Endocrine drugs Flashcards
1) What is the P drug which tends to be used for hypothyroidism.
2) Which beta blocker is the P drug which us used for hyperthyroidism.
3) Name the 2 thionamide P drugs which are used to treat hyperthyroidism.
4) Name 2 other P drugs which can be used to treat hyperthyroidism.
1) Levothyroxine
2) Propranolol
3) Carbimazole and propylthiouracil.
4) Radioiodine (Iodine 131) and aqueous iodine oral solution.
Give the 2 main clinical indications for the use of thyroid hormones such as Levothyroxine.
1) Primary hypothyroidism.
2) Hypothyroidism secondary to hypopituitarism.
1) What hormone does the thyroid produce?
2) What happens to this thyroid hormone?
3) What do the thyroid hormones do?
4) How is hypothyroidism treated?
1) T4.
2) T4 is converted to the more active T3 in target tissues.
3) Regulate metabolism and growth.
4) Long term replacement of thyroid hormones, most usually Levothyroxine (T4).
What is the difference between levothyroxine and liothyronine.
1) Levothyroxine is synthetic T4, Liothyronine is synthetic T3.
2) Liothyronin has a shorter half life and quicker onset and offset of action.
1) What situations is the use of Liothyronine preferred over Levothyroxine?
2) What are the adverse effects of Levothyroxine usually due to?
1) Liothyronine is reserved for emergency treatment of severe or acute hypothyroidism.
2) Excessive doses.
Describe the predictable side effects which can occur with excess thyroid hormone treatment.
1) GI adverse effects (D+V, weight loss)
2) Cardiac (palpitations, arrhythmias, angina)
3) Neurological (tremor, restlessness, insomnia).
1) Why can thyroid hormones precipitate cardiac ischaemia in people with coronary artery disease?
2) Because of this, how should thyroid replacement be started in patients with coronary artery disease?
3) In hypopituitarism, why must corticosteroid therapy be initiated before thyroid hormone replacement?
1) Because they increase heart rate and metabolism.
2) Replacement should be started cautiously at a low dose with careful monitoring.
3) In order to avoid precipitating an Addisonian crisis.
1) Why does administration of Levothyroxine and need to be separated with antacids, calcium or iron salts by 4 hours?
2) When might an increase in Levothyroxine dose be required?
3) What can be a result of Levothyroxine-induced changes in metabolism in patients with DM?
4) What does Levothyroxine to to Warfarin?
1) Because GI absorption of Levothyroxine is reduced by antacids, calcium or iron salts.
2) In patients taking CYP540 inducers (Phenytoin, Carbamazepine).
3) They can increase insulin or oral hypoglycaemic requirements.
4) Enhances the effect of Warfarin.
1) How is levothyroxine available for administration?
2) Describe the recommended starting dose of Levothyroxine.
3) How should the dose of Levothyroxine be adjusted?
1) Orally.
2) 50-100mcg OD recommended, except in elderly and those with cardiac disease who should start on 25mcg OD.
3) Adjust dose monthly in 25-50mcg increments according to monitoring, to a usual maintenance dose of 50-200mcg OD.
Give 5 main uses of glucocorticoids.
1) Replacement therapy
2) Endocrine testing
3) Treatment of inflammatory disorders - acute and chronic
4) Neoplastic disease
5) Organ transplantation
Name the 3 glucocorticoid P drugs.
Hydrocortisone, Prednisolone and Dexamethasone.
Give the main pharmacological use of mineralocorticoids.
Replacement therapy - primary (Addisonian) adrenal failure.
What is the P drug which is a mineralocorticoid?
Fludrocortisone.
What is Tetracosactide used for?
Testing adrenocortical function.
Give 2 main uses of synthetic growth hormone.
1) Growth hormone deficiency in children and adults
2) Turner’s syndrome and Prader-Willi syndrome in children
Name the P drug which is a synthetic growth hormone.
Somatropin.
Give 3 main uses of Dopamine (D2) agonists.
1) Galactorrhoea
2) Hyperprolactinaemia
3) Prolactin secreting pituitary adenomas
Name the P drug which is a Dopamine (D2) agonist.
Cabergoline.
What can testosterone and its esters be used for?
Male hypogonadism.
Name the 2 testosterone P drugs.
1) Sustanon 250® (testosterone esters - IM depot)
2) Testogel® (testosterone - transdermal)
Give the 4 main clinical uses of Bisphosphonates.
1) Postmenopausal osteoporosis
2) Prevention of corticosteroid-induced osteoporosis
3) Hypercalcaemia
4) Paget’s disease of bone
Name 3 P drugs which are Bisphosphonates.
1) Alendronic acid
2) Risedronate
3) Zoledronic acid
Give 3 clinical uses for Calcium salts.
1) Mild hypocalcaemia [oral supplement]
2) Moderate to severe acute hypocalcaemia [parenteral - IV]
3) Hyperkalaemia for cardioprotection [parenteral - IV]
Name 3 P drugs which are calcium salts and state how each is administered.
1) Calcichew® (Oral supplement)
2) Calcium gluconate (Parenteral - IV)
3) Calcium chloride (Parenteral - IV)
Give 4 clinical uses for vitamin D compounds.
1) Vitamin D deficiency
2) Hypocalcaemia
3) Hypoparathyroidism
4) Renal bone disease [secondary hyperparathyroidism of chronic renal disease]
Name the 3 P drugs which are vitamin D compounds.
1) Alfacalcidol (1α- Hydroxycholecalciferol)
2) Calcitriol (1,25- Dihydroxycholecalciferol)
3) Ergocalciferol (Vitamin D2)
Give 3 clinical indications for the use of Vasopressin analogues.
1) Cranial diabetes insipidus [desmopressin]
2) Oesophageal bleeding [terlipressin]
3) Bleeding reduction in mild to moderate haemophilia [desmopressin]
Name the 2 P drugs which are vasopressin analogues.
Desmopressin and Terlipressin.
When are vasopressin V2 receptor antagonists used?
Hyponatraemia secondary to SIADH.
Name the P drug which is a vasopressin V2 receptor antagonist.
Tolvaptan.
