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Pharmacology 1 > drugs and the endocrine system > Flashcards

drugs and the endocrine system Flashcards

1
Q

what are endocrine diseases?

A

hormones involved - wide spread and diverse effects on body
hormone deficiency
hormone over activity

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2
Q

what is thyroid disease and what does it affect?

A

can be hypothyroidism or hyperthyroidism

can affect CNS, metabolism and CV system

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3
Q

what are the symptoms of hypothyroidism?

A 
slow speech
lethargy
hypotension
bradycardia
anaemia
weight gain low body temp intolerant to cold
(everything depressed - under active)
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4
Q

what are the symptoms of hyperthyroidism?

A 
anxiety
nervousness
hypertension
tachycardia
low grade fever
inholerant to heat
weight loss
(everything activated - over active)
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5
Q

is a goitre present in hypo or hyperthyroidism?

A

both

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6
Q

what causes a goitre in hypothyroidism?

A

not enough iodine so insufficient T3 and T4
disrupts negative feedback
no TSH production

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7
Q

what causes a goitre in hyperthyroidism?

A

activation of TSH receptors by antibodies

increase in size and function of thyroid gland

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8
Q

what causes hyperthyroidism?

A

thyroid cells stimulated by auto-antibodies (autoimmune disease such as graves disease)

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9
Q

can treatment cure hyperthyroidism?

A

no but can supress

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10
Q

give two examples of drugs used to treat hyperthyroidism

A

Carbimazole
Propylthiouracil
(plus limited iodine intake)

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11
Q

what treatments other an drugs can be used to treat hyperthyroidism?

A

surgery or radioactive iodine - block and replace therapy

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12
Q

what does the drug carbimazole do to treat hyperthyroidism?

A

blocks T3 and T4 production - this is then replaced in small amounts
interferes with synthesis of thyroxine
(short half life)

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13
Q

where is carbimazole absorbed, activated and excreted?

A

absorbed in gut
activated in liver
excreted in urine

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14
Q

what are the side effects of carbimazole?

A

nausea
rash
agranulocytosis - deficiency of granulocytes in blood causing increased risk of infection
can cross placenta causing neonatal hyperthyroidism

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15
Q

how is hypothyroidism treated?

A

with thyroxine substitute

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16
Q

name two thyroxine substitutes

A

levothyroxine T4

triiodothyronine T3 - severe cases (IV)

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17
Q

which thyroxine substitute has a shorter half life and balances blood level?

A

triiodothyronine T3

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18
Q

name two drugs which can cause hypothyroidism

A

lithium (depression)

amiodarone (antiarrhythmic)

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19
Q

which hormone promotes reabsorption of Ca2+ from the kidneys?

A

parathyroid hormone

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20
Q

what does calcitonin (c-cells) do?

A

reduces Ca2+ - inhibits osteoclasts and reabsorption of Ca2+ from kidneys

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21
Q

what does calcitriol (vit D3) do?

A

increases Ca2+ - increase bone mobilisation and increase reabsorption in gut

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22
Q

what is hypocalcaemia?

A

not enough calcium

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23
Q

what are the symptoms of hypocalcaemia?

A 
neuromuscular probs
muscle cramps
mental probs
seizures
cataracts
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24
Q

what are the causes of hypocalcaemia?

A

reduced Ca2+ intake (diet)
deficiency in PTH
lack of vit D (needed for absorption of Ca2+)
renal probs

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25
Q

what is used to treat hypocalcaemia due to vit D deficiency?

A

ergocalciferol (vit D) - good kidney function needed

calcitriol

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26
Q

what is used to treat hypocalcaemia due to Ca2+ deficiency?

A

calcium glucornate IV infusion - with or within calcium

27
Q

what is hypercalcaemia?

A

too much calcium - urgent help needed

28
Q

what symptoms would hypercalcaemia cause?

A

kidney stones
renal failure
muscle probs
cardiac arrest

29
Q

what treatments would be used for hypercalcaemia?

A

Biphoshonates

Calcitonin - inhibits osteoblasts and reabsorption of Ca2+ from kidneys (reduces plasma Ca2+ levels)

30
Q

which biphoshonate would be used to treat hypercalcaemia? and how does it do this?

A

alendronic acid - slows bone growth and turnover/ prevents Ca2+ loss (treats osteoporosis)

31
Q

what side effects does alendronic acid have?

A

abdominal pain
GI problems
Oesophageal probs

32
Q

why would alendronic acid be used instead of calcitonin?

A

(usually from salmon - salmaonin)
expensive
short half life
ineffective long term

33
Q

name 4 steroids that are released naturally from the adrenal cortex but can also be given synthetically to treat endocrine dysfunction and immune disorders

A

corticosteroids
mineralocorticoids
glucocorticoids
endogenous hormones

34
Q

what is the function of glucocorticoids?

A

lower BP

lower glucose

35
Q

name five glucocorticoids?

A 
hydrocortisone (cortisol)
prednisolone
methylprednisolone
dexamethasone
beclametasone
36
Q

what is hydrocortisone (cortisol) used to treat and how is it administered?

A

treats Addison’s disease/ crisis and adrenal insuffiency
reduces inflammation in acute allergy
administered - oral/ IV/ topically

37
Q

what is prednisolone used to treat?

A

treats acute asthma attacks (5x stronger than hydrocortisone)

38
Q

what is methylprednisolone used to treat?

A

prevents rejection of organ transplanted (given parentally - not via GI tract)

39
Q

what is dexamethasone used to treat and how is it administered?

A

high anti-inflammatory action (20x stronger than hydrocortisone )
treats cerebral oedema
administered orally or parentally

40
Q

what is beclametasone used to treat?

A

asthma - brown inhaler

41
Q

do glucocorticoids produce local or systemic effects?

A

wide systemic effects

42
Q

list some of the adverse side effects of oral glucocorticoids

A 
buffalo hump
hypertension
muscle wasting
osteoporosis
moon face
increased abdo. fat
thinning skin
poor wound healing
(known collectively as cushingoid features)
43
Q

glucocorticoids cause stunting of growth, how does this differ between oral steroids and inhaled beclamethasone?

A

oral steroids - growth greatly stunted/ cushingoid features

inhaled beclamethasone - growth less affected/ no cushingoid features

44
Q

what are the unwanted effects of inhaled glucocorticoids?

A

local immunosuppression in mouth/throat can cause opportunist candida albicans (oral thrush)
vocal cords affected - dysphonia (hoarseness) can result

45
Q

what can reduce the unwanted effects of inhaled glucocorticoids?

A

using a spacer

rinsing mouth after inhaler used

46
Q

what other side effects are associated with glucocorticoids

A
  • psychiatric reaction (rare - high dose of systemic glucocorticoids) - prescribe with care to patients with existing or predisposition to mental health issues.
  • risk of chickenpox
47
Q

what would you advice patients when prescribing glucocorticoids?

A

immunosuppression
adrenal suppression
mood changes
GI tract probs

48
Q

when stopping glucocorticoids use how must the process be managed and why?

A

glucocorticoids must be withdrawn slowly

abrupt withdrawal causes neg. feedback of ACTH/cortisol disruption - patient could enter addisonian crisis

49
Q

what are the symptoms of an addisonian crisis?

A

low BP
low glucose
high K+
high Na

50
Q

name two commonly used reproductive steriods

A

oral contraceptives-
combined pill
mini pill

51
Q

describe how the combined pill is used and how it works

A

oestrogen and progesterone
inhibits ovulation
21days pill then 7days no pill

52
Q

what are the benefits of the combined pill?

A

regulates menstrual cycle
reliable/reversible
reduces PMT
high dose - morning after pill

53
Q

what are the risks associated with taking the combined pill?

A 
MI /stroke
hypertension
DVT or PE
cervical/breast cancer
headaches
54
Q

describe how the mini pill works

A 
progesterone only
inhibits ovulation (40%)
alters endometrium/cervical mucus
55
Q

what is medroxyprogesterone?

A

depot - progesterone only contraceptive injection

56
Q

what are the risks associated with the mini pill?

A

nausea
vomiting
breast pain

57
Q

how does the combined pill inhibit ovulation?

A

stimulates negative feedback which in turn inhibits the release of FSH, LH and GnRH

58
Q

what happens to women post menopausally?

A

reduced oestrogen levels = ovulation stops

increased LH/FSH

59
Q

how is the menopause treated?

A

using HRT - oestrogen (50ug)/oestrodiols

60
Q

what are the risks associated with HRT?

A 
cardiovascular disease
osteoporosis
cancer
DVTs
breast cancer
61
Q

what are hormone modulators?

A

drugs that can be given to modulate the effect of hormones occurring naturally in the body

62
Q

name five drugs which are given to modulate hormones

A
  • tamoxifen - breast cancer due to oestrogen
  • Clomiphene - stimulates ovulation
  • somatatrophin
  • oxytocin peptide hormones (PP)- induces labour (used with ergometrine to reduce haemorrhage
  • prostaglandins - causes muscle contraction - induce labour/abortion
63
Q

what is somatatrophin used for?

A

analogue of hGH
used in stunted growth (children)
turners syndrome/ russel silver syndrome (no appetite)
* also used after pituitary surgery

Pharmacology 1 (11 decks)

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