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Pharmacology > Endocrine > Flashcards

Endocrine Flashcards

1
Q

Levothyroxine is a replacement for

A

T4

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2
Q

Why is levothyroxine better than liothyronine

A

Requires less frequent dosing and has a lower risk of causing thyrotoxicosis

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3
Q

What is levothyroxine dosed in and how is it administered

A

mg/kg orally BID

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4
Q

How long after starting therapy should you start measuring T4 levels

A

4 weeks

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5
Q

What drugs could interfere with thyroid test results

A

Phenobarbital, zonisamide, glucocorticoids, phenylbutazone, quinidine

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6
Q

What is the only veterinary approved thyroid drug

A

Thyro tabs

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7
Q

What are the three pharmalogical ways to treat hyperthyroidism

A

Prevent production
Prevent release of preformed hormone
Prevent conversion of T3 to T4 in tissues

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8
Q

Methimazole is a ____ and inhibits ____

A

Thioureylene

Hormone synthesis

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9
Q

Methimazole is consistently ___ and side effects are ___

A

Efficacious

Uncommon and most are manageable

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10
Q

What are the mild/common side effects of Methimazole

A

GI signs (vomiting), transient hematologic changes on CBC

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11
Q

What are the severe/uncommon side effects of Methimazole

A

Refractory GI signs, idiosyncratic reactions (facial excoriation, hepatopathy, bone marrow suppression)

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12
Q

What are the forms of Methimazole

A

Tapazole, felimazole, transdermal methimazole

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13
Q

What are the parenteral calcium options and when would they be given

A

Ca Gluconate, Ca Choloride

Emergency Acute Hypocalcemia

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14
Q

Ca Chloride is ____ and should never be given ___

A

Caustic, SQ/IM

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15
Q

Rapid IV administration of Calcium can cause

A

Arrhythmias

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16
Q

Why should Ca Chloride and Ca Gluconate be given IV

A

So they are immediately diluted and don’t sit one spot for long periods of time

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17
Q

What are the Oral Ca options for chronic hypocalcemia

A

Ca Carbonate, Ca Proprionate

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18
Q

What is required when giving oral calcium

A

GI tract must be able to absorb the calcium

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19
Q

What causes the GI tract to not be able to absorb calcium

A 
No PTH (hypoparathyroidism)
Vitamin D is not converted to calcitriol
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20
Q

What is given to increase calcium absorption

A

Calcitriol

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21
Q

Calcitriol is the _____ activated form of vitamin D and is the most ____

A

Most potent activated form of Vitamin D and is the most rapid

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22
Q

What is the biggest potential side effect of calcitriol

A

Hypercalcemia

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23
Q

How can dextrose be administered

A

Orally
Intravenous bolus in emergency (50% diluted 1:4)
Ongoing IV (5% concentration)

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24
Q

How is glucagon adminitered and in what measurement

A

IV injection - nanograms

Not commonly used

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25
Q

What is the equation to determine amount of stock to add

A

% desired over % stock times volume in bag

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26
Q

What is the primary goal of DM therapy

A

Address insulin deficiency not to bring down blood glucose

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27
Q

Oral hypoglycemic agents cause ___

A

hypoglycemia, they don’t treat it

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28
Q

The only clinically relevant oral hypoglycemic drug is

A

Glipizide

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29
Q

Glipizide is used for ____ and only in ____

A

Type II diabetes in cats

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30
Q

Mechanism of Action of Glipizide

A

Stimulate insulin secretion by the pancreatic beta cells by blocking K channels
Increase tissue sensitivity to insulin

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31
Q

Insulin is produced by

A

Beta cells of the islets of Langerhans in the endocrine pancreas

32
Q

Exogenous Insulins are all given by

A

Injection (IV, SQ, IM)

33
Q

What are the different durations of action for exogenous insulin

A

Short, Intermediate and Long acting

34
Q

The potency of various formulations is usually very similar except for ___

A

detemir - 4x higher

35
Q

What is the only insulin that can be given IV

A

Regular insulin

36
Q

Regular insulins duration of action is ___ and is usually used for

A

Short acting

Used for hospitalized patients that aren’t eating

37
Q

What are the intermediate acting insulins

A

NPH, vetsulin/caninsulin

38
Q

How are intermediate acting insulins given

A

SC only

39
Q

Vetsulin/Caninsulin is good for

A

Good starting insulin for dogs

40
Q

What are the long acting insulins

A

Protamine Zinc, Glargine and Detemir

41
Q

How are long acting insulins given

A

SC Only

42
Q

Which drug forms microprecipitates in physiologic pH which results in very gradual absorption

A

Glargine

43
Q

Which drug is a veterinary approved product and may have a shorter duration particularly in cats

A

PZI - Protamine Zinc

44
Q

What are the only two mineralcorticoids

A

Fludrocortisone and DOCP

45
Q

Where are glucocoirticoids produced

A

zona fasciculata

46
Q

What are the Glucocorticoid drugs

A

Prednisone, dexamethasone, triamcinolone, methylprednisolone

47
Q

Glucocorticoids are used for their _____ effects

A

anti-inflammatory

48
Q

Glucocorticoid Non-genomic effect

A

Glucocorticoid receptors in the membrane - rapid effects

49
Q

Glucocorticoid Genomic effects

A

Nuclear type GCRs in the cytoplasm - increase or decrease gene expression

50
Q

Physiological Effects of Glucocorticoids

A

Increase calcium excretion
Reduce fever
Suppress immune response
Lymphotoxic

51
Q

Adverse Effects of Glucocorticoids

A

PU/PD, Catabolic, antagonize insulin, inhibit fertility, stress leukogram, Increase GI acid and decrease mucus

52
Q

Clinical uses for glucocorticoids

A

Diagnostic testing
Physiologic Replacement Therapy (Addison’s)
Anti-inflammatory (allergies)
Immunosuppressive

53
Q

Glucocorticoids are well absorbed ___ or ____

A

Orally or Parenterally

54
Q

Glucocorticoids are ___ bound

A

Protein

55
Q

The specific transporter for glucocorticoids is ____ and it has a ____ affinity and ____ capacity

A

Transcortin

High Affinity and Low Capacity

56
Q

The secondary transport for glucocorticoids is ____ and it has a ____ affinity and ____ capacity

A

Albumin

Low Affinity and High Capacity

57
Q

Which glucocorticoids are Pro-drugs and must be hydrolyzed

A

Prednisone –> prednisolone
Cortisone –> Cortisol
Methylprednisone –> methylprednisolone

58
Q

Metabolites are excreted in ___

A

Urine

59
Q

List Glucocorticoids in order of potency

A

Cortisol, Prednisone, Tramcinolone, Dexamethasone

60
Q

What are the salt esters

A

Succinate and phosphate

61
Q

What are the insoluble esters

A

Pivalate, acetate and acetonide

62
Q

What do salt esters do

A

Make steroid soluble and suitable for IV administration

63
Q

Salt esters the onset may be ___ but duration is ____

A

Onset may be faster but duration is unchanged

64
Q

Insoluble esters ___ onset and have a ____ duration

A

Delayed onset and long duration

Less soluble the ester the longer it will take to absorb

65
Q

Opaque suspensions cannot be give by ___

A

IV

66
Q

Short Term (3-5 days) Side Effects of glucocorticoids

A

Not serious
Stress leukogram, decreased thyroid
PU/PD
Fetal abnormalities/abortion

67
Q

Long term (> 1 wk) Side Effects of Glucocorticoids

A

Susceptibility to infection
Skin changes (collagen disease, delayed wound healing)
Hypertension
Latrogenic Addison’s

68
Q

Where are mineralcorticoids produced

A

Zona glomerulosa

69
Q

What do mineralcorticoids regulate

A

Na retention and K excretion by the kidney

70
Q

How is Fludrocortisone given

A

Orally BID

71
Q

How is DOCP given

A

Parenterally (IM, SC)

72
Q

What is Typical Addison’s

A

Lacking both glucocorticoids and mineralcorticoids

73
Q

What drugs are needed for typical addison’s

A

prednisone and DOCP/Fludrocortisone

74
Q

What is atypical addison’s

A

Lacking just glucocortocoid

75
Q

What drug is needed for atypical addison’s

A

just prednisone

Pharmacology (5 decks)

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