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Systems Pharmacology > Endocrine P and T > Flashcards

Endocrine P and T Flashcards

1
Q

what 4 glands are commonly affected by endocrine diseases

A

pancreas, thyroid, adrenal, pituitary

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2
Q

describe 3 functions of insulin

A

promotes cellular uptake and metabolism of glucose, promotes synthesis of glycogen, proteins and fat, involved in cellular ion uptake

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3
Q

why is the species origin of insulin significant?

A

may be antigenically different to species used in and therefore risk of antibody development.
(porcine identical to canine)

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4
Q

what is the name of the licensed insulin product and what is its conc?

A

caninsulin, 40IU/ml (most 100)

available as a pen for injection

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5
Q

describe properties of fast acting insulins

A

short duration of action, IV/IM/SC, used for diabetic ketoacidosis

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6
Q

describe the properties of intermediate insulins

A

e.g. caninsulin. with zinc salts and given SC

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7
Q

describe the properties of long-acting insulins

A

e.g. human recombinant. slower onset of action, given SC

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8
Q

how are ‘well’ diabetics treated?

A

SC intermediate acting. once/twice/day

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9
Q

how are unwell diabetics treated?

A

may need fast acting in emergency, also CRI and once stable IM injection.

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10
Q

What are the SE’s of insulin? and how are they treated?

A

hypoglycaemia; confusion, ataxia, seizures, death
treat with oral glucose solutions/ IV dextrose
antibody formation

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11
Q

when are oral hypoglycaemic drugs used? give an example

A

when owners decline insulin therapy, sulphonylureas

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12
Q

how do sulphonylureas work? SE?

A

stimuklate insulin production by B cells. (need functioning cells)
SE = V and liver toxicity

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13
Q

what drug is used to treat cows in -ve energy balance/ ketosis?

A

monensin - intra-ruminal bolus = preventative, an antibiotic which alters flora to allow more efficient fermentation. (increased propionate?)

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14
Q

what are the functions of thyroid hormones?

A

increase BMR, CNS development, thermoregulation, glycogenolysis, glycolysis, protein metabolism, hair and skin growth. increase HR and contractility

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15
Q

what is the most common thyroid disorder in dogs?

A

hypothyroidism caused by lymphocytic thyroiditis (immune mediated)

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16
Q

what are the clinical features of hypothyroidism in dogs?

A

metabolic - lethargy, dullness, obesity, cold intolerance

dermatological - hair loss

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17
Q

how is hypothyroidism treated?

A

admin L-thyroxine; synthetic analogue of T4. (converted to T3 - active)
given orally once/ twice.
e.g. levothyroxine
thyrotoxicosis is rare

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18
Q

what is the most common endocrine disorder in cats?

A

hypethyroidism.

mostly cause by benign adenoma of thyroid tissue

19
Q

what are the consequences of hyperthyroidism?

A

increased BMR, CO, BP, HR, GI motility and CNS activity

decreased body weight and sleep

20
Q

how is hyperthyroidism treated?

A

surgery, low iodine diet, radioactive iodine and anti-thyroid drugs

21
Q

name 2 anti-thyroid drugs

A

methimazole and carbimazole

22
Q

what is the mechanism of action of anti-thyroid drugs?

A

actively conc in thyroid gland, inhibit thyroid pyroxidase so block incorporation of I into tyrosyl groups and prevent coupling of iodotyrosyl groups to form T3 and T4.

23
Q

describe 3 preparations of anti-thyroid drugs

A

slow-release carbimazole (less potent) tablets - converted to methimazole, 1/d.
methimazole tablets - 2 tablets/ d
also transdermal methimazole

24
Q

describe the pharmacokinetics of anti-thyroid drugs

A

rapid oral absorption with high bioavailability (increased with food), dosages rate for M (2) and C (1) due to half lives
mainly urinary excretion

don’t split tablets as teratogenic.

25
Q

describe minor common SE of anti-thyroid drugs

A

V, anorexia, lethargy

26
Q

describe severe rare SE of anti-thyroid drugs

A

hepatopathy, dermatitis, persistent GI signs etc

27
Q

what is cushing’s disease?

A

hyperadrenocorticism

28
Q

what is addison’s disease?

A

hypoadrenocorticism

29
Q

name 2 hormones released from the adrenal gland

A

aldosterone and cortisol

30
Q

what is the difference between primary and secondary hypoadrenocorticism?

A 
P = adrenal gland problem
S = pituitary gland problem
31
Q

what is the role of aldosterone

A

involved in cardiac remodelling and generation of sodium channels in DCT and CD. Na retention, K and H+ excretion

32
Q

what is the role of cortisol

A

fluid homeostasis
decrease protein synthesis
suppress inflammatory reactions
increase gluconeogenesis and lipolysis

33
Q

what are the clinical signs of primary hypoadrenocorticism for cortisol and aldosterone?

A

C - weakness, V, anorexia especially during stress

A - hyponatraemia, hyperK (not always)

34
Q

how is hypoadrenocorticism managed?

A

C - replacement. dexamethasone injection in acute crisis, prednisolone tablets for maintenance
mineralocorticoids - replacement. fludrocortisone acetate 2/d/.
SE = hypernatraemia, hypok. also some glucocorticoid activity so SE = excess

35
Q

what is the main cause of hyperadrenocorticism?

A

pituitary dependent tumours (adenoma), over production of ACTH. adrenal tumours less common (excess cortisol)

36
Q

what are the clinical features of cushing’s?

A

median age 10y, PUPD, polyphagia, pot-bellied, panting, exercise intolerance, alopecia, thin skin, nervous signs poss.

37
Q

how is PDH treated? (pit dep hyper)

A

trilostane capsule. once/d, beter absorption with food. blocks enzymes associated with the synthesis of cortisol.
anti-progesterone properties so pregnant women avoid.

38
Q

what are the SE’s of trilostane?

A

GI, addisons, adrenal necrosis

39
Q

what other treatments are available for PDH?

A

other drugs, radiation therapy, surgery (hypophysectomy)

40
Q

what is the fulll name for equine cushing’s?

A

pituitary pars intermedia dysfunction (PPID)

41
Q

how is PPID caused?

A

reduced dopamine production from hypothalamus, less inhibition of pituitary POMCs therefore excess production.

42
Q

what are the clinical signs of PPID?

A

excess hair growth, laminitis, PUPD, weight loss, altered fat distribution, CNS signs

43
Q

how is PPID treated?

A

Management changes - farriery, clipping, parasite control etc
Pergolide tablets - dopamine agonist, rapid onset of action
1/ d unless split for better efficacy but unlicensed
SE - anorexia, D, colic
pregnant women wear gloves

Systems Pharmacology (11 decks)

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