4 endocrine pharm hypothalamus pituitary thyroid Flash Cards

Play Memory | Create Card File | Append to Card File
Title: 4 endocrine pharm hypothalamus pituitary thyroid
Description: endocrine pharm HT pit
Number of Cards: 25
Save Count: 3
Author: rgwood7
Created: 2008-01-25
Tags: endocrine hypothalamus pharm pituitary thyroid
Private No

Save Count represents the number of people who have saved this card set to their flashcard list. Consider this an endorsement!

    • Question
    • Answer
    • Side 3
    • GH pharm agents
    • SERMORELIN was released to beef up our SOMATROP (in)
      Wasn't enough had to have an IGF MECASERMIN
    • GH analog
    • SOMATROP (in)
    • SOMATROPin
      moa
      indication
    • GH analog-->JAK STAT
      gh def, cachexia(non neo) p-willi, kids CRF, idiopathic short (must have documetation
    • GH challenge
    • levadopa, arginine,clonidine, glucagon, insulin induced hypoglycemia
      all should = gh release
    • GHRH agonist
    • SERMORELIN
    • IGF-1 agonist
    • MECASERMIN
    • Rx acromegaly, Gigantism
    • gh EXCESS (USUALLY PIT TUMOR)
      PEGVISOMANt
      BROMOCRIPTINE
      OCTREOTIDE
      Went too far, PEGVISOMAN stopped the sermin BROMOCRIPTINE stole the dope (it was a tumor) and the soma OCTREOTIDE
    • BROMOCRIPTINE
      Moa
    • DOPAmine agonist (D1,D2)
      paradox dec GH in tumors (incr normally)
    • PEGVISOMAN
      moa
      SEs
    • GH-R antagonist in liver
      = dec IGF-1 secretion
      2nd line drug (dec blood sugar and hepatotoxic)
    • Octreotide
      Moa
      indic
    • somatostatin analogue
      (Gi--->dec Camp)
      dec GH (even shrinks some tumors) also carcinoid tumor, VIPoma hormonal diarrhea
    • ADH analog
      named
    • desmopressin--sc, or inranasal.....
      has less V-constriction than ADH
    • desmopressin
      indications
    • • Diabetes insipidus (absence of ADH)
       Control polydipsia, polyuria, dehydration)

      • Central diabetes insipidus (very rare)

      • Nocturnal enuresis (bed wetting)(NOT ANYMORE DUE TO HYPONATREMIA)

      • Hemophilia A (mild)

      • Von Willebrand’s dz (mild)
    • desmopressin
      SEs
    • • Water intoxication
      •  Hyponatremia
       Retain H2O…effectively decreased Na+ concentration
      • Caution in dz’s assoc w/ electrolyte imbalance (e.g. cystic fibrosis)
      • Nasal congestion, etc. may interfere w/ absorption of intranasal drug
      • Effects on bleeding disorders are limited (not that powerful)
    • Rx for hyperprolactinemia
    • dopamine agonists-(-) PrL secretion
      Bromocriptine (D1,D2)
      Cabergoline(D2)
    • somatotropin
      SEs
    • metabolic-hyper/hypoglycemia
      fluid retention edema (attn HF)
    • somatotropin
      CIs
    • corticosteroids inhibit GH
       Epiphyseal closure
       Active neoplastic disease
       Intracranial HTN
       Acute critical illness
       Caution in DM
       Caution in scoliosis (growth spurts dangerous)
       Hypothyroid pts will have inadequate response
    • causes of hyperprolactinemia
    • Antipsychotics
      lactation
      prolactinoma (the one to treat)
      CRF
      nipple stimulation
      polycystic ovarian disease
    • DRugs for hypothyroidism
    • LEVOthyroxine(synthroid)
      LIOthyronine
      LIOtrix
      Four pre thyr (levo)= T4
      Three (lio) = T3
      Three "trix" = both
    • Rx for Hyperthyroidism
    • Propylthiouracil
      methimazole
      K+ perchlorate
      I131 (kills thyroid

      Was freakin out they PROPYL-THIO-(UR ACIL) and ME THINAZOLE in Peroxide
      I tried to inhibit the pump the Pot (assium) perch (l) or Ate Oh tried to save me with the K+ IODIDE but they pulled out the big ALPHA to search me out
    • Propylthiouracil
      methimazole
      MoA
    • Inhibit Thyroid Hormone Synthesis
      • BOTH Inhibit thyroid peroxidase enzyme

      • Propylthiouracil also inhibits conversion of peripheral T4 → T3 conversion
       Inhibits 5’-deiodinase
    • Propylthiouracil
      methimazole
      SEs
    • • Cross placenta & excreted in breast milk
       ↓ Thyroid hormone in fetus / neonate (-)’s CNS development (PTU more protein bound so better)
      • Granulocytopenia
      • Agranulocytosis
      • Hepatotoxicity (rare)
    • Potassium perchlorate
      MoA
      SEs
    • inhibit I pump
      fatal aplastic anemia
    • potassium iodide
      MoA
      uses
      SEs
    • unkown mech
      take quickly to reverse radioactive idodine
      SEs-• Pregnancy
       Can cause goiter / cretinism in fetus
      • Excreted in breast milk
      • Monitor K+ in patients with renal problems (e.g. acute dehydration, mm. cramps, adrenal insufficiency, CV disease)
    • THYROGEN ALPHA
      moA
      uses
    • TSH(ish) ?
      used to test if all thyroid tissue is gone after ablation
    • I123
    • for thyroid scan