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Fa: Pharm 3 > 3. Endocrine 2 > Flashcards

3. Endocrine 2 Flashcards

1
Q

T4 half life

A

7-8 days

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2
Q

T3 half life

A

1-2 days

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3
Q

hyperthyroidism drugs

A

methimazol
PTU
iodide
beta blockers

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4
Q

methimazol mech

A

inhibits orgamnification and coupling

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5
Q

PTU mech

A

inhibits peripheral T4 to T3 conversion

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6
Q

iodide mech

A

block proteolysis
inhibits hormone release
decr thyroid synth release

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7
Q

iodide indications

A

surgical prep
thyroid storm
severe hyperthyroid

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8
Q

beta blocker (propranolol) mech

A

decr T4 to T3 conversion

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9
Q

goal for hyperthyroid pre-op

A

establish euthyroid
antithyroid
beta blocker
glucocorticoids

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10
Q

how long does it take to establish euthyroid

A

6-8 weeks

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11
Q

hyperthyroid induction

A

slow inhalational

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12
Q

hyperthyroid vasopressor

A

phenyleprhine to incr sensitivity to catecholamines

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13
Q

can you use regional in hyperthyroid

A

yes - avoid epi

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14
Q

propranolol hyperthyroid dose

A

10 mg IV

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15
Q

propranolol titration to

A

HR < 90 bpm

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16
Q

propranolol mech

A

manage CV effects
decr perip T4 to T3 conversion

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17
Q

decadron dose

A

2 mg IV every 6 hrs

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18
Q

decadron mech

A

decr periph T4 to T3 conversion

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19
Q

which pts are at higher risk to anesthetic complications

A

hypothyorid

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20
Q

which pts need lower doses due to excessiv eresponse to anesthetics

A

hypothyroid

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21
Q

hypothyroid SE

A

resp depression
bradycardia
hypotension resistant to pressors
longer recovery

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22
Q

Chronic hypothyroid treatment

A

levothyroxine (T4)
L-triiodythyronine (T3)
Liotirx (T4:T3)

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23
Q

severe myxedema is a type of

A

hypothyrpidism

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24
Q

severe myxedema SE

A

T4 < 1.0 mcg/dL
altered mental status
pericardial effusion
HF
coma

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25
Q

PONV management for thyroid sx

A

ondansetron
opioid sparing
TIVA

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26
Q

thyroid storm S+S

A

hyperthermia
cardiac dysfunction
altered metnation

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27
Q

thyroid storm treatment

A

beta blocker (propranolol)
dexamethasone
hydrocortisone
acetaminophen
phenylephrine
PTU

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28
Q

what can thyroid storm present like

A

MH

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29
Q

what can you give for thyroid storm if you cannot confirme hyperthyroidism

A

treat like MH : give dantrolene

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30
Q

hydrocortisone doseing

A

100-200 mg

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31
Q

PTU dose

A

200-400 mg

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32
Q

how do you have to admin PTU

A

NG

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33
Q

pheochromocytoma

A

catecholamine secreting tumor

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34
Q

pheo diagnosis

A

urine VMNA

35
Q

pheo initial treatment

A

alpha blockers
phenoxybenzamine

36
Q

alpha blocker mech

A

lower BP
incr intravascular volume
myocardial-protective

37
Q

phenoxybenzamine mech

A

non-competitive alpha 1 antagonist
some alpha 2 antagnoism

38
Q

phenoxybenzamine duration

A

longer DOA

39
Q

phenoxy dose

A

1-2x daily 14 days prior to surgery

40
Q

phenoxy SE

A

orthostatic hypotension
tachycardia

41
Q

which do you block first in pheos?

A

alpha before beta

42
Q

periope pheo treatment

A

competative alpha 1 antag
beta blocker
phenoxy
metyrosine
CCB
ACEi
anti arrythmics

43
Q

alpha 1 antagnoists

A

prazosin
doxazosin

44
Q

alpha 1 duration

A

shorter

45
Q

alpha 1 SE

A

less tachycardias

46
Q

BB indication in pheo

A

pts who are tachycardic with phenoxybenzamine

47
Q

labetalol mech

A

alpha 1
beta 1
beta 2

48
Q

esmolol mech

A

beta 1 selective antagonist

49
Q

esmolol indication

A

EPI secreting tumor

50
Q

phenoxy before surgery

A

STOP or Lower dose 24-48 hrs prior

51
Q

metyrosine pmech

A

inhibits tyrosine hydroxylase in catecholamine synth

52
Q

drugs to avoid w/pheo

A

atracurium
ketamine
deslurane

53
Q

why avoid atracurium w/pheo

A

histamine reaction causing incr catecholamines

54
Q

why avoid ketamine w/pheo

A

blocks catecholamine reuptake

55
Q

why avoid desflurane w/pheo

A

causes sympa stimulation

56
Q

drugs to treat periop HTN

A

nipride
phentolamine
CCB
incr depth
add opioid
NTG
labetalol
mag sulfate

57
Q

nirpide mech

A

direct vasodilator

58
Q

nipride onset/duration

A

fast on
short DOA

59
Q

nipride CI

A

renal insufficiency

60
Q

phentolamine mech

A

competitive alpha blocker
direct vasodilator

61
Q

vasopressin mech

A

non-adrenergic acting alternative

62
Q

mag sulfate mech

A

inhibit catecholamine release
direct vasodilator

63
Q

how to treat hypotension

A

fluids
vasopressin

64
Q

primary adrenal

A

addison’s
adrenal gland unable to provide corticosteroids

65
Q

secondary adrenal

A

ioatrogenic
xurgery
steroid therapy

66
Q

short acting corticosteroids

A

hydrocortisone

67
Q

intd acting corticosteroids

A

prednisone
prednisolone
methylprednisolone
tramcinalone

68
Q

long acting corticosteroids

A

dexamethasone

69
Q

corticosteroids SE

A

adrenal supression
hyperglycemia
HTN
acute adrenal isufficiency

70
Q

adrenal suppression is dependent on

A

dose and duration

71
Q

prednisone can cause adrenal suppression after

A

20 mg for > 3 weeks

72
Q

acute adrenal insufficiency

A

fever
myalgias
arthralgias
malaise
hTN
shock

73
Q

what causes acute adrenal insufficien cy

A

abrupt steroid discontinuation

74
Q

corticosteroid indication

A

allergic rxn
inflammation
RA

75
Q

if pts have suppressed HPT

A

give periopcorticosteroiud

76
Q

< 5 mcg/dL

A

supplement steroids

77
Q

5-10 mcg/dL

A

give ACTH test
or
supplement steroids

78
Q

> 10 mcg/dL

A

give usual dose

79
Q

adrenal dysfunction S+S

A

hyperglycemia
HTN
fluid retention
incr infection risk

80
Q

minor srugery

A

none required

81
Q

mod surgery

A

50 mg IV
25 mg ever 8 hrs for 24 hrs

82
Q

maj surgery

A

100 mg IV
50 mg every 8 hrs for 24 hrs

83
Q

????

A

Fa: Pharm 3 (10 decks)

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