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Pharmacy > Endocrine > Flashcards

Endocrine Flashcards

0
Q

Pituitary

A

Releases follicle SH

Stimulates ovaries/testes

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1
Q

Hypothalamus

A

Releases Gonadotropin RH

Stimulate pituitary

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2
Q

Best predictor of menstruation onset

A

Weight

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3
Q

Peripheral early puberty

A

Decrease in GnRH

Results in shorter adult height

Treat with hormones that reduce estrogen/androgen (GnRH analog/antagonist)

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4
Q

Childhood obesity appetite suppressant

A

Phentermine
Orlistat: saturated lipstatin, inhibit lipases. Give multivitamin b/c less absorption of fat soluble vit.

Sibutramine inhibit 5HT,NE, reuptake
Mazindol inhibit NE

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5
Q

Satiety

A

Ghrelin increases hunger (inhibit)
Leptin decreases hunger

hypothalamus

Serotonergic

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6
Q

Anorexia nervosa

A

High cortisol, low 5HT, NE

Fluoxetine

Olanzapine atypical antipsych
Risperidone

Calcium vitD for bone health

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7
Q

Bulimia

A

Dehydration
Electrolyte imbalance

Fluoxetine
TCA
BZD
Ondansetron for N/V

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8
Q

Bone remodeling

A

Clast : chip
Blast : build

10 years to remodel entire skeleton

Constantly remodel BMUnits

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9
Q

Rank ligand

A

matures osteoclasts

Stimulated by PTH to increase calcium

OPG suppresses maturation

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10
Q

Calcium

Ionized=active

A

Most abundant mineral in human body

For neurotransmission
Muscle contraction
Bone formation

Regulated by parathyroid gland and VitD

Kidney, intestine, bone major organs involved in calcium-mineral processes

Affected by albumin, pH

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11
Q

Hypercalcemia >10.5

Primary hyperPTH

Confusion, dehydration, kidney stones

A

Fluids and loop diuretics
(Furosemide, bumetanide)

N-Biphosphonate: ARBZ
Have PCP backbone, inhibit FPPS and osteoclastgenesis

Non-N containing ECT- compete with ATP in osteoclasts, decrease resorption

Can give corticosteroids

May be due to lithium toxicity

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12
Q

6) Calcitonin

A

Produced in thyroid

Opposes parathyroid and reduces blood calcium

Negative feedback from high Ca levels

3rd line: only decreases vertebral fractures

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13
Q

Hypocalcemia <9

A

Hypoparathyroidism, vit D deficiency

CaCO3 give with meals

CaCitrate with or within meals

Cardio and muscle weakness, brittle hair, hand spasm

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14
Q

Active Vit D3

A

125 cholecalciferol or calcitriol

2 hydroxylase (renal) steps to add OH

Promotes Ca absorption
And reabsorption in kidney

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15
Q

Osteoporosis

Reassess BMD every 2 years
Height every year
DXA scan to monitor drug therapy
Non-pharm tai chi, exercise

A

Teriparatide (PTH)

Intermittent daily for treatment

For women with high risk of fracture

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16
Q

Antiresorptive agents

A

Biphophonates
Calcitonin
Estrogen replacement

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17
Q

Parathyroid hormone

Regulate ECF calcium

A

Increase bone resorption
GI Ca absorption (due to increased calcitriol production)
Kidney reabsorption (increase Ca transport proteins)

Increase RANKL osteoclastgenesis

Intermittent injections build bone

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18
Q

5) Denosumab

Refractory to biphosphonates

A

Inhibit RANKL to suppress osteoclastgenesis

Decrease risk of non vertebral and hip fractures

May cause hypocalcemia
Avoid if renal impairment

19
Q

Compact bone

A

For strength

20
Q

Trabecular/cancellous

A

Metabolically active

21
Q

Osteoid

A

Collagen

22
Q

Mineral

A

Calcium, phosphorus

Hydroxyapatite

23
Q

Corrected calcium

A

Measured Ca + 0.8(4-albumin)

24
Q

Osteomalacia

A

Defective bone mineralization
VitD deficiency

Softening of bones

Rickets in children, reduced renal hydroxylase activity, bowing

Elevated PTH in response and elevated alkaline phosphatase (high bone turnover)

Phenytoin, phenobarbital

25
Q

Osteoporosis

Diagnose with DEXA X-ray for
women >65, men >70

BMD t score <-2.5

FRAX 10 year risk score

A

Fragility of bone decreased amount of bone, but normal cellular composition

Increased osteoclast activity

Menopause, aging, white, dementia, smoking alcohol

Decline of estrogen

Hip fracture is most serious

Corticosteroids, aluminum, lithium

26
Q

Primary hyperparathyroidism labs

Causes hypercalcemia

A

High serum Ca
Low serum phosphate (excretion inc)
High PTH

HypoPTH: opposite and low Mg

27
Q

Solidarity adenoma

A

Single PTH gland enlarged

Benign

28
Q

PTH hyperplasia

A

All four glands enlarged

Cancer PTHrP

29
Q

Pagets disease

A

Resorption with abnormal repair

Elevated alkaline phosphatase

30
Q

Renalosteodystrophy

A

Bone mineral abnormality with renal failure

Lack of kidney hydroxylase causing decreased production of 125 Vit D (calcitriol)

31
Q

Secondary hyper PTH

A

Response to hypocalcemia to normalize Ca

32
Q

Tertiary hyperPTH

A

Hypertrophy parathyroid due to secondary PTH

and uncontrolled PTH secretion causing hypercalcemia

33
Q

Calcium VitD supplementation

A

800 vit D, 1200 calcium in men and women >70

Women >50 need 1200 calcium

Space calcium from iron zinc, levothyroxine by at least 2 hours

Caution, increased risk of MI

34
Q

1) Alendronate

ARBZ

A

Take in morning with water, without food

Decreases hip,spine, and vertebral fractures

Max 5 year treatment

35
Q

2) Risedronate

A

Decreases vertebral and non-vertebral fractures

36
Q

3) Ibandronate (boniva)

All of these biphosphonates can help those expected to take corticosteroids >1 year

A

Only decreases vertebral fractures

37
Q

4) zoledronic acid

A

Prevent new fractures in patients with recent low trauma hip fracture

Decreases vertebral, non vertebral, and hip fractures

38
Q

Osteonecrosis of the jaw

A

Due to biphosphonates

Treat with chlorhexidine mouth rinse

1-3 weeks of antibiotics

Prevent with dental hygiene

DC biphosphonates after 5 years

39
Q

Estrogens with/without progestin

A

Approved for prevention of osteoporosis

40
Q

Phenobarbital

A

Enzyme inducer

Decrease vit D levels

41
Q

Delayed puberty

A

Give low dose estrogen/testosterone

42
Q

Lithium

A

Increases set point of calcium levels

43
Q

Osteoporosis risk factors

A

Low weight, female, Asian, white
Smoking, pregnant, menopause

Corticosteroids, aluminum
PPI decrease calcium absorption

No exercise

44
Q

Duavee

A

CEE estrogen + bazedoxifine

Estrogen agonist in tissue
Antagonist in uterus
Decreases risk of endometrial hyperplasia

Pharmacy (63 decks)

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