SECTION SYNTHESIS Identify the drug class of the following drugs: 1. Glipizide 2. Metformin 3.
Drugs
ending in -GLITAZONE 4. Drugs ending in -GLINIDE 5. Drugs ending in -BOSE 6. Drugs ending in -
GLIFOZIN 7. Drugs ending in -GLIPTINS Look at the names of secretagogues. They all end in -IDE. So if
they ask you about DM drugs and it ends in -IDE, the MOA will be related to increasing the insulin
secretion. With the exception of GLP-1 Angonist. Second generation SURs all start in “G” Meglitinides
end in GLINIDE – “Glinide ni Meg yung floor” Amylin analogs have AMYLIN in their name e.g..
prAMLINtide - GlitazONEs are ThiazolidinediONES (One true PPAR [pair]) - BOSE are Alpha-
Glucosidase inhibitors – related to glucose - GLP1 inhibitors mnemonic: GLP (Read as GULP): Diba sa
7/11 may Gulp na drink? Imagine mo may person na bumibili ng GULP, pangalan ay LIRA. Nagexena si
LIRA sa 7/11 dahil mali ang order niya” Dr. Rodriguez, Im DRUGS FOR OBESITY SUPPLEMENT:
PHENTERMINE [X] An appetite suppressant which is an amphetamine derivative. Side effects will be
similar with amphetamine ORLISTAT (Xenical) MOA Inhibits gastrointestinal and pancreatic lipases.
Reduces absorption of fats. Uses Obesity, Type 2 diabetes SE Weight loss, Flatulence, Steatorrhea,
Fecal incontinence, Malabsorption of fat-soluble vitamins (A, D, E, K), Hepatotoxicity Notes •
Rebound weight gain upon discontinuation Contraindicated in pregnancy, reduced hepatobiliary
function and malabsorption states SIBUTRAMINE MOA Inhibits norepinephrine and serotonin
reuptake in the CNS. Reduces appetite (anorectic effect). Uses Obesity SE Dry mouth, Gastrointestinal
disturbance, Tachycardia, Hypertension, Cardiovascular events (myocardial infarction, arrhythmias),
Stroke Notes • Withdrawn due to increased risk of cardiovascular events and strokes Familiar with
Reductil? This has been banned since this drug is a relative of Methamphetamine RIMONABANT
TOPNOTCH MEDICAL BOARD PREP PHARMACOLOGY MAIN HANDOUT BY DR. YNS PEREYRA-
BORLONGAN, MD-MBA For inquiries visit www.topnotchboardprep.com.ph or
https://www.facebook.com/topnotchmedicalboardprep/ This handout is only valid for October 2022
PLE batch. This will be rendered obsolete for the next batch since we update our handouts regularly.
MOA Selectively blocks cannabinoid-1 (CB-1) receptors. Reduces appetite (anorectic effect). Uses
Obesity, Smoking cessation, Drug addiction SE Notes Suicidality, Depression, Nausea Withdrawn
because of increased risk of suicides, depression and other serious psychiatric problems GLUCAGON
Organ PTH Bone Calcium and phosphate resorption increased by continuous high concentrations.
Low intermittent doses increase bone formation Active Vitamin D Metabolites Direct effect is
increased calcium and phosphate resorption; indirect effect is promoting mineralization by increasing
the availability of calcium and phosphate GLUCAGON (Secreted by A cells of pancreas) MOA
Activates glucagon receptors Severe hypoglycemia, Diagnosis of endocrine disorders, Beta-blocker
overdose, Radiology of the bowels Uses Glucagon can increase heart rate and force of contraction
Increases hepatic glycogenolysis and gluconeogenesis Relaxes smooth muscle SE Notes Nausea,
Vomiting, Hypotension Glucagon-secreting tumors (glucagonomas) present with decreased amino
acids in blood, anemia, diarrhea, weight loss and necrolytic migratory erythema DRUGS THAT AFFECT
BONE AND MINERAL HOMEOSTASIS Drugs under this section will be divided mainly under hormonal
regulators, and the non-hormonal regulators. Dr. Rodriguez HORMONAL REGULATORS Organ PTH
Active Vitamin D Metabolites Intestine Indirectly increases calcium and phosphate absorption by
increasing Vitamin D metabolites Increased calcium and phosphate absorption Kidney Decreased
calcium excretion, increased phosphate excretion Increased resorption of calcium and phosphate but
usually net increase in urinary calcium due to effects in GI tract and bone Net effect on serum levels
Serum calcium increased, serum phosphate decreased Serum calcium and phosphate both increased
Drug MOA SERM: RALOXIFENE [X] Interacts selectively with estrogen receptors leading to inhibition
of bone resorption w/o stimulating breast or endometrial hyperplasia Uses Osteoporosis SE
Increased risk of VTE PARATHYROID HORMONE • acts on membrane G-protein-coupled receptors to
increase cAMP in bone and renal tubular cells • inhibits calcium excretion, promotes phosphate
excretion and stimulates the production of active vitamin D metabolites • promotes bone turnover
by increasing the activity of both osteoblasts and osteoclasts o osteoclast activation is not a direct
effect and instead results from PTH stimulation of osteoblast formation of RANK ligand (RANKL) • at
high doses, net effect of elevated PTH is increased bone resorption, hypercalcemia, and
hyperphosphatemia • low intermittent doses of PTH produce a net increase in bone formation •
Stimulus: decreased free ionized calcium stimulates PTH release MNEMONICS: Parathyroid Hormone
What are the signs and symptoms of excess PTH? Painful bones Renal stones Abdominal groans
Psychiatric overtones CALCITONIN • Peptide hormone secreted by parafollicular C cells in the thyroid
gland • decreases serum calcium and phosphate by inhibiting bone resorption and inhibiting renal
excretion of these minerals • bone formation is not impaired initially, but ultimately it is reduced •
MNEMONIC: Calcitonin means CALCium INside the bone RECOMBINANT PARATHYROID HORMONE
Teriparatide MOA Acts through PTH receptors to produce a net increase in bone formation,
stimulates bone turnover Uses SE Osteoporosis Hypercalcemia, Hypercalciuria, arthralgia, rhinitis,
nausea, weakness, dizziness, pharyngitis, dyspepsia, rash Notes • Must be administered in low
intermittent doses to stimulate bone formation • Used IV for osteoporosis VITAMIN D • MOA:
Regulates gene transcription via the vitamin D receptor. Stimulates intestinal calcium absorption,
bone resorption, renal calcium and phosphate reabsorption. Decrease PTH, promote Innate
Immunity • USES: o Vitamin D deficiency (rickets, Osteomalacia, intestinal osteodystrophy, CKD,
chronic liver disease, hypoparathyroidism, nephrotic syndrome) o Osteoporosis, psoriasis, Renal
Failure, malabsorption • SE: Hypercalcemia, Hyperphosphatemia, Hypercalciuria INACTIVE
ERGOCALCIFEROL, CHOLECALCIFEROL Notes • Commonly added to dairy products and other food
products • Given topically for psoriasis; given with calcium supplements for osteoporosis
