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  • So let's start with chapter 7 endocrine this is our last chapter and we're going

  • to start with three OTC medications. Most people don't know that insulins are

  • over-the-counter because they aren't literally over-the-counter they're in

  • the refrigerator in the pharmacy but they don't require a prescription or two

  • of them don't. Regular insulin which is humulin R and NPH insulin which is humulin

  • N and alphabetically you say that well why didn't you put the N first why did

  • you put the R first? traditionally insulins

  • when we talk about them and list them, we list them in the order of the speed that

  • they work so I'll mention these in the insulin column but regular insulin works

  • for less time than NPH insulin so that's how we would put it, regular then

  • NPH. Emergency contraception: so the stem here is the -gest- that lets you know it's

  • a progestin so levonorgestrel is Plan B one step. Why is it called one

  • step? Well it used to be two steps, used to be two pills and the plan B comes

  • from, well plan A might have been a condom or something like that that broke

  • and Plan B was to take this pill for emergency contraception it used to be by

  • prescription then it went behind the counter then recently it's gone

  • over-the-counter and available readily. So let's go with the prescription

  • medications now so we'll start with the oral anti-diabetics and to remind us

  • that diabetes is an issue of a blood glucose that's elevated so what we're

  • trying to do is reduce that blood glucose the order that I put them in is

  • by alphabetically by their class so that if you have other medications you want

  • to put in you can just put in more biguanides or more DPP-4 inhibitors

  • but the B proceeds the D proceeds the sulfonylurea. So metformin has the

  • -formin stem, f-o-r-m-i-n but you'll usually see some kind of g-l-

  • in these generic names and metformin is the exception. So the manufacturer made

  • Glucophage, the gl- is in the gluco for glucose and then phage to phage something

  • is to eat it so if you've heard of cell eating it's phagocytosis, cell drinking is

  • pinocytosis so that's kind of where that comes from. The DPP-4 inhibitor sitagliptin

  • some people just call them 'gliptins' because it's just hard to say

  • DPP-4 and that's Januvia. So the second generation sulfonylureas, glipizide and

  • we have the gli- prefix its brand name Glucotrol so you can see glucose

  • control is what I think they were going for with a brand name and then glyburide

  • the gly- prefix and Diabeta is the brand name so you can see most of the

  • word diabetes is in there or you can think of the beta cells and insulin

  • secretion and what they do there and the islets of Langerhans so those are if

  • you have a patient that has too much blood sugar, however sometimes we have a

  • condition of hypoglycemia and you would use glucagon when the glucose is gone is

  • the best way I think to think of that and that brand name is Glucagen

  • so we are generating glucose where there isn't any. So let's go on to the insulins

  • and another situation where we have too much or too little of a hormone. So I've

  • put the insulins here in order of how long they work so insulin lispro works

  • very quickly should be taken with a meal and because it works so quickly it's by

  • prescription and the brand name is Humalog which is a combination of human

  • insulin and analog insulin. The regular insulin and NPH I already talked about

  • but this is where they would be placed if you were to put the four insulins

  • together in terms of how long they work so insulin

  • lispro, regular insulin, NPH insulin then insulin glargine I've heard lazy

  • Lantus to remind you that it's very slow acting it works all day and then Toujeo is

  • a newer brand name but those four insulins in that order

  • just as diabetes was an issue with high glucose and sometimes we get

  • hypoglycemic, hypothyroidism is simply adding thyroid if you want to treat that

  • so levothyroxine is the actual hormone and the brand name comes from Synthroid

  • which is synthetic thyroid is how they came up with that brand I believe and

  • then hyperthyroidism when we have too much thyroid hormone we would use

  • something like propylthiouracil which just uses the P, the T, and the U from

  • propylthiouracil to make PTU. Hormone replacement, so testosterone the

  • -ster- is the stem indicating it's a steroid

  • and then Andro- meaning man and then gel because testosterone is generally

  • regarded as a male hormone. So from there let's go on to some birth control and

  • issues with the bladder. So beginning with the combined oral contraceptives or

  • the pill as most people would call it. The estr- is an estrogen and then the

  • 'gest' again is a progestin and these get really complicated but if you want to

  • look at the estrogens you see that in all four of these ethinyl estradiol is

  • the estrogen so we don't have to change anything there what we're doing is we're

  • either adding a supplement or we're adding a progestin. So the first one is

  • norethindrone ethinyl estradiol and ferrous fumarate which makes

  • Loestrin 24 and then we use the Fe, the abbreviation

  • from the periodic table of elements for iron.

  • norgestimate with ethanol estradiol is Tri-Sprintec, the Tri- comes from

  • that it's triphasic. And those are oral contraceptives, so if we're trying to

  • remember something again we try to go head to toe and the patch would probably

  • be something you put on the belly and norelgestromin, the -gest- for the

  • progestin with ethanol estradiol is Ortho Evra so that patch you can put on

  • your belly the ring is a vaginal ring so we're going further down. Etonogestrel

  • and ethanol estradiol. Again we're using those stems and the brand name I think

  • comes from new vaginal ring where they just took the Nu- from and make the sound

  • new, the -va from vaginal and then ring. While the tablets or the pill we have

  • you know seven-seven-seven and then usually off for a week for 28-day cycle

  • these, the patch and the ring, are used for seven days and then a new one

  • replaces it. Overactive bladder so some of these brand names actually helped

  • quite a bit so with oxybutynin, the detrusor muscle

  • is an issue with overactive bladder so Ditropan alludes to the detrusor muscle

  • and then that -trol- from control you could think of you're in control with

  • Oxytrol OTC. the -fenacin in solifenacin is the stem and VESIcare

  • vesicae actually means bladder in latin and somebody must have been a classics

  • major that helped make this brand name but VESIcare is care for the bladder

  • and then tolterodine, again detrusor muscle control

  • in the brand-name. Urinary retention, so we've talked about a little bit about

  • cholinergic versus anticholinergic and a side effect of anticholinergics is that

  • everything is dry so there's anhidrosis, stopped sweating

  • there's blurry vision secondary to dry eyes, there's dry mouth,

  • there's urinary retention, there's constipation, and then tachycardia

  • but that urinary retention is what would normally cause this kind of state so to

  • treat an anticholinergic state what we would do is we would give a cholinergic

  • so bethanechol, -chol and that's not actually a stem so I'll erase it, is a

  • cholinergic medication and you can see the part of acetylcholine that's in the

  • brand name but again that's not a stem I just wanted to point it out. Erectile

  • dysfunction so these have the -afil stem and I believe there's actually an

  • infix in here because there's a vardenafil and a sildenafil and those

  • have that same -den- in there but I won't mess with that right now.

  • So sildenafil is Viagra it's the first that came out it's prominently talked

  • about in Love & Other Drugs, a recent movie, and via- means life and gr- are the

  • first two [letters] in growth. So give life, growth, however you want to take that for

  • erectile dysfunction. Tadalafil is also an erectile dysfunction medication with

  • a much longer half-life. They call it the weekend pill this is the one where

  • the the couples there with the bath tubs next to each other at sunset. I can't

  • mention the mnemonic really my students used something to the effect of tada but

  • I'm not going to get to that. Okay alright so we just have

  • four drugs left we've done 196 so we're going to go on to the benign prostatic

  • hyperplasia alpha blocker and then benign prostatic hyperplasia 5-alpha

  • reductase inhibitor. So I mentioned that alpha blockers are used for hypertension

  • but they also are helpful for a condition called benign prostatic

  • hyperplasia or BPH and this is a benign growth of the prostate where there's an

  • issue with urine flow. So to make the brand name the manufacturer must have

  • thought of you know the urine flow being slowed so now we're going to get maximum

  • flow to make Flomax. And then alfuzosin also alludes to this urine with

  • the 'ur-' [in the brand name] and then control '-tral' instead of '-trol' the -osin at the end of

  • tamsulosin and alfuzosin it's not an actual stem, but some students use it to

  • remind themselves that the BPH drugs are related. The last two drugs so BPH

  • 5-alpha reductase inhibitors so the dutasteride and finasteride. Avodart is

  • the brand name for dutasteride. Finasteride is interesting that it has

  • two brand names and I should have put Proscar first for prostate care because

  • that really matches up with the Avodart but interestingly enough as people were

  • taking the finasteride they were growing hair, something called hirsutism, and not

  • to lose an opportunity the manufacturer said okay well let's create a medication

  • name that's going to indicate that the person has is going to grow hair so

  • alopecia is the loss of hair, propecia I guess would be adding here so that's how

  • that name came about. At the end of movies in the old black and whites

  • there was always 'fin' or 'fini' or done. So we have finished our 200 medications

  • and hopefully these videos were helpful.

So let's start with chapter 7 endocrine this is our last chapter and we're going

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