Endocrine (Glucocorticoids/Vitamin D) Drugs

Question 1

Cushing’s syndrome (glucocorticoids)

Answer 1

truncal obesity, thinning of extremities, hyperglycemia, edema, HTN, osteoporosis myopathy

Question 2

Glucocorticoids: betamethasone, dexmethaxone, hydrocortisone, methylprednisolone, prednisone “-sone”

Answer 2

Indication: RA, SLE, ulcerative colitis, Crohn’s disease, asthma, neoplasm, general inflammatory respiratory
Side effects: osteoporosis, high glucose, myopathy, low K, growth retardation, PUD, Cushing’s syndrome
Contraindiction: NSAIDs, digoxin, diuretics, vaccines, HTN, CHF
Treatment: fludrocortisone

Question 3

Calcium carbonate, calcium citrate

Answer 3

Side effects: hypercalcemia (less than 3-4 gm/day), GI upset, high gastric secretion, kidney stones
-Calc. carbonate: 500-600 mg
-Calc. citrate: 200-300 mg
Contraindication: severe brady (digoxin), prednisone, tetracycline, thyroid hormone, low calc. absorption

Question 4

ergocalciferol (vitamin D), cholecalciferol

Answer 4

Adult 400-800 IU/day
Adult older than 50 800-1000 IU/day
-unprotected sun (15 minutes/day)
-eggs, milk, fish
-multivitamin supplement

Question 5

alendronate, risedronate, ibandronate sodium

Answer 5

For osteoporosis, prevent postmenopause
Side effects: esophagitis, gastritis, ulcers, gas production, acid reflux, actonel carthralgia, diarrhea, HA, rash, N, GI, BONJ
Implication: givie with 8 oz. water, not eat for 30 minutes, remain upright atleast 30 minutes

Question 6

zoledronic acid

Answer 6

-yearly 2 year IV

Side effects: bone/joint pain, fever (44%), dyspnea, BONJ

Question 7

somatrem, somatropin

Answer 7

Indication: pediatric growth, short stature (HGHD)
Side effect: hyperglycemia, interact with glucocorticoids
Contraindication: malignancies, tumor, diabetes
Implication: growth rate, examine epiphyseal closure, don’t use if cloudy

Question 8

vasopressin, desmopressin

Answer 8

-antidiuretic
Action: renal conservation. low urine output, high motility, vasoconstriction
Indiction: hypothalmic diabetes insipidus, low ADH, high 50 ml/kg/24 hr
Side effects: H2O intoxication, vasocontrict=overeffect, extravasation