivation of cholinesterase enzyme

alters interaction between poison and Ach

7
Q

Benzodiazepine poisoning:

What are the possible drugs for treatment?

A

Flumazenil

8
Q

Benzodiazepine poisoning:

Treatment Mechanism of Flumazenil

A

Benzodiazepine binding site antagonist

9
Q

Methanol Poisoning:

What are the possible drugs for treatment?

A

Fomepizole (Also Ethanol)

10
Q

Methanol Poisoning:

Treatment Mechanism of Fomepizole

A

Competitive inhibitor of alcohol dehydrogenase

11
Q

Lead Poisoning:

What are the possible drugs for treatment?(2)

A

Calcium EDTA and Dimercaprol (BAL)

12
Q

Lead Poisoning:

Treatment Mechanism of Calcium EDTA and Dimercaprol (BAL)?

A

Chelating Agents

13
Q

Opioids Poisoning:

What are the possible drugs for treatment?(2)

A

Nalorphine and Naloxone

14
Q

Opioids Poisoning:

Treatment Mechanism of Nalorphine

A

μ-receptor antagonist

15
Q

Opioids Poisoning:

Treatment Mechanism of Naloxone

A

Opioid antagonist

16
Q

Digoxin toxicity:

What are the possible drugs for treatment?(2)

A

Lidocaine and Anti-Digoxin Antibodies

17
Q

Digoxin toxicity:

Treatment Mechanism of Anti-Digoxin Antibodies

A

Neutralize the effect of the drug

18
Q

Digoxin toxicity:

Treatment Mechanism of Lidocaine

A

Antiarrhythmic (Na+-channel blocker)

19
Q

β-blockers - Mode of action:

A
  • Blood pressure ↓

- Cardiovascular effects

20
Q

ACE inhibitors - Mode of action:

A
  • Blood pressure ↓

- Cardiovascular effects

21
Q

Angiotensin inhibitors - Mode of action:

A
  • Blood pressure ↓

- Cardiovascular effects

22
Q

Ca2+ channel blockers - Mode of action:

A
  • Blood pressure ↓

- Cardiovascular effects

23
Q

Diuretics - Mode of action:

A
  • Reduce edema and fluid retention

- Improves CHF

24
Q

Statin - Mode of action:

A

Reduce cholesterol absorption

25
Q

Aspirin - Mode of action:

A

Anti-Platelet Aggregation

26
Q

Clopidogrel - Mode of action:

A

Anti-Platelet Aggregation

27
Q

Hyperprolactinemia:

What are the possible drugs for treatment?

A

Bromocriptine

28
Q

Hyperprolactinemia:

Treatment Mechanism of Bromocriptine

A

Dopamine agonist (inhibits PRL release)

29
Q

Acromegaly:

What are the possible drugs for treatment?(3)

A

1) Bromocriptine
2) SST Analogues
3) GH Analogues

30
Q

Acromegaly:

Treatment Mechanism of Bromocriptine

A

Dopamine agonist

potential GH release inhibitor

31
Q

Acromegaly:

Treatment Mechanism of Somatostatin analogues

A

Inhibition of GH release

32
Q

Acromegaly:

Treatment Mechanism of GH Analogues

A

Antagonizes endogenous GH by blocking

GH binding to its receptor in the liver

33
Q

Central Diabetes Insipidus:

What are the possible drugs for treatment?

A

Desmopressin

34
Q

Central Diabetes Insipidus:

Treatment Mechanism of Desmopressin

A

ADH analogue (V2 receptor agonist)

35
Q

Nephrogenic Diabetes Insipidus:

What are the possible drugs for treatment?

A

Hydrochlorothiazide (HCTZ)

36
Q

Nephrogenic Diabetes Insipidus:

Treatment Mechanism of Hydrochlorothiazide?

A

Enhance fluid reabsorption in proximal tubule

37
Q

SIADH:

Treatment Mechanism of Demeclocycline?

A

ADH inhibitor; V2 receptor antagonist

38
Q

SIADH:

What are the possible drugs for treatment?

A

Demeclocycline

39
Q

Adrenocortical Hypofunction:

What are the possible drugs for treatment?(2)

A

Hydrocortisone Dexamethasone

40
Q

Adrenocortical Hypofunction:

Treatment Mechanism of Hydrocortisone ?

A

Synthetic Cortisol

41
Q

Adrenocortical Hypofunction:

Treatment Mechanism of Dexamethasone?

A

Glucocorticoid analogue

42
Q

Hyperthyroidism:

What are the possible drugs for treatment?(2)

A

Carbimazole and Propylthiouracil (PTU)

43
Q

Hyperthyroidism:

Treatment Mechanism of Propylthiouracil (PTU)?

A

Inhibits thyroid peroxidase

Inhibits deiodinase enzyme (T4 → T3)

44
Q

Hyperthyroidism:

Treatment Mechanism of Methimazole (Carbimazole)?

A

Inhibits thyroid peroxidase enzyme

45
Q

Hypothyroidism:

What are the possible drugs for treatment?

A

Levothyroxine

46
Q

Hypothyroidism:

Treatment Mechanism of Levothyroxine?

A

Synthetic T4

47
Q

Hypercalcemia (Hyperparathyroidism):

What are the possible drugs for treatment?(4)

A

1) Loop diuretics (Furosemide)
2) Calcitonin
3) Bisphosphonate
4) Calcimimetic agent (Cinacalcet)

48
Q

Hypercalcemia (Hyperparathyroidism):

Treatment Mechanism of Furosemide?

A

Decreases Ca2+ renal reabsorption

49
Q

Hypercalcemia (Hyperparathyroidism):

Treatment Mechanism of Calcitonin?

A

Inhibits osteoclast activity

50
Q

Hypercalcemia (Hyperparathyroidism):

Treatment Mechanism of Bisphosphonate?

A

Inhibits osteoclast activity

by inducing Apoptosis after phagocytosed

51
Q

Hypercalcemia (Hyperparathyroidism):

Treatment Mechanism of Cinacalcet?

A

Shunting-off parathyroid activity

Increases sensitivity of Ca2+ sensing

52
Q

Hyperlipidemia:

What are the possible drugs for treatment?(7)

A

1) HMG-CoA reductase inhibitor (Statin)
2) Cholesterol absorption inhibitor (Ezetimibe)
3) Bile acid sequestrants
4) MTP inhibitor (microsomal triglyceride transfer protein)
5) Apo-B inhibitor
6) Nicotinic acid
7) Omega-3 fatty acids

53
Q

Hyperlipidemia:

Treatment Mechanism of Statin?

A

HMG-CoA reductase inhibitor:
Cholesterol synthesis ↓
Hepatic LDL receptors ↑
VLDL production ↓

54
Q

Hyperlipidemia:

Treatment Mechanism of Ezetimibe?

A

Cholesterol absorption inhibitor:
Cholesterol absorption ↓ (NPC1L1 inhibitor)
LDL receptors ↑

55
Q

Hyperlipidemia:

Treatment Mechanism of Bile acid sequestrants?

A

Bile acid excretion ↑

LDL receptors ↑

56
Q

Hyperlipidemia:

Treatment Mechanism of MTP inhibitor?

A

Microsomal Triglyceride Transfer Protein

VLDL production ↓

57
Q

Hyperlipidemia:

Treatment Mechanism of Apo-B inhibitor?

A

VLDL production ↓

58
Q

Hyperlipidemia:

Treatment Mechanism of Nicotinic acid?

A

VLDL production ↓

TG synthesis ↓

59
Q

Hyperlipidemia:

Treatment Mechanism of Omega-3 fatty acids?

A

TG catabolism ↑

60
Q

Acute Gout Arthritis:

What are the possible drugs for treatment?(3)

A

1) NSAIDs
2) Steroids
3) Colchicine

61
Q

Acute Gout Arthritis:

Treatment Mechanism of NSAIDs?

A

COX inhibitor

62
Q

Acute Gout Arthritis:

Treatment Mechanism of Steroids?

A

Anti-inflammatory

63
Q

Acute Gout Arthritis:

Treatment Mechanism of Colchicine?

A

Interfere with gout inflammation

64
Q

Chronic Hyperuricemic Arthritis:

Treatment Mechanism of Allopurinol?

A

Inhibits xanthine oxidase (uric acid synthesis ↓)

65
Q

Chronic Hyperuricemic Arthritis:

Treatment Mechanism of Probenecid?

A

Uricosuric effect - increased renal excretion

66
Q

Chronic Hyperuricemic Arthritis:

Treatment Mechanism of Colchicine?

A

Interfere with gout inflammation

67
Q

Chronic Hyperuricemic Arthritis:

What are the possible drugs for treatment?(3)

A

1) Allopurinol
2) Probenecid
3) Colchicine

68
Q

Anti-Hyperglycemic (DM) therapy - Treatment Mechanism of Biguanides (Metformin)?

A
  • Hepatic gluconeogenesis ↓

- Peripheral glucose uptake ↑

69
Q

Anti-Hyperglycemic (DM) therapy - Treatment Mechanism of Sulfonylurea?

A

Closes ATP-sensitive K+ channel → Insulin secretion ↑

70
Q

Anti-Hyperglycemic (DM) therapy - Treatment Mechanism of Thiazolidinediones (TZD)?

A
  • PPAR-γ agonist
  • Insulin resistance ↓
  • Glucose utilization ↑
  • Improves lipid profile
71
Q

Anti-Hyperglycemic (DM) therapy - Treatment Mechanism of GLP-1 receptor agonist?

A
  • Insulin secretion ↑
  • Glucagon secretion ↓
  • Slow gastric emptying
  • Satiety
72
Q

Anti-Hyperglycemic (DM) therapy - Treatment Mechanism of DPP-4 inhibitor (dipeptidyl peptidase)?

A

Prolong endogenous GLP-1 action (inhibits

degradation)

73
Q

Anti-Hyperglycemic (DM) therapy - Treatment Mechanism of SGLT-2 inhibitor?

A

Activation-Na+/glucose co-transporter → Urinary glucose excretion ↑

74
Q

Anti-Hyperglycemic (DM) therapy - Treatment Mechanism of Insulin?

A
  • Glucose utilization ↑
  • Hepatic gluconeogenesis ↓
  • Anabolic actions
75
Q

What is the drug treatment for Chronic Fibrous -

Riedel’s Thyroiditis?

A

Prednisone

76
Q

Why is Metformin (biguanide) the best treatment for T2DM treatment ?

A

Activates AMP kinase→ ↓Gluconeogenesis and Insulin resistance .
Also, Cardiovascular protection↑

77
Q

What is the effect of Short-acting insulin on DM Patients?

A
Absorbed slowly (reaching peak after 60-90 minutes)
and may predispose for hypoglycemia. Could be used in Medical Emergencies.
78
Q

What are the Short-acting insulin analogues? (3)

A

● Insulin-Lispro
● Insulin-Aspart
● Insulin-Glulisine

79
Q

Short-acting insulin analogues are engineered to:

A

Dissociate more rapidly (than the original)

80
Q

Long-acting insulin:
The action of human insulin can be _______ by the
addition of zinc or protamine.

A

Long-acting insulin:
The action of human insulin can be prolonged by the
addition of zinc or protamine.

81
Q

What is the most widely used protamine used for Long-acting insulin?

A

NPH

82
Q

What are the Long-acting insulin analogues? (2)

A

● Insulin-Glargine

● Insulin-Detemir

83
Q

What drug would be used as a heme replacement in Acute Porphyria?

A

Heme-arginate

84
Q

What are the Drugs used as Copper chelators for Wilson’s Disease?(2)

A

1) D-penicillamine + vitamin B6

2) Trientine

85
Q

What is the Vitamin should be AVOIDED for patients with Hemochromatosis? Why?

A

Vitamin C - Increase Iron absorption

86
Q

What are emergency drug given to people with Hypocalcemic Tetany?

A

Ca-gluconate (Should be given slowly)

87
Q

What is the common Antidote for Diethylene glycol, Ethylene glycol and Methanol Intoxication?

A

Ethanol

88
Q

What is the drug given to reduce Immune mediated damage in Gout?

A

Prednisone

89
Q

Drug-induced Diabetes Mellitus - What are the eliciting drugs?
(High Doses over a long period of time)

A

Corticosteroides: Hydrocortisone, Dexamethasone and Prednisone

90
Q

What is the drug of choice for Acetaminophen Intoxication?

A

N-Acetylcysteine