Endocrinology Top 300: Exam 2

What is the brand for Medroxyprogesterone?

Provera, Depo-Provera

What is the drug class for Medroxyprogesterone?

Progestin Hormone

What are the dosage forms for Medroxyprogesterone?

Tablet

What are the on-label uses for Medroxyprogesterone?

- Abnormal uterine bleeding unrelated to menstrual cycle

- Prevention of estrogen-induced endometrial hyperplasia

- Secondary physiologic amenorrhea

What are the off-label uses for Medroxyprogesterone?

Treatment of endometrial hyperplasia

What is the MOA for Medroxyprogesterone?

- Transforms proliferative into secretory endometrium

- Androgenic and anabolic effects have been noted, but the drug is devoid of significant estrogenic activity

What are the box warnings for Medroxyprogesterone?

- Increased risk of cardiovascular disorders

- Breast cancer

- Dementia

- Loss of BMD; not for long-term use, risk vs benefit weighed

What are the contraindications for Medroxyprogesterone?

- Hypersensitivity to medroxyprogesterone

- Abnormal genital bleeding

- History of estrogen- or progesterone-dependent neoplasia

- Active or history of DVT or PE

- Severe liver dysfunction

- Known or suspected pregnancy

Is Medroxyprogesterone safe for pregnancy/lactation?

Pregnancy: contraindicated

Lactation: compatible

What are the adverse effects for Medroxyprogesterone?

- Weight gain

- Headache

- Amenorrhea

- Breast tenderness

- Nervousness

What is the brand for Progesterone?

Prometrium, Endometrin, Crinone

What is the drug class for Progesterone?

Progestin Hormone

What are the dosage forms for Progesterone?

- Capsule

- Vaginal Gel

- Vaginal Insert

What are the on-label uses for Progesterone?

- Prevention of estrogen-induced endometrial hyperplasia

- Secondary physiologic amenorrhea

- Assisted reproduction for infertile women

What are the off-label uses for Progesterone?

- Abnormal uterine bleeding

- Prevention of spontaneous pre-term birth

What is the MOA for Progesterone?

- Progesterone transforms proliferative endometrium into secretory endometrium

- Parenterally administered progesterone inhibits gonadotropin production, which in turn prevents follicular maturation and ovulation

What are the box warnings for Progesterone?

- Should not be used for the prevention of cardiovascular disorders or dementia

- Increased risk of breast cancer

What are the contraindications for Progesterone?

- Hypersensitivity to progesterone or any component of formulation including peanuts/peanut oil

- History of estrogen- or progesterone-dependent neoplasia

- Active or history of DVT or PE

- Known or suspected pregnancy

- Abnormal uterine bleeding not evaluated by provider

Is Progesterone safe for pregnancy/lactation?

Weigh risks and benefits

What are the adverse effects for Progesterone?

Weight change, headache, amenorrhea, breast tenderness, abdominal pain

What is the brand for Testosterone?

AndroGel, Androderm

What is the drug class for Testosterone?

Androgen (C-III)

What are the dosage forms for Testosterone?

- Topical Solution

- Transdermal Gel

- Transdermal Pump

- Transdermal Patch

- Nasal Gel

- Oral Capsule

What are the on-label uses for Testosterone?

Hypogonadism

What are the off-label uses for Testosterone?

Hormone therapy for transgender men

What is the MOA for Testosterone?

- Responsible for normal growth and development of male sex organs

- Involved in the growth and maturation of the prostate, seminal vesicles, penis, and scrotum

What are the box warnings for Testosterone?

- Virilization after secondary exposure (topical)

- BP increases (oral)

- Pulmonary oil microembolism (POME) reactions (injectable)

What are the contraindications for Testosterone?

- Hypersensitivity to testosterone

- Men with breast or prostate cancer

- Women who are pregnant

- Who may become pregnant, or who are breastfeeding

Is Testosterone safe for pregnancy/lactation?

Contraindicated

What are the adverse effects for Testosterone?

- Benign prostatic hyperplasia

- Testicular atrophy

- PSA increase

- HTN

- Application site rash or blisters

What is the brand for Modafinil?

Provigil

What is the drug class for Modafinil?

CNS Stimulant (C-IV)

What are the dosage forms for Modafinil?

Tablet

What are the on-label uses for Modafinil?

- Narcolepsy

- Obstructive Sleep Apnea (improve excessive sleepiness)

- Shift work-sleep disorder

What are the off-label uses for Modafinil?

- Illness-related fatigue (cancer, MS)

- Depression (antidepressant augmentation)

What is the MOA for Modafinil?

Wakefulness-promoting agent acting as a CNS stimulant

What are the box warnings for Modafinil?

None

What are the contraindications for Modafinil?

Hypersensitivity to modafinil or armodafinil

Is Modafinil safe for pregnancy/lactation?

Pregnancy: moderate risk

Lactation: potential toxicity

What are the adverse effects for Modafinil?

Headache, insomnia, nausea

What is the brand for Phentermine?

Adipex-P, Lomaira

What is the drug class for Phentermine?

Centrally Acting Appetite Suppressant (C-IV)

What are the dosage forms for Phentermine?

Capsule, Tablet

What are the on-label uses for Phentermine?

Obesity

What are the off-label uses for Phentermine?

None

What is the MOA for Phentermine?

- Sympathomimetic amine with pharmacologic activity similar to amphetamines

- CNS stimulation and elevation of BP

- Weight loss is due to anorectic effect, primarily one of appetite suppression

What are the box warnings for Phentermine?

None

What are the contraindications for Phentermine?

- Hypersensitivity to phentermine or other sympathomimetic amines

- Use in agitated states

- Cardiovascular disease

- History of drug abuse

- Glaucoma, moderate to severe HTN

- Hyperthyroidism

Is Phentermine safe for pregnancy/lactation?

Contraindicated

What are the adverse effects for Phentermine?

None

What is the brand for Alendronate?

Fosamax, Binosto

What is the drug class for Alendronate?

Bisphosphonate

What are the dosage forms for Alendronate?

Tablet, Effervescent Tablet, Oral Solution

What are the on-label uses for Alendronate?

- Osteoporosis prevention: men and postmenopausal women

- Fracture risk reduction: men and postmenopausal women

- Paget disease

- Glucocorticoid-induced osteoporosis in those with daily dosage ≥7.5 mg of prednisone (or equivalent) prophylaxis

What are the off-label uses for Alendronate?

Androgen deprivation therapy-associated osteoporosis prophylaxis

What is the MOA for Alendronate?

Attaches to bone hydroxyapatite and works at the cellular level to inhibit osteoclast activity, reducing bone resorption and helping regulate bone metabolism.

What are the box warnings for Alendronate?

None

What are the contraindications for Alendronate?

- Esophageal abnormalities

- Aspiration risk

- Hypersensitivity

- Hypocalcemia

- Inability to sit or stand upright for at least 30 min

Is Alendronate safe for pregnancy/lactation?

Pregnancy: potential risk

Lactation: comptaible

What are the adverse effects for Alendronate?

Fever and decreased serum calcium

What is the brand for Ibandronate?

Boniva

What is the drug class for Ibandronate?

Bisphosphonate

What are the dosage forms for Ibandronate?

Tablet

What are the on-label uses for Ibandronate?

Postmenopausal osteoporosis: treatment and prophylaxis

What are the off-label uses for Ibandronate?

None

What is the MOA for Ibandronate?

Binds to bone hydroxyapatite and, at the cellular level, inhibits osteoclast activity, thereby modulating bone metabolism

What are the box warnings for Ibandronate?

None

What are the contraindications for Ibandronate?

- Esophageal abnormalities

- Which delay esophageal emptying

- Hypocalcemia

- Inability to sit or stand upright for at least 60 min

Is Ibandronate safe for pregnancy/lactation?

Pregnancy: Moderate risk

Lactation: Compatible

What are the adverse effects for Ibandronate?

Indigestion, backache, respiratory tract infections

What is the brand for Risedronate?

Actonel, Atelvia

What is the drug class for Risedronate?

Bisphosphonate

What are the dosage forms for Risedronate?

Tablet, DR Tablet

What are the on-label uses for Risedronate?

- Osteoporosis (males & postmenopausal women): prevention and treatment

- Paget disease

What are the off-label uses for Risedronate?

- Prostate cancer

- Bone loss associated with androgen deprivation

What is the MOA for Risedronate?

Binds to bone hydroxyapatite and inhibits osteoclast activity at the cellular level, thereby modulating bone metabolism

What are the box warnings for Risedronate?

None

What are the contraindications for Risedronate?

- Known hypersensitivity to Risedronate

- Esophageal abnormalities that delay esophageal emptying

- Hypocalcemia

- Inability to sit or stand upright for at least 30 min

Is Risedronate safe for pregnancy/lactation?

Pregnancy: risk

Lactation: compatible

What are the adverse effects for Risedronate?

Rash, abdominal pain, constipation, diarrhea, nausea, indigestion, backache, UTI

What is the brand for Raloxifene?

Evista

What is the drug class for Raloxifene?

Selective Estrogen Receptor Modulator

What are the dosage forms for Raloxifene?

Tablet

What are the on-label uses for Raloxifene?

- Breast cancer

- Postmenopausal osteoporosis (prevention or treatment)

What are the off-label uses for Raloxifene?

None

What is the MOA for Raloxifene?

Acts as an estrogen agonist in bone, decreasing bone resorption and bone turnover and increasing BMD

What are the box warnings for Raloxifene?

- Venous thromboembolism

- Stroke-related deaths

What are the contraindications for Raloxifene?

- Hypersensitivity to raloxifene

- Pregnancy or lactation

- Current or history of thromboembolic disorders

Is Raloxifene safe for pregnancy/lactation?

Contraindicated

What are the adverse effects for Raloxifene?

Hot flashes, arthralgia, flu-like symptoms, fluid retention

What is the brand for Levothyroxine?

Synthroid, Ermeza, Levoxyl

What is the drug class for Levothyroxine?

Thyroid Supplement, synthetic thyroxine (T4)

What are the dosage forms for Levothyroxine?

Tablet, Capsule, Oral Solution

What are the on-label uses for Levothyroxine?

- Hypothyroidism

- Thyroid-stimulating hormone suppression (pituitary)

What are the off-label uses for Levothyroxine?

- Toxicity due to radiotherapy

- Subclinical hypothyroidism

What is the MOA for Levothyroxine?

- Levothyroxine = synthetic thyroid hormone (T4)

- T3/T4 enter nucleus and bind thyroid receptors on DNA, which activates gene transcription and increases mRNA & protein synthesis

What are the box warnings for Levothyroxine?

Not for use for weight reduction

What are the contraindications for Levothyroxine?

- Hypersensitivity

- Nontoxic diffuse goiter or nodular thyroid disease

- Thyrotoxicosis, AMI

- Treatment of obesity or weight loss

- Uncorrected adrenal insufficiency (may precipitate acute adrenal crisis)

Is Levothyroxine safe for pregnancy/lactation?

Yes

What are the adverse effects for Levothyroxine?

None