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Endocrine - Pharmacology > DRUGS AFFECTING HYPOTALMIC, PITUITARY, and THYROID FUNCTION > Flashcards

DRUGS AFFECTING HYPOTALMIC, PITUITARY, and THYROID FUNCTION Flashcards

1
Q

Somatropin
MOA
INDICATION

A

Somatropin

MOA
hGH (human growth hormone) that acts through GH receptors to increase the production of IGF-1

INDICATION
Kids under 2 years old benefit the most from hGH therapy
Adults get increased muscle mass and decreased adipose tissue
HIV associated wasting

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2
Q 
Somatotropin
Side Effects (children, adults)
A

Somatropin
SIDE EFFECTS
Children:
Few typically; intracranial HTN, papilledema, visual changes, headache, N/V
LEUKEMIA – reported in kids 1-2 yrs out from tx for pediatric tumors

Adults:
• peripheral edema, carpal tunnel syndrome, arthralgia, myalgia

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3
Q

Mescasermin
MOA
Indication

A

Mecasermin

MOA
hIGF-1 complexed with hIGF binding protein 3 (binding protein increases half-life)

INDICATION
IGF-1 deficiency in children (kids don’t respond to growth hormone)

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4
Q

Mescamerimin
Side Effects

A

Mecasermin

SIDE EFFECTS:
Hypoglycemia, intracranial HTN, increased liver enzymes

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5
Q

Pegvisomant
MOA
Indications

A

Pegvisomant

MOA
Growth hormone receptor antagonist, decreases levels of IGF-1; PEG added to increase duration of action

INDICATION
Acromegaly

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6
Q

Pegvisomant
Side Effects

A

Pegvisomant

SIDE EFFECTS
Increased Liver enzymes

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7
Q

What is the general indication for Somatotropin and Mescamerimin?

A

Natural Hormones and associated drugs: Somatropin, Mecasermin

GH analogs are used in adults who have general obesity, low muscle mass, and reduced cardiac output from decreased GH. It can also decrease mortality from CV disease and AIDS associated wasting

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8
Q

Octreotide
Administration
MOA

A

Octreotide/Lantreotide
Administration
Octreotide: 3x per day injections
Lantreotide: 1 injection every 4 weeks

MOA
Somatostain analog

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9
Q

Octreotide
Indications
Side Effects

A

Octreotide/Lantreotide

INDICATION
Acromegaly; Inoperable pituitary tumors

SIDE EFFECTS
Diarrhea, nausea, abdominal pain

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10
Q

Lantreotide
Administration
MOA

A

Octreotide/Lantreotide
Administration
Octreotide: 3x per day injections
Lantreotide: 1 injection every 4 weeks

MOA
Somatostain analog

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11
Q

Lantreotide
Indication
Side Effects

A

Octreotide/Lantreotide

INDICATION
Acromegaly; Inoperable pituitary tumors

SIDE EFFECTS
Diarrhea, nausea, abdominal pain

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12
Q

What is the general indication for growth hormone inhibitors?
• name them.

A

GH inhibitors: Octreotide/Lantreotide, Pegvisomant

Somatostatin is a negative regulator or GH and TSH. Analogs of somatostatin are the best treatment when pituitary surgery is impossible.

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13
Q

What drugs inhibit Prolactin secretion?
• indication?

A

Drugs inhibiting Prolactin Secretion: Carbergoline, Bromocriptine

Indication:
• these drugs are recommended BEFORE surgical intervention in prolactinomas (this is different than GH tumors)

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14
Q

Cabergoline
MOA
Inhdication

A

Cabergoline/Bromocriptine

MOA
Cabergoline: High affinity for D2 receptors

Bromocriptine: Dopamine receptor Agonist (not well tolerated)

INDICATION

Used in the treatment of hyperprolactinemia associated with pituitary ademomas

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15
Q

Cabergoline
Side Effects

A

Cabergoline/Bromocriptine

SIDE EFFECTS
GI disturbances, orthostatic hypoTN, HA, psychiatric disturbances, pulmonary infiltrates

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16
Q

Bromocriptine
MOA
Indication

A

Cabergoline/Bromocriptine

MOA
Cabergoline: High affinity for D2 receptors

Bromocriptine: Dopamine receptor Agonist (not well tolerated)

INDICATION

Used in the treatment of hyperprolactinemia associated with pituitary ademomas

17
Q

Bromocriptine
Side Effects

A

Cabergoline/Bromocriptine

SIDE EFFECTS
GI disturbances, orthostatic hypoTN, HA, psychiatric disturbances, pulmonary infiltrates

18
Q

Protirelin
MOA
Indication

A

Protirelin

MOA
TRH that stimulates TSH release from pituitary

INDICATION
Used in thyroid function testing

19
Q

Thyrotropin

A

Thyrotropin (TSH)

MOA

TSH

INDICATION
Used in diagnostics for thyroglobulin levels

20
Q

Levothyroxine
MOA
Indication

A

Levothyroxine, Liothyronine Sodium, Liotrix
Administration

MOA
Levothryoxine: L-T4 – may take longer to reach steady state

Liothyronine Sodium: L-T3
Liotrix: Mixture of T4 and T3

INDICATION
Hypothyroidism

21
Q

Liothyronine Sodium
MOA
Indication

A

Levothyroxine, Liothyronine Sodium, Liotrix
Administration

MOA
Levothryoxine: L-T4 – may take longer to reach steady state

Liothyronine Sodium: L-T3
Liotrix: Mixture of T4 and T3

INDICATION
Hypothyroidism

22
Q

Liotrix
MOA
Indication

A

Levothyroxine, Liothyronine Sodium, Liotrix
Administration

MOA
Levothryoxine: L-T4 – may take longer to reach steady state

Liothyronine Sodium: L-T3
Liotrix: Mixture of T4 and T3

INDICATION
Hypothyroidism

23
Q

Name the thyroid hormone analogs and their side effects.

A

Levothyroxine, Liothyronine Sodium, Liotrix

SIDE EFFECTS
Hyperthyroidism (Tachycardia, cardiac hypertrophy, Heat Intolerantce, decreased PVR, increased pulse pressure)

24
Q

What should you keep in mind when administering thyroid replacement therapy?
• how does administration differ in children?

A

Thyroid Hormone Replacement Therapies: Levothyroxine, liothyronine sodium, liotrix

NOTE: These may have to be administered in higher doses to children and it may take several weeks to reach a steady state level (b/c it take 4-5 half-lives to reach the steady state level of a drug and T3 and T4 have 24 hour and 4 day half-lives)

25
Q

Name the 3 anti-thyroid drugs.

A

Anti-thyroid Drugs (THIOAMIDES): PTU (propylthiouracil), methimazole, carbimazole

26
Q

PTU (propylthiouricil)
Administration
MOA

A

PTU (propylthiouracil)
Administration
Shorter half-life than methimazole and less potent

MOA
Inhibition of thyroid peroxidase (iodination and coupling) and inhibits peripheral conversion of T4 to T3 (via 5’-iodinase)

27
Q

PTU (propylthiouricil)
Indication
Side Effects

A

PTU (propylthiouracil)

INDICATION
Hyperthyroidism; Safer for pregnant women because it does NOT cross the placenta and is not excreted in milk

SIDE EFFECTS
Agranulocytosis, Skin rash, HypOthyroidism

28
Q

Methimazole/Carbimazole
Administration
MOA
Indication

A

Methimazole/Carbimazole
Administration
Longer half-life than PTU

MOA
Inhibition of thyroid peroxidase catalyzed iodination and coupling

INDICATION

Hyperthyroidism

29
Q

Methimazole/Carbimazole
Side Effects
Contraindications

A

Methimazole/Carbimazole

SIDE EFFECTS
Agranulocytosis, Skin rash, Hypothyroidism; can cross the placenta to cause fetal hypothyroidism

CONTRAINDICATIONS
DO NOT GIVE TO WOMEN THAT ARE PREGNANT OR NURSING

30
Q

What endocrine risk is associated with administering iodine contrast media?

A

Iodinate Contrast media: can cause hyperthyroidism in euthyroid patients or thyroid storm in hyperthyroid patients

31
Q

Iodine/Lugol’s Solution
MOA
Indication

A

Iodine/ Lugol’s Solution

MOA
High doses work to inhibit thyroid peroxidase and prevent thyroid hormone synthesis at all levels in the thyroid (Wolff-Chaikoff effect). Works only in SHORT TERM Tx.

INDICATION

  • *Thyroid Storm**
  • Pre-operative tx for thyroid – decreases vascularity fragility and size of hyperplastic thyroids before surgery*
32
Q

Lugol’s Solution/Iodine
Side Effects
Contraindications

A

Iodine/ Lugol’s Solution

SIDE EFFECTS
Rare toxicity – Rash, drug fever, metallic taste, bleeding disorders, anaphylaxis

CONTRAINDICATIONS
DO NOT use prior to radioactive iodine tx (makes radioactive iodide less effective)

33
Q

Radioactive Iodine
MOA
Indication

A

Radioactive Iodine

MOA
Concentrates in the thyroid where beta radiation will destroy all/part of the parenchymal cells, tissue surrounding thyroid is left alone

INDICATION
Hyperthyroidism

34
Q

Radioactive Iodine
Contraindications

A

Radioactive Iodine

CONTRAINDICATIONS

People must be 35 or older; NOT in women of child-bearing age

35
Q
A

Endocrine - Pharmacology (5 decks)

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