Endocrine drugs

Question 1

somatropin

Answer 1

• GH deficiency
• indication: dwarfism (before epiphyseal closure)
• route: IM/SubQ
• Contraindication: other types of dwarfism unrelated to GH, obesity, respiratory disease (sleep apnea)

Question 2

octreotide

Answer 2

• GH excess
• indication: gigantism/acromegaly, SEVERE DIARRHEA, ESOPHAGEAL BLEED
• SE: organs
• Route: IV/PO/subQ
• Monitor: kidney, liver

Question 3

levothyroxine sodium

Answer 3

• MOA: synthetic thyroid hormone (T4)
• indication: PO - hypothyroidism, IV - myxedema coma (severe)
• SE: s/s hyperthyroidism (OD), s/s hypothyroidism (underdose), hyperglycemia, tachypnea, highly protein-bound
• AE: tachydysrhythmia, chest pain, HTN, seizure
• Contraindication: MI, adrenal insufficiency

Question 4

methimazole and PTU

Answer 4

• MOA: inhibits TH synthesis
• indication: hyperthyroidism, graves’, thyrotoxicosis, adjunct to irritation
• SE: s/s of overdose and underdose, GI distress
• contraindication: pregnancy and lactation

Question 5

Corticotropin

Answer 5

• must be given parenteral (IV/IM/subQ)
• indication: secondary adrenal insufficiency (most important), dx for primary v secondary, acute exacerbation of inflammatory disorders
• contraindication: primary adrenal insufficiency (addison’s)
• SE: fluid, organ, levels

Question 6

glucocorticoids

Answer 6

• indication: primary adrenocortical insufficiency (addison’s, and adrenal crisis), many inflammatory, autoimmune and allergic disease
• contraindication: fungal/viral infections, live virus vaccine
• Routes: PO, IM, IV, topical, aerosol, intra-articular

Question 7

desmopressin

Answer 7

• indication: DI
• MOA: decrease urine output, increase osmolality of urine, little vasoconstrictive effect
• routes: nasal spray, PO, IV, subQ

Question 8

tolvaptan

Answer 8

• MOA: aquaresis (excretion of water without electrolyte loss)
• indication: SIADH
• SE: hypovolemia, increase K, increase BG
• only excreting H2O*

Question 9

calcitriol

Answer 9

• PO/IV: active Vitamin D
• MOA: increases Ca absorption and reabsorption (increase osteoclasts)
• SE: dizziness, vertigo, fall, metallic taste
• indication: hypoparathyroidism, vit. D deficiency, renal hormone replacement ESRD and HD

Question 10

calcitonin-salmon

Answer 10

• route: IM/subQ, nasal spray
• MOA: calcitonin receptor agonist, deposit Ca into bones, increase renal excretion
• SE: hypocalcemia