Endo final summary for treatments

what drug classes are used to treat ovarian dysfunction in PCOS

SERMs
aromatase inh
gonadotropin

what drugs are used to treat ovarian dysfunction in PCOS

SERMs
-clomiphene
aromatase inh
-letrozole
gonadotropin

what drug classes are used to treat hyperandrogenism in PCOS

oral contraception
anti-androgen therapy (aldosterone antagonist- Spironolactone)
drugs to normalize hair growth patterns

what drugs to normalize hair growth patterns

spironolactone
Eflornithine
Finasteride

What drugs are used to treat prolactinomas

cabergoline (dostinex)
bromocriptine (parlodel)

what drugs classes are used to treat hyperthyroidism

radiated iodine
Thioamides
Beta blockers
iodide

what beta blockers are used for hyperthyroidism

propanolol
nadolol

What are the Thioamides and what are they used for

PTU and Methamizole (tapazole)
Hyperthyroidism

what drug classes are used to treat hypoparathyroidism

Vit D
Calcium supplements
thazides
magnesium and phosphate binders

what drug are used to treat hyperparathyroidism

cincalet (sensipar)
etalactide (Parsabiv)

what drug classes are used to treat hyperparathyroidism

calcimimetics

what drug classes are used in anti-resorptive therapy for osteroporosis

bisphosphonates
RANK-L inh (Denosumab)
SERMs
Estrogen/Hormonal therapy
Calcitonin

what drug classes are used in anabolic therapy for osteroporosis

PTH and PTHrH analogs (forteo and Tymlos)
Sclerostin inh (romosozumab - Evenity)

What drug classes are used to treat hyper-adrenal diseases

Steroidogenesis inhibitors
Glucocorticoid receptor blocking agents
Neuromodulators of ACTH release
--somatostatin analogs
--D2 receptor agonists

What drug classes are used to treat hypo-adrenal diseases

replace glucocorticoids

How do you treat neurogenic diabetes insipidus

replace ADH (desmopressin)

How do you treat nephrogenic diabetes insipidus

reduce osmotic load
thiazides
prostaglandin inh

What is mifepristone's drug class and what is it used for

glucocorticoid receptor blocking agent
hyper-adrenal diseases

Name the steroidogenisis inhibitors and what they are used for

etomidate, ketoconazole, metapyrone, osilodrostat, levoketoconazole

Mifepristone ADEs

Endometrial hypertrophy (inc. progesterone), inc. endogenous ACTH, cortisol, hypokalemia, hypertension, nausea, fatigue, peripheral edema

which Steroidogenesis Inhibitors is preferable in pregnant women

Metyrapone (Metopirone)

which Steroidogenesis Inhibitors is preferable in women

ketoconazole

which Steroidogenesis Inhibitors is preferable in men

Metyrapone (Metopirone)Osilodrostat (Isturisa)

Ketoconazole ADEs

GI upset, hepatotoxicity & QT prolongation (BW), male hypogonadism, dermatologic reactions

Metyrapone ADEs

GI upset, androgenic effects (hirsutism, acne), hypotension, hypokalemia, headache, dizziness, allergic rash

Osilodrostat ADEs

Headache, nausea, arthralgias, dizziness, androgenic effects (hirsutism, acne), edema, hypotension, hypokalemia

Etomidate ADEs

Sedation, pain at injection site, hypotension, myoclonus, nausea, vomiting

Mitotane ADEs

GI upset, lethargy, somnolence, CNS disturbances, risk of adrenal crisis in setting of shock or severe trauma (BW)

Levoketoconazole ADEs

nausea/vomiting, hypokalemia, hemorrhage/contusion, hypertension, headache, uterine bleeding, fatigue, insomnia, peripheral edema, myalgia

Cabergoline ADEs

Asthenia
GI upset
Dizziness
Valvulopathy (bolded)
Psychiatric symptoms

Pasireotide ADEs

Nausea/diarrhea
Cholelithiasis
Hyperglycemia (increase A1c by 1.4%)

Bisphosphonates contraindiations

alendronate and ZA CrCl

Bisphosphonates ADEs

dyspepsia, transient or chronic MSK pain, nausea, flu-like illness (ZA), GERDRare: ONJ, AFF

Denosumab ADEs

back pain, arthralgia, eczema, cellulitis and infection, hypocalcemia (more common in those with severe renal impairment)Rare: ONJ & AFF

Denosumab warnings and precautions

active infection

Warnings for Estrogen therapy (ET)/hormonal therapy (HT)

increased risk of stroke, DVT/PE

ADEs for Estrogen therapy (ET)/hormonal therapy (HT)

hot flushes, leg pain, spasms, or cramps, peripheral edema, venous thromboembolism

ADEs for SERMs

hot flushes, leg pain, spasms, or cramps, peripheral edema, venous thromboembolism

Warnings for SERMs

increased risk of stroke, DVT/PE

Calcitonin ADEs

flushing, injection site reactions, epistaxis, rhinitis, hypocalcemia

Calcitonin contraindications

allergy to salmon

PTH and PTHrP Analogs ADEs

first dose orthostasis, injection site pain, hypercalcemia, hypercalciuria, dizziness

PTH and PTHrP Analogs black box warning

osteosarcoma for Abaloparatide (Tymlos)

Romosozumab ADEs

arthralgia, headaches, mild injection site pain, hypocalcemia; ONJ, AFF (rare)

Romosozumab warnings

major cardiovascular eventsblack box warning for MI, stoke, and cardiovascular death

T3 brands

Cytomel, Triostat

What is Wolff-Chaikoff Effect

High Iodide can transiently inhibit further iodide binding/uptake into thyroid follicle; transient hypothyroid symptoms

Iodides Side Effects

Allergic ReactionsDose-related toxicity (Iodism)Metallic taste"Escape" phenomenon

Dopamine agonist therapy contraindications

•Uncontrolled HTN
•History of cardiac valve disorder
•History of pulmonary or pericardial fibrotic disorders
•Breastfeeding (interfere with lactation)

Letrozole ADEs

hot flashes, night sweats, insomnia. Increased likelihood of multiple births

Clomiphene ADEs

hot flashes, breast discomfort, ovarian hyperstimulation syndrome, abdominal distention/bloating Increased likelihood of multiple births.

What warning is associate with spironolactone

Warning: May cause birth defects, avoid in pregnancy or patients planning to be pregnant

Which oral contraceptions have the least androgenic activity

ethynodiol, norgestimate, gestodene, desogestrel

Which oral contraceptions have the most androgenic activity

norgestrel, levonorgestrel ​

TZDs CTX

NYHA Class III or IV HFOsteoporotic in high fracture risk individuals

SGLT2 inh ADEs

Genitourinary tract infections (yeast or UTIs)
Polyuria
Risk of hypotension and hypovolemia due to osmotic diuresis
Euglycemic ketoacidosis (primarily in T1DM);
DC prior to any scheduled surgery
Amputations (?); primarily occur in patients with history of PAD or prior amputation
Fractures (Canagliflozin)
Necrotizing fasciitis of the perineum (Fournier's gangrene)

SGLT2 inh ctx

Severe renal impairment (GFR < 20 mL/min, ESRD/on dialysis)
History of severe hypersensitivity rcns

metformin ctx

Creatinine clearance less than 45 mL/min (initiation);
< 30 ml/min otherwise
Severe hepatic, pulmonary, or cardiac (HF) disease
Hold for 24 hours before and 48 hrs after procedures using iodinated contrast dyes

TZD's ADEs

Weight gain
Fluid retention (especially with insulin, NSAID, GC, or DHP-CCB use)
Heart failure exacerbation
"Atypical" bone fractures (hands and feet)
Very rare hepatotoxicity and macular edema
Bladder cancer (pioglitazone)???

TZD's ctx

ALT \> 2.5 ULN
NYHA Class III and IV HF

Colesevelam ctx

History of bowel obstructionTriglycerides greater than 500 mg/dLHistory of hypertriglyceridemia-induced pancreatitis

What is the rule of 1800

1800/total daily dose of insulin \= correction factor for 1 unit of rapid-acting insulin

what is the rule of 1500

1500/total daily dose of insulin \= correction factor for 1 unit of regular insulin

what is the rule of 500

500/TDD of insulin \= grams of carbs covered by 1 unit of rapid-acting insulin

GLP-1As ADEs

GI: Nausea, Vomiting, DiarrheaHeadache
Rare: Renal dysfunction, Pancreatitis, Cholelithiasis

GLP-1As CTX

Creatinine clearance < 30 mL/minute for Exenatide and Exenatide LAR
Medullary thyroid carcinoma (MTC), personal or family history, or in patients with multiple endocrine neoplasia syndrome type 2 (MEN2): applies to Liraglutide and Weekly GLP-1 RA's Gastroparesis (?