Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Pharmacology > Endocrine Agents > Flashcards

Endocrine Agents Flashcards

1
Q

What is the corticosteroid treatment for minimal surgical stress?

A

25mg hydrocortisone x1

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What are some side effects of corticosteroids that we should be aware of in the OR?

A

electrolyte and metabolic changes (hyperkalemia)

decreased effectiveness of anticoagulants

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What is the pathway for the synthesis of cortisol?

A

Corticotropic-releasing hormone and vasopressin from hypothalamus→ACTH (anterior pituitary)→synthesis of cortisol

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What hormones counter the hypoglycemic effects of insulin?

A

ACTH, estrogens, glucagon

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

stimulation of ACTH in the perioperative period is caused by what three things?

A

incision, pain, reversal of anesthesia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Why does the surgeon ask you for Glucagon while doing a ERCP?

A

relaxes the sphincter of Oddi

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What are the intermediate acting insulins?

A

NPH

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What is the dose of dexamethasone for PONV?

A

2.5-5mg

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Which thionamide has a black box warning? What’s the warning for?

A

Propylthiouracil - cause hepatic toxicity

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What is the dose of dexamethasone for post-op pain?

A

0.1mg/kg

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Which synthetic corticosteroid has Na retaining activity?

A

Fludrocortisone

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What can a bolus dose or high infusion rate of oxytocin lead to?

A

hypotension

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What is the onset, peak and DOA of very rapid acting insulins?

A

onset 15 minutes
peak 45-75 minutes
DOA 2-4 hours

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What is the corticosteroid treatment for a patient taking <5mg prednisone with no HPA axis suppression?

A

No treatment

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What inhibits insulin release?

A

alpha receptor stimulation or beta antagonism

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

How do the thionamides work?

A

prevents hormone synthesis by inhibiting the peroxidase catalyzed reactions and blocking iodine organification

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

How does metformin work?

A

decreases glucose production, decreases absorption, and increases sensitivity

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

What medication is used to treat hypothyroidism? Is it synthetic T3 or T4?

A

Levothyroxine. T4

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Which side effect of iodine should we be aware of when intubating?

A

mucus membrane ulcers

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

What drugs are the thionamides?

A

methimazole and propylthiouracil

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Which form of insulin is the best choice to treat hyperglycemia and ketoacidosis?

A

regular insulin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

What is the most commonly used preparation of insulin?

A

U-100, 100 U/mL

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

What is the glucocorticoid affect of the corticosteroids?

A

anti-inflammatory

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

Which medication is used to block sympathetic stimulation seen with thyrotoxicosis?

A

Propranolol- adrenoreceptor blocker

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

What are side effects of metformin?

A

B12 deficiency, lactic acidosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

Inadequate secretion of what leads to DI?

A

vasopressin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

what are the clinical symptoms of diabetic ketoacidosis?

A

N/V, abdominal pain, kussmal respirations, mental status changes, elevated ketones and glucose.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

How do we treat thyroid storm in the OR?

A

Propranolol 1-2mg slowly, up to 10mg
Esmolol 50-100 mg/kg
Propylthiouracil 500-1000 mg
Hydrocortisone 50mg Q6h

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

Which sulfonylurea causes severe hyponatremia?

A

chloropropamide

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

What inhibits thyroid peroxidase to prevent incorporation of iodine into tyrosine and inhibits formation of thyroid hormone?

A

Iodides and thioamides

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

What drugs are the alpha-glucosidase inhibitors?

A

acarbose and miglitol

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

How do sulfonylureas work?

A

inhibits ATP-K channels on beta cells, increasing insulin release

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

What are the ultra rapid acting insulins?

A

Lispro, glulisine, aspart

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

What are the symptoms of hypoglycemia we will notice as anesthetists? Which is he most specific?

A

tachycardia, HTN Diaphoresis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

What increases cortisol release?

A

increased ACTH, tissue damage, inflammatory mediators

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
36
Q

What class of drugs is Metformin?

A

Biguanides

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
37
Q

How does iodine work for the treatment of hyperthyroidism?

A

antagonizes TSH release

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
38
Q

How is aldosterone stimulated?

A

Hyperkalemia and RAAS.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
39
Q

Which brain structure releases thyrotropin releasing hormone, dopamine, GHRH, somatostatin, GTRH, CTRH, oxytocin, vasopressin

A

hypothalamus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
40
Q

Corticosteroid binding globulin is increased in which situations?

A

pregnancy, estrogen administration, hyperthyroidism

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
41
Q

What is the onset, peak and duration of regular insulin?

A

30 min onset
2-4h peak
6-8h duration

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
42
Q

What is the dose of insulin is used to treat diabetic ketoacidosis?

A

0.1 units/kg/h

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
43
Q

Do the hypothalamus and pituitary gland lay inside or outside the BBB?

A

outside

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
44
Q

Thiaolidinediones should be used cautiously with CHF patients due to?

A

increase in ECV -> weight gain and edema

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
45
Q

What degrades the protamine in NPH for insulin absorption?

A

Proteolytic enzymes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
46
Q

Which sulfonylureas have a diuretic effect?

A

glyburide, and glipizide

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
47
Q

What is the most abundant hormone in the anterior pituitary?

A

growth hormone

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
48
Q

Which patients should we avoid metformin use?

A

lactic acidosis, kidney injury, hepatic disease

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
49
Q

If you are doing a thyroidectomy, what drugs will you likely see on the home med list?

A

Thionamides – methimazole and propylthiouracil

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
50
Q

Why do we give dexamethasone to patients after they are asleep?

A

causes perianal burning

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
51
Q

When catecholamines are released, what does the thyroid hormone do to beta receptors?

A

increase the number of beta receptors

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
52
Q

What is the onset, peak and duration of long acting insulin?

A

1.5-2h onset
3-9h peak
6-12h duration

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
53
Q

Which drugs prolong the duration of insulin?

A

Antibiotics (tetracyclines, chloramphenicol), salicylates, phenylbutazone

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
54
Q

What do glucocorticoid target cells contain that converts cortisol to cortisone?

A

11-beta hydroxysteroid dehydrogenase

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
55
Q

Which thionamide is the preferred treatment for hyperthyroid?

A

methimazole, 10x more potent than propylthiouracil

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
56
Q

What is the corticosteroid treatment for a patient taking 5-20 mg prednisone for more than 3 weeks in the last year?

A

further analysis needed…

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
57
Q

What is the corticosteroid treatment for moderate surgical stress?

A

50-75 mg hydrocortisone, 1-2 days

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
58
Q

What medication is used for Graves disease?

A

radioactive iodine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
59
Q

Where are sulfonylureas metabolized and excreted?

A

metabolized in the liver, excreted in the kidneys

60
Q

What is the risk in giving sulfonylureas to a patient that with a history of MI?

A

It inhibits a cardio protective mechanism, increased risk of mortality

61
Q

What does cortisol do in the body?

A

gluconeogenesis, decrease immune function, anti-inflammatory, breaks down protein, mobilizes fatty acid

62
Q

What medications are synthetic corticosteroids?

A

Prednisolone, predinisone, methylprednisolone, betamethasone, dexamethasone, triamcinolone

63
Q

What is desmopressin?

A

intense antidiuretic

64
Q

Which class of drugs is used to treat Graves Disease?

A

Thioamides. Methimazole > propylthiaouracil

65
Q

What is the cascade of events starting with TRH and ending with the release of T4 and T3?

A

TRH released from the hypothalamus, stimulates TSH, TSH stimulates release of T4 and T3

66
Q

What class of medications do corticosteroids potentiate?

A

beta adrenergic agonists

67
Q

What is Cushings syndrome?

A

ACTH secreting pituitary adenoma - excess of cortisol

68
Q

What is the corticosteroid treatment for major surgical stress?

A

100-150mg hydrocortisone, 2-3 days

69
Q

What is the only sulfonylurea that excretes uric acid in the urine?

A

acetohexamide

70
Q

Is graves disease hypothyroid or hyperthyroid?

A

hyperthyroid

71
Q

What is the preferred drug in anesthesia for PONV?

A

dexamethasone

72
Q

What is the dose of hydrocortisone for Addisons Disease?

A

20-30mg

73
Q

Cortisol is stimulated by the release of what hormone?

A

ACTH

74
Q

What can high concentration of oxytocin cause?

A

fluid retention, hyponatremia, heart failure, seizures, death

75
Q

what type of drugs affect insulin production and release?

A

beta adrenergic

76
Q

What class of drugs is used to treat hyperthyroidism?

A

Thionamides

77
Q

In what instances do we use corticosteroids in the OR?

A

anti-inflammatory for difficult intubation

PONV prevention

78
Q

What is a side effect of inhaled glucocorticoids that can be exacerbated by extubation?

A

hoarse voice, dysphonia

79
Q

What is the bolus dose for rapid acting insulin?

A

1-5 units

80
Q

Where is metformin eliminated?

A

kidneys

81
Q

How do we treat the patient taking Metformins lactic acidosis?

A

Bicarb

82
Q

What causes intermediate acting insulins to have a delayed onset?

A

addition of protamine

83
Q

Exhaustion of beta cells can occur due to prolonged use of (3)?

A

glucagon, GH, corticosteroids

84
Q

How do thiaolidinediones work?

A

decrease insulin resistance and glucose production

85
Q

Which diabetic agent should you avoid in pheochromocytoma?

A

Glucagon, its causes release of catecholamines and increases BP

86
Q

What is the treatment for hyperkalemia?

A

dextrose and insulin

87
Q

What is the mineralocorticoid affect of the corticosteroids?

A

Distal convoluted tubule reabsorption of Na in exchange for K

88
Q

What are adjunct medications used to treat hyperthyroidism?

A

B blockers, CCBs, barbiturates, cholestyramine

89
Q

What are parenteral glucocorticoids used for?

A

prep treatment of RAD

Intraop bronchospasm

90
Q

If a patient is taking NPH insulin and we give protamine intraop, what is a risk?

A

allergic reaction

91
Q

How do we treat DI?

A

Desmopressin (DDAVP)

92
Q

How does propylthiouracil work?

A

inhibits deiodination of T4 and T3

93
Q

What type of drugs decreases thyroxine levels? (bad thing)

A

metabolic inducers. rifampin, phenobarb, carbamazepine, phenytoin, tyrosine kinase inhibitors, HIV protease inhibitors

94
Q

What links the CNS to the endocrine system?

A

Hypothalamus

95
Q

which type of diabetes s caused by beta cell dysfunction and tissue resistance to insulin?

A

DM2

96
Q

What drugs are in the class of sulfonylureas?

A

End in -ide

Tolbutamide, Glyburide, Glipizide, acetohexaide, chloropropamide

97
Q

What drugs potentiate the effects of sulfonylureas?

A

sulfonamide antibiotics, alcohol, salicylates, and warfarin

98
Q

What is the dose of insulin for DM1?

A

0.5-1 units/kg/day

99
Q

Where do meglitinides work?

A

pancreatic beta cells

can lower A1C by 1%

100
Q

What is the dose of cortisol for RAD and bronchospasm?

A

1-2mg

101
Q

What class of drugs potentiates hypoglycemia?

A

MAOIs

102
Q

Where is cortisol released from?

A

adrenal cortex

103
Q

What drugs are the thiaolidinediones?

A

end in -glitazone

rosiglitazone, pioglitazone

104
Q

Cortisol is regulated by negative feedback from which two organs?

A

hypothalamus and anterior pituitary gland

105
Q

which type of diabetes is caused by autoimmune destruction of beta cells?

A

DM1

106
Q

which organ releases thyroxine, and triiodothyronine

A

Thyroid

107
Q

What endocrine organ regulates serum calcium

A

parathyroid glands

108
Q

What is the loading dose of T3 used to treat myxedema coma?

A

5-20 mcg IV

109
Q

What are the rapid acting insulins?

A

Regular insulin

110
Q

What are the adverse effects of triamcinolone?

A

weakness, anorexia, sedation

111
Q

Whats the treatment for hypoglycemia?

A

D50, 50-100mL

Glucagon 0.5-1 mg

112
Q

How is amiodarone induced hypothyroidism treated?

A

Levothyroxine

113
Q

What does glucagon do?

A

stimulates glycogenolysis

increases gluconeogenesis

114
Q

What is the dose of oxytocin to stimulate uterine contractions?

A

0.5-2 mU/min, max 20mU/min

115
Q

If you are unable to treat thyroid storm with B blockers, what medication do you use?

A

Diltiazem 5-10mg

116
Q

What is the epidural steroid injection dose of triamcinolone?

A

25-50 mg with lidocaine

117
Q

What causes Hashimoto Thyroiditis?

A

inhibited thyroid hormone synthesis - Hypothyroidism

118
Q

What is the onset, peak and duration of rapid acting insulin?

A

30 min onset
2-4 peak
6-8 duration

119
Q

What are the ultra long acting insulins?

A

Degludec

120
Q

Which synthetic corticosteroid is used for replacement therapy in adrenocortical deficiency?

A

Prednisolone

121
Q

What is the onset, peak and duration of intermediate insulin?

A

2h onset
4-14h peak
18-28h duration

122
Q

What is the dose of oxytocin to control post-op uterine bleeding?

A

10-40 units added to a 1L bag of fluids

10 units IM

123
Q

What hormone released by the thyroid decreases serum calcium?

A

calcitonin

124
Q

What drugs are the meglitinides?

A

end in -glinide

Repaglinide and nateglinide

125
Q

Which drugs are best used for short term TSH suppression?

A

T3 drugs

Liothyronine

126
Q

How does myxedema coma present?

A

weakness, stupor, hypothermic, hyperventilate, hypoglycemia, hyponatremia, shock, death

127
Q

Corticosteroid binding globulin is decreased in which situations?

A

hypothyroid, genetic defects, protein deficiency

128
Q

What is the onset and duration of ultra long acting insulin?

A

2h onset

>40h duration

129
Q

What hormone is highly bound in plasma corticosteroid binding globulin?

A

Cortisol

130
Q

What releases oxytocin, vasopressin,, stored ADH?

A

Posterior Pituitary

131
Q

How does aldosterone affect BP and fluid status?

A

increases blood pressure and CVP.

132
Q

How do the alpha-glucosidase inhibitors work?

A

interfere with intestinal glucosidase activity, decreasing carb digestion and absorption

133
Q

60% of islet cells from the pancreas are what type of cells?

A

beta cells

134
Q

what is the dose of DDAVP?

A

1-4 mcg/day

135
Q

Why can glucagon be given for beta blocker overdose?

A

Potent inotrope and chronotrope, increasing cAMP production

136
Q

Where is glucagon degraded?

A

liver, kidney, and plasma at tissue receptor sites

137
Q

Does cortisol inhibit or potentiate beta agonists?

A

potentiate

138
Q

What is the loading dose of levothyroxine used to treat myxedema coma?

A

300-400 mcg IV

139
Q

What releases GH, TSH, Adrenocorticotropic hormone, FSH, LH, and prolactin?

A

anterior pituitary

140
Q

Which form of thyroid hormone is the active form

A

T3 is active

T4 is the prohormone

141
Q

What is the corticosteroid treatment for a patient taking >20mg prednisone for more than 3 weeks with HPA axis suppression?

A

Treat

142
Q

What are the long acting insulins?

A

Detemir and glargine

143
Q

Which diabetic agent should you avoid with sulfa allergies?

A

sulfonylureas

144
Q

What stimulates insulin release?

A

beta receptor stimulation and acetylcholine

145
Q

What does perioperative stress do to pituitary hormone secretion?

A

stress increases SNS activation, increasing pituitary hormone secretion

Pharmacology (6 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions