Endo Treatment Flashcards
Treatment for acromegaly
tumor resection
Tx for papillary thyroid cancer?
surgery then if stage 3 or 4 do radioactive iodine
How do you treat adrenal crisis?
hydrocortisone
What is treatment for central diabetes insipidus?
Desmopressin
Tx for pheochromocytoma
alpha blockade followed by beta blockade to lower BP
then once BP controlled laptoscopic adrenalectomy
Treatment for graves dz
Methimazole to stop TH production and then thyroidectomy or radioactive iodine ablation
once thyroid is taken out will need levothyroxine later one because will be hypothyroid
After starting a patient on levothyroxine when should you check their labs?
4-6 weeks
Treatment for pregnant patient with Graves disease
PTU
Treatment for thyroid storm
steroids
What are long acting insulin therapy choices that can be used for basal rate?
Glargine or Detemir
What are short acting insulin therapies that can be used for bolus?
lispro
aspart
glulisine
Hypothyroidism tx
give T4 (body will convert to T3)
Octreotide class
Somatostatin analog
Lanreotide class
Somatostatin analog
Desmopressin (DDAVP) class
Anti-Diuretic Hormone (synthetic)
Spironolactone class
Potassium-sparing Diuretics
Eplerenone class
Potassium-sparing Diuretics
Levothyroxine class
Thyroid Hormone (synthetic)
Methimazole class
Thyroid Hormone Synthesis Inhibitor
If you have low TOTAL calcium what do you have to make sure to correct?
low albumin
Diabetes glycemic control targets
HbA1C <7%, pre-prandial capillary glucose 80-130, peak post-pranial glucose <180
What does U 100 mean?
100 units of insulin per mililiter
What are the rapid acting insulin drugs?
Lispro
Aspart
Glulisine
What are the long acting insulin drugs?
Glargine
Detemir
Degludec (very long)
What are the intermediate acting insulin drugs?
NPH
How much insulin is required daily?
0.6-0.7 units/kg
SOA of alpha-Glucosidase inhibitors
GI tract dec carb absorption
SOA of metformin
liver dec glucose production
SOA of GLP-1 agonist
and DPP-4 inhibitor
GI tract
and increases insulin secretion at pancreas
SOA of Sulfonylureas, Meglitinides and Nateglinide
Pancreas- increases insulin secretion
SOA of Glitazones
muscle and fat increases glucose uptake
SOA of SGLT2 inhibitor
kidney increases glycosuria
SE GLP1
weight loss
SE of insulin
wt gain
Metformin SE
GI SE
contraind w/ GFR <30
DPP4 SE
risk of acute pancreatitis
renal dose adj-for Januvia®, Nesina®, Onglyza®
SGLT-2 Inhibitors renal considerations
Decreased efficacy as GFR
decreases, not recommended with GFR <30-60
SGLT-2 Inhibitors SE
Risk of DKA (class effect)
Genitourinary infections
Risk of volume depletion
Increased LDL cholesterol
Pioglitazone BBW
CHF
also has risk of bone fx and bladder ca
What oral agent should you avoid in patients with high HbA1C?
DPP-4 inhibitor
What are the injectables for DM treatment?
GLP1 RA and insulin
GLP1 RA SE
BBW medullary thyroid ca
GI SE
How should you change insulin dose as GFR decreases?
Lower insulin doses as GFR
decreases due to increased risk of hypoglycemia
Tx of primary hyperparathyroidism
surgery
What do you need to warn pts about when taking Levothyroxine
Do not take within 1 hr of food or 4 hrs of calcium or iron
