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🄼💊MSY2 Pharm (Endocrine/Repro/Thyroid) > Calcium and Anti-Thyroid > Flashcards

Calcium and Anti-Thyroid Flashcards

1
Q

List the [Vitamin D] drugs (4)

A
  1. Calcitriol
  2. Doxercalciferol
  3. Ergocholecalciferol
  4. Cholecalciferol
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2
Q

[Vitamin D] Indications (5)

A

“Vitamin D allows 2 Huns to Run in Sun Openly”

  1. Supplement
  2. Rickets / Osteomalacia
  3. Osteoporosis Px
  4. hypOparathyroidism
  5. 2º Hyperparathyroidism
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3
Q

[Vitamin D] MOA

A

Vit D Receptor Agonist –> RIPO

(Renal Ca+/P absorption)

(Intestinal Ca+/P absorption)

(PTH expression DEC)

Osteoblast stimulation

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4
Q

[Vitamin D] SE

A

Hypercalcemia

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5
Q

When should [Vitamin D] not be administered?

A

If pt has Hyperphosphatemia as this would–> Malignant Calcification

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6
Q

List the Bisphosphonates drugs (4)

A
  1. Alendronate
  2. Pamidronate
  3. Risendronate
  4. Zoledronate
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7
Q

Bisphosphonates Indications (3)

A
  1. Osteoporosis
  2. Hypercalcemia
  3. [Paget’s Osteitis Deformans]
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8
Q

Bisphosphonates MOA (3)

A

Inhibits Farensyl Pyrophosphate Synthase –>

DEC Protein Farnesylation

Osteoclast Apoptosis

DEC Osteoclast Precursors

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9
Q

Bisphosphonates SE (4)

A
  1. Esophageal irritation
  2. Occular problems
  3. Jaw Osteonecrosis
  4. Renal impairment
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10
Q

Bisphosphonates Contraindications (2)

A
  1. Esophageal Dz
  2. Chronic Kidney Dz
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11
Q

Denosumab Indications (3)

A
  1. Osteoporosis
  2. Hypercalcemia
  3. Giant Cell Tumor of Bone
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12
Q

Denosumab MOA

A

[Anti-RANKL monoclonal Ab]

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13
Q

Denosumab SE (2)

A
  1. Jaw Osteonecrosis
  2. hypOcalcemia
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14
Q

Denosumab Contraindication

A

hypOcalcemia

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15
Q

Teriparitide Indications

A

Osteoporosis

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16
Q

Teriparitide MOA

A

[Intermittent PTH R Agonist] –> which actually Stimulates OsteoBLast –>

Bone growth

INC [Renal 1a-hydroxylase]

INC Renal Ca+ reabsorption

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17
Q

Teriparitide SE (3)

A
  1. Transient Hypercalcemia
  2. Transient Hyperuricemia
  3. Osteosarcoma INC risk
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18
Q

Teriparitide Contraindications (6)

A

Don’t Play YOGA By Teri

  1. Gout
  2. Osteosarcoma (or any active bone malignancy)
  3. Bone Radiation therapy
  4. Alkaline Phosphatase INC unexplained
  5. [Paget’s Osteitis Deformans]
  6. Youth (kids/teens)
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19
Q

Calcitonin Indications (3)

A
  1. Osteoporosis
  2. Hypercalcemia
  3. [Paget’s Osteitis Deformans]
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20
Q

Calcitonin SE (4)

A
  1. Hand Swelling
  2. GI: Abd Cramps & Nausea
  3. INC CA Risk
  4. hypOcalcemia
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21
Q

How long does Calcitonin take to reduce Ca+

A

Rapidly Reduces Ca+ in 4-6 Hours!

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22
Q

Cinacalcet Indications (3)

A
  1. 2° HyperParathyroidism from Renal Failure
  2. 1° HyperParathyroidism
  3. Hypercalcemia
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23
Q

Cinacalcet MOA

A

Calcimimetic that allosterically enhances Ca+ affinity for CaSR in Parathyroid

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24
Q

Cinacalcet SE (2)

A
  1. hypOcalcemia
  2. Seizures
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25
Q

Cinacalcet Contraindication

A

If Ca+ < 8.4

26
Q

[Levothyroxine T4] Indication

A

hypOthyroidism

27
Q

[Levothyroxine T4] MOA

A

ProHormone thts converted to active T3 –>[VDR tx factor agonist]

28
Q

[Levothyroxine T4] SE (3)

A
  1. Hyperthyroidism with OD
  2. A Fib
  3. Bone loss in premenopausal women
29
Q

[Levothyroxine T4] onset

A

3-5 Days (slow)

30
Q

[Levothyroxine T4] Peak

A

4 -6 Weeks

31
Q

[Levothyroxine T4] Half life

A

7 Days

32
Q

[Liothyronine T3] Indication (2)

A
  1. emergent hypOthyroidism (i.e. myxedema coma)
  2. Radioiodine therapy prep drug (Thyroid CA pts) - avoids extended period of thyroid hormone withdrawal
33
Q

[Liothyronine T3] MOA

A

[Direct VDR tx factor agonist]

34
Q

[Liothyronine T3] SE

A

Thyrotoxicosis with OD

35
Q

[Liothyronine T3] onset

A

2-4 Hours (fast)

36
Q

[Liothyronine T3] Peak

A

Extreme Peaks & Troughs

37
Q

[Liothyronine T3] Half life

A

19 hours

38
Q

List the [Beta Blocker] drugs used in Hyperthyroidism (2)

A
  1. Propranolol
  2. Esmolol
39
Q

[Beta Blocker] Indications in Hyperthyroidism

A

Ameliorates Adrenergic sx associated with Hyperthyroidism

40
Q

[Beta Blocker] MOA in Hyperthyroidism (2)

A
  • Propranolol mildly inhibits peripheral conversion of T4 –> T3
  • Beta Blockers
41
Q

[Beta Blocker] SE (3)

A
  1. CHF Exacerbation
  2. INC Airway resistance
  3. Peripheral Artery Dz Exacerbation
42
Q

[Beta Blockers] Contraindications (3)

A
  1. Asthma
  2. COPD
  3. HF
43
Q

If Beta Blockers are contraindicated for Hyperthyroidism, what are the alternative drug choices for it (3)

A

DAM, I can’t use my normal Beta Blockers

  • Diltiazem
  • Metoprolol
  • Atenolol
44
Q

List the [Thionamide Thiourylene] drugs (2)

A
  1. Methimazole (MMI)
  2. Propylthiouracil (PTU)
45
Q

[Thionamide Thiourylene] Indications

A

Grave’s Dz (Hyperthyroidism)

46
Q

[Thionamide Thiourylene] MOA (3)

A
  1. Inhibits [Thyroid Peroxidase Coupling]
  2. Does NOT inhibit release of already formed Thyroid hormone
  3. ONLY PTU inhibits peripheal Deiodination of T4–>T3
47
Q

[Thionamide Thiourylene] SE (6)

A

“A Grave reminder she HASTA Jog more!”

  1. Skin Rash
  2. Joint Pain
  3. Hepatotoxic (PTU)
  4. ANCA-positive vasculitis (PTU)
  5. Agranulocytosis (PTU and MMI)
  6. Teratogenic (MMI)
48
Q

Which [Thionamide Thiourylene] is preferred in NonPregnant pts?

A

Methimazole (MMI)

49
Q

Which [Thionamide Thiourylene] is preferred in [1st trimester pregnant] pts?

A

Propylthiouracil (PTU)

P for use in Pregnant pts

50
Q

IodiDE Indications (3)

A
  1. Thyroid Storm: Severe Hyperthyroidism
  2. Thyroidectomy PreOp prep
  3. [Radioiodine uptake px after nuclear accident occurs]
51
Q

IodiDE MOA (3)

A
  1. Inhibits Hormone secretion
  2. Inhibits Hormone synthesis via [Transient Wolff Chaikoff Effect]
  3. DEC Thyroid vascularity
52
Q

How long does IodiDE [Transient Wolff Chaikoff Effect] last

A

10 days

53
Q

[Radioactive Iodine] Indication (2)

A
  1. Toxic Nodular Goiter
  2. Grave’s Dz Hyperthyroidism
54
Q

[Radioactive Iodine] MOA

A

Beta particle Emission causes Follicular cell necrosis

55
Q

[Radioactive Iodine] SE (2)

A
  1. Radiation Thyroiditis
  2. Grave’s Exopthalmous Exacerbation
56
Q

[Radioactive Iodine] Contraindications (3)

A
  1. Pregnancy
  2. Breast Feeding
  3. Severe Exopthalmous
57
Q

How long does it take for [Radioactive Iodine] to reach effect

A

2-3 months!

58
Q

Cholestyramine MOA

A

Bile Acid Sequestrant that prevents [Thyroid hormone reabsorption]

59
Q

Cholestyramine Indication

A

Thyroid Storm

60
Q

Amiodarone Elimination half life

A

100 days

discontinuation will not have instant effect

61
Q

How does Amiodarone cause Thyroid Dysfunction (4)

A
  1. High iodine content –> [REFRACTORY Wolff-Chaikoff effect]
  2. Inhibits Deiodination of T4–> T3
  3. Blocks binding of T3 to [Thyroid Hormone Receptor]
  4. Direct effect on [Thyroid Follicular cell] –> Destructive Thyroiditis

🄼💊MSY2 Pharm (Endocrine/Repro/Thyroid) (6 decks)

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