Endocrine Drugs Thyroid, Hypothalamus, Glucocorticoids

Question 1

What is propythiouracil & Methimazole
MOA?
SEs?

Answer 1

Used for Hyperthyroidism

Block thyroid peroxidase, inhibiting the oxidation and organification of iodide–>inhibits thyroid hormone synthesis

PTU blocks peripheral conversion and can be used in Preggos. Methimazole CANNOT!! its a teratogen (aplastic cutis..i met him and so lost my hair (skin))

SEs: AGRANULOCYTOSIS and hepatotoxic

Question 2

What is a drug used to replace thyroxine?

Answer 2

Levothyroxine, and Triiodothyronine

For Hypothryroid, mxyedema

SEs: (hyperthryoid symptoms, ie heat intolerance, tremors, arrythmias)

Question 3

What drug can be used for Turners or a GH deficiency?

Answer 3

GH

Question 4

What drug can be used for acromegaly, carcinoid? What else can it be used for?

Answer 4

Somatostatin (Octreotide)

Also used for Gastrinoma, glucanoma, esophageal varices

Question 5

What is oxytocin used for?

Answer 5

Stimulate labor by stimulating uterine contractions, milk let down, controls uterine hemorrhage

Question 6

What is ADH (DDAVP) used for?

Answer 6

Central Diabetes Insipidis

NOT NEPHROGENIC!!

Question 7

What is used for SIADH?

Answer 7

Demeclocycline

Its an ADH antagonist (helps kidny ignore ADH so water can be excreted)

SEs: Nephrogenic DI…here the kidney ignoring ADH too much

Question 8

What are the glucocorticoids?

Answer 8

Hydrocortisone, 
prednisone, 
triamcinolone, 
dexamethasone, 
beclomethasone, 
fludrocortisone (mineralocorticoid and glucocorticoid activity)

Question 9

What are glucocorticoids used for?

Answer 9

Metabolic, catabolic, anti-inflamm, immunosuppressive

Bind to gluco response elements and inhibits transc factors such as NF-kB

also interacts with Rank-Rankl on osteoblasts which leads to osteoporosis

Addison Disease, inflammation, immune suppression, asthma

Question 10

SEs: of glucos

Answer 10

Cushing
Adrenocortical atrophy, peptic ulcers, diabetes if chronic use

If stopped using abruptly, get adrenal insufficiency

Increase neutrophils, eos, basophils, monocytes
Decrease T>B

Question 11

What are SGLT2 inhibitors?

Answer 11

Drugs used for a diabetic patient having trouble keeping A1c levels in check. It will increase urine glucose

SEs: All that sugar in urine–>UTI which can be very bad for diabetics

Question 12

What happens when glucorticoids are used in HAART therapy?

Answer 12

HIV protease inhibitors are P450 Inhibitors and thus glucocortiocs stay around longer and prevents liver from taking up chylomicrons and trig clearance

All this leads to Cushings

Question 13

What is Leuprolide and what is it used for?

Answer 13

Its a GnRH analog
If used in a continuous manner, then it will initially increase LH & FSH, but later it will inhibit their release which will lower Testosterone levels

Used in prostate CA so at first the symptoms will be worse (bone pain will increase)
but will eventually go away