Endocrine

Question 1

For hypoglycemia?

Answer 1

Dextrose

Question 2

For hypocalcemia

Answer 2

Calcium Gluconate

Question 3

For hypothyroidism

Answer 3

Levothyroxine

Question 4

For hypoadrenocorticism (Addison’s disease)

Answer 4

DOCP/Fludrocortisone and prednisone

Question 5

For diabetes mellitus?

Answer 5

Insulin

Question 6

For hypocalcemia from low PTH?

Answer 6

Vitamin D/Calcitriol

Question 7

Side effects are typically related to excess of the_______ substances in these cases

Answer 7

endogenous

Question 8

Targets for Drug Action - Hyper

What is the underlying cause of the excess?

Answer 8

• Lack of response to normal feedback Hyperplasia
• Benign neoplasia (adenoma)
• Malignant neoplasia (carcinoma)

Question 9

There may be multiple targets for drug therapy; Destroy the abnormal tissue / get rid of the source?

Answer 9

I131(thyroid), mitotane (adrenal)

Question 10

Inhibit production of the substance?

Answer 10

Methimazole (thyroid)

Trilostane (adrenal)

Question 11

Enhance elimination of the substance? examples

Answer 11

Saline diuresis (calcium)

Question 12

Inhibit function of the substance
Receptor blockers (\_\_\_\_\_\_for treating the effects of pheochromocytoma)

Answer 12

phenoxybenzamine

Question 13

Did the homeostatic disruption happen quickly or gradually?

Answer 13

Generally, if there is an acute change it needs to be reversed acutely. If it is an extremely gradual change then it should be reversed over a period of time.

Question 14

What are the consequences of correcting it too quickly?

Answer 14

(rebound effects, transient clinical signs, risk of toxicity)

Question 15

Hypothyroidism in dogs

Goal of therapy:

Answer 15

Replace hormone the body is not producing.

Levothyroxine (T4)

Question 16

Pharmacologic considerations:

Levothyroxine requires?

Route of Administration?

Answer 16

Levothyroxine requires less frequent dosing and has lower risk of causing thyrotoxicosis (excessive T4 levels) than liothyronine

Reduce risk of over supplementation in large patients (>50lb)

Given orally BID (sometimes SID – half-life is variable) Injectable only used for rare situations like myxedema coma

Question 17

How long with Levothyroxine be given for hypothyroidism in dogs?

Answer 17

Pharmacologic considerations:
Must be given for the rest of the patient’s life

Monitored by measuring T4 levels

Timing of sample is important

Start measuring about 4 weeks after starting therapy, be mindful of drugs that could interfere with thyroid test results (e.g. Phenobarbital, zonisamide, sulfonamides, glucocorticoids, phenylbutazone, quinidine and others)

Thyro-tabs are currently the only veterinary approved product.

Question 18

Hyperthyroidism in cats

Goal of therapy:

Answer 18

Stop excessive hormone production

Question 19

Target for surgical thyroidectomy (hyperthyroidism in cats?) along with radioactive iodine?

Answer 19

Remove abnormal tissue

Question 20

Target for Hills y/d (hyperthyroidism in cats??

Answer 20

Prevent production (iodine uptake)

Question 21

Target for pharmacologic (hyperthyroidism in cats??

Answer 21

Prevent production (interfere with synthesis)

Prevent release of preformed hormone

Prevent conversion of T4 to T3 in tissues

Question 22

_______ Inhibit thyroid hormone synthesis

Answer 22

Methimazole