Post on 14-Jan-2016
description
+Endocrine and Reproductive Pharmacology Shan Nanji
+Endocrine Pharmacology
nPropylthiouracil, Methimazole
MOA: nBlocks __________________ nBlocks __________________
nS/E: n Skin Rash
n __________________ n Hepatotoxicity associated with __________________
nClinical Use: n Hyperthyroidism
Shan Nanji - NanjiMD@gmail.com
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+Endocrine Pharmacology
nLevothyroxine, Triiodothyronine MOA:
n Thyroxine Replacement nS/E:
n Tachycardia n Heat Intolerance n Tremors n Arrhythmias
nClinical Use: n HypOthyroidism n Myxedema
Shan Nanji - NanjiMD@gmail.com
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+Endocrine Pharmacology
nDemeclocycline (+etracycline)
MOA: n __________________
nS/E: n __________________ n Photosensitivity n Tooth and Bone Abnormalities
nClinical Use: n __________________
Shan Nanji - NanjiMD@gmail.com
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+Endocrine Pharmacology
Shan Nanji - NanjiMD@gmail.com
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nGH n Clinical Use:
n GH Deficiency n Turner Syndrome
nSomatostatin (Octreotide) n Clinical Use:
n Esophageal Varices n __________________ n __________________ n Gastrinoma n Glucagonoma
+Endocrine Pharmacology
Shan Nanji - NanjiMD@gmail.com
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nOxytocin nClinical Use:
n Stimulates Labor n Uterine Contractions n Lactation
n __________________
nADH (desmopressin) nClinical Use:
n __________________
+Endocrine Pharmacology
Shan Nanji - NanjiMD@gmail.com
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nLeuprolide MOA:
n GnRH Analog
n Agonist Properties if ________ Administration n Clinical Use:
n Pulsatile Dose
n __________________ n Continuous Dose
n Prostate Cancer (Coadministered with Flutamide) n Uterine Fibroids n Precocious Puberty
+Endocrine Pharmacology
Shan Nanji - NanjiMD@gmail.com
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nTestosterone, Methyltestosterone MOA:
n Androgen Receptor Agonist n Inhibits LH -> Produce Less Testosterone
n S/E: n Masculinization (Females) n Gonadal Atrophy n Increase LDL n Decrease HDL n Early Epiphyseal Plate Closure
n Clinical Use: n Hypogonadism n Promote Anabolism in Burn Patients
+Endocrine: Antiandrogens
Shan Nanji - NanjiMD@gmail.com
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nFinasteride nMOA: __________________-> Slow Conversion Testosterone to
DHT n Clinical Use: BPH and Male Pattern Baldness
nFlutamide nMOA: __________________ n Clinical Use: Prostate Carcinoma
+Endocrine: Antiandrogens
Shan Nanji - NanjiMD@gmail.com
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nKetoconazole nMOA: Inhibits 17,20-Desmolase (Steroid Synthesis) n Clinical Use: __________________
nSpironolactone nMOA: Inhibits Steroid Synthesis
n Clinical Use: __________________
nKetoconazole and Spironolactone n Used in Polycystic Ovarian Syndrome
n Prevention of Hirsuitism
+Endocrine Pharmacology
Shan Nanji - NanjiMD@gmail.com
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nEstrogens: Ethinyl Estradiol, DES, Mestranol MOA:
n Bind Estrogen Receptors
nClinical Use: n Hypogonadism n Ovarian Failure
n __________________ n __________________
+Endocrine Pharmacology
Shan Nanji - NanjiMD@gmail.com
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nEstrogens: Ethinyl Estradiol, DES, Mestranol nS/E:
n Increase Risk Endometrial Cancer n Postmenopausal Bleeding
n __________________ n Contraindicated in:
n ER-Positive Breast Cancer
n __________________
+Endocrine: SERMs (Selective Estrogen Receptor Modulator)
Shan Nanji - NanjiMD@gmail.com
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nClomiphene nMOA: Partial Estrogen Receptor Agonist nS/E:
n __________________ n Ovarian Enlargement n __________________
n Clinical Use: n __________________ n PCOS
+Endocrine: SERMs (Selective Estrogen Receptor Modulator)
Shan Nanji - NanjiMD@gmail.com
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nTamoxifen, Raloxifen nMOA: n Antagonist at Breast n Agonist at Bones
n Clinical Use: n Prevention of Recurrent ER-Positive Breast Cancer n __________________
n RELAXifen Dont Worry about Risks of Endometrial Carcinoma
+Endocrine: Pharmacology
Shan Nanji - NanjiMD@gmail.com
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nAnastrozole/Exemestane nMOA: Aromatase Inhibitor n Clinical Use:
n Postmenopausal Patient with Breast Cancer
+Endocrine: Pharmacology
Shan Nanji - NanjiMD@gmail.com
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nProgestins MOA: n Bind Progesterone Receptors
n Increase __________________
n Clinical Use: n __________________ n __________________ n Abnormal Uterine Bleeding
+Endocrine: Pharmacology
Shan Nanji - NanjiMD@gmail.com
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nMifepristone (aka RU-486) MOA: n Competitive Inhibitor of Progestins
n At Progesterone Receptors nS/E:
n __________________ n GI (Nausea, Vomiting, Anorexia) n Abdominal Pain
n Clinical Use: n Abortifacent n Coadministered with __________________
+Endocrine: Pharmacology
Shan Nanji - NanjiMD@gmail.com
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nTerbutaline MOA: n2-Agonist
n __________________ n Clinical Use:
n Reduce __________________
+Endocrine: Pharmacology
Shan Nanji - NanjiMD@gmail.com
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nTamsulosin MOA:
n __________________ n Inhibits Smooth Muscle Contraction
n Clinical Use: n BPH n Selective 1A,D Receptor
n Found in Prostate
n TAMEsulosin -> Least Side Effects TAME
+Endocrine: Pharmacology
Shan Nanji - NanjiMD@gmail.com
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nSildenaFIL, VardenaFIL MOA:
nInhibit __________________ n Increase in cGMP -> Vasodilation
n Clinical Use: n Erectile Dysfunction
n__________________ n -> Help FILL the Corpus Cavernosum with Blood!
+Endocrine: Pharmacology
Shan Nanji - NanjiMD@gmail.com
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nSildenaFIL, VardenaFIL nS/E:
n Dyspepsia n Headache n Flushing
n Impaired __________________Color Vision n Severe HypOtension
n In Patients Taking Nitrates Concurrently
n PDE5 Inhibitors n-> Help FILL the Corpus Cavernosum with Blood!
+Endocrine: Pharmacology
Shan Nanji - NanjiMD@gmail.com
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nDanazol MOA: n Partial Agonist at Androgen Receptors
n (Synthetic Androgen) n Clinical Use:
n __________________ n __________________
n S/E: n Weight Gain n Edema n Hirsutism and Acne n Decrease HDL n Hepatotoxicity
+Gastrointestinal Hormones Shan Nanji
+Endocrine: Pharmacology
Shan Nanji - NanjiMD@gmail.com
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nGastrin (G-Cells) ACTION: n Increase Gastric H+ Secretion n Increase Gastric Mucosa Growth n Increase Gastric Motility
REGULATION: n Increase by Stomach Distention/Alkilinity n Decrease by pH < 1.5
ORIGIN: n G-Cells in Stomach Antrum
+Endocrine: Pharmacology
Shan Nanji - NanjiMD@gmail.com
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n(CCK)Cholecystokinin (I-Cells) ACTION: n Increase Pancreatic Secretion n Increase Gallbladder Contraction n Increase Sphincter of Oddi Relaxation n Decrease Gastric Emptying
REGULATION: n Increase by Fatty Acids n Increase by Amino Acids
ORIGIN: n I-Cells in Doudenum and Jejunum
+Endocrine: Pharmacology
Shan Nanji - NanjiMD@gmail.com
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nSecretin ACTION: n Increase Pancreatic HCO3 Secretion n Increase Bile Secretion n Decrease Gastric Acid Secretion
REGULATION: n Increase by Acids n Increase by Fatty Acids in Duodenum
ORIGIN: n S-Cells in Doudenum
+Endocrine: Pharmacology
Shan Nanji - NanjiMD@gmail.com
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nSomatostatin ACTION: n Decrease Gastric Acid and Pepsinogen Secretion n Decrease Pancreatic and Small Intestine Fluid Secretion n Decrease Gallbladder Contraction n Decrease Insulin and Glucagon
REGULATION: n Increase by Acids n Decrease by Vagal Stimulation
ORIGIN: n D-Cells in Pancreatic Islets and GI Mucosa
+Endocrine: Pharmacology
Shan Nanji - NanjiMD@gmail.com
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nGlucose-dependent Insulinotropic Peptide (GIP) ACTION: n Exocrine: n Decrease Gastric H+ Secretion
n Endocrine: n Increase Insulin Release
REGULATION: n Increase by Fatty Acids n Increase by Amino Acids n Increase by Oral Glucose
ORIGIN: n K-Cells in Doudenum and Jejunum
+Endocrine: Pharmacology
Shan Nanji - NanjiMD@gmail.com
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nVasoactive Intestinal Peptide (VIP) ACTION: n Increase Intestinal Water and Electrolyte Secretion n Increase Relaxation of Intestinal Smooth Muscle and Sphincters
REGULATION: n Increase by Distension n Increase by Vagal Stimulation n Decrease by Adrenergic Input
ORIGIN: n Parasympathetic Ganglia in Sphincters, Gallbladder, and Small Intestine
+Endocrine: Pharmacology
Shan Nanji - NanjiMD@gmail.com
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nMotilin ACTION: n Produces Migrating Motor Complexes (MMC)
REGULATION: n Increase During Fasting State
ORIGIN: n Small Intestine
+Endocrine: Pharmacology
Shan Nanji - NanjiMD@gmail.com
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nIntrinsic Factor ACTION: n Binds Vitamin B12
REGULATION:
ORIGIN: n Parietal Cells in Stomach
+Endocrine: Pharmacology
Shan Nanji - NanjiMD@gmail.com
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nPepsin ACTION: n Decrease Stomach pH
REGULATION: n Increase by Histamine, Ach, and Gastrin n Decrease by Somatostatin, GIP, Prostaglandins, and Secretin
ORIGIN: n Parietal Cells in Stomach
+Endocrine: Pharmacology
Shan Nanji - NanjiMD@gmail.com
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nGastric Acid ACTION: n Protein Digestion
REGULATION: n Increase by Vagal Stimulation n Increase by Acid
ORIGIN: n Chief Cells in Stomach
+Endocrine: Pharmacology
Shan Nanji - NanjiMD@gmail.com
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nHCO3 ACTION: n Neutralizes Acid
REGULATION: n Increase by Pancreatic and Biliary Secretion with Secretin
ORIGIN: n Mucosal Cells in Stomach, Doudenum, Salivary Glands, and Pancreas n Brunners Glands in Doudenum