Endocrine Pharm (Exam 3)

Question 1

aminoglutethimide: MOA

Answer 1

Blocks the synthesis of all adrenal steroids

Question 2

aminoglutethimide: Indications

Answer 2

Temporary therapy to decrease cortisol production

Usually they are waiting on radiations

CUSHINGS

Question 3

aminoglutethimide: Adverse reactions

Answer 3

Drowsiness
Nausea
Anorexia
Rash

Question 4

aminoglutethimide: NSG considerations

Answer 4

Reduces cortisol levels by 50%

Do not use long term

Question 5

Ketoconazole: MOA

Answer 5

Antifungal drug that also inhibits glucocorticoid synthesis

ONLY cortisol

Question 6

Ketoconazole: Indications

Answer 6

Adjunct therapy to surgery or radiation for Cushing’s syndrome

Question 7

Ketoconazole: Adverse reactions

Answer 7

Liver damage

Very hepatotoxic

Question 8

Ketoconazole: NSG consideration

Answer 8

Do not take with ETOH or other drugs that harm liver

Damage fetal thyroid

Question 9

phenoxybenzamine: MOA

Answer 9

Long lasting, irreversible blockage of alpha-adrenergic receptor

Question 10

phenoxybenzamine: Indications

Answer 10

Pheochromocytoma

Question 11

phenoxybenzamine: Adverse Reactions

Answer 11

Related to low blood pressure

Orthostatic Hypotension
Reflex Tachycardia
Nasal Congestion
Sexual Side Effects in men

Question 12

Phenoxybenzamine: NSG considerations

Answer 12

Lowers blood pressure and is non reversible

Question 13

demeclocycline: MOA

Answer 13

Interferes with renal response to ADH

Question 14

demeclocycline: Indications

Answer 14

SIADH

Question 15

demeclocycline: Adverse Reactions

Answer 15

Photosensitivity

Teeth Staining

Nephrotoxic

Question 16

DDAVP desmopressin: MOA

Answer 16

Synthetic ADH replacement

Question 17

DDAVP desmopressin: Indications

Answer 17

Neurogenic DI

Question 18

DDAVP desmopressin: Adverse Reactions

Answer 18

Small dose: None

Nasal Spray: Irritation

Large Dose: Hyponatremia and water intoxication

Question 19

levothyroxine: Class

Answer 19

T4 synthetic thyroid hormone

Question 20

levothyroxine: MOA

Answer 20

Converted to T3 in the body

Question 21

levothyroxine: Indications

Answer 21

Hypothyrodisim

Question 22

Levothyroxine: Adverse Reactions

Answer 22

Hyperthyroidism if dosing to high

Question 23

levothyroxine: NSG considerations

Answer 23

Drug life = 7 days (takes month to see results)

Food and Drug decrease absorption

Warfarin can increase bleeding

Have to take this medication for life

Question 24

propylthiouracil: MOA

Answer 24

Blocks thyroid hormone synthesis, suppresses conversion of T4 to T3

Question 25

propylthiouracil: Indications

Answer 25

Hyperthyroidism

Question 26

propylthiouracil: NSG considrations

Answer 26

BBW: Hepatotoxicity

Question 27

Drug Therapy for Cushing's

Answer 27

Depends on the cause: Primary or Secondary = Surgery or Radiations Exogenous Steroids = Taper The drugs are just temporary to suppress

Question 28

Glucocorticoids: What are they? What are they for?

Answer 28

Hydrocortisone Prednisone Dexamethasone For Addison's

Question 29

Glucocorticoids: Adverse Affects

Answer 29

Short term: Increase IOP Fluid Retention Mood swing Weight Gain Long term: Cataracts High blood sugar Depressed Immune sys Thinning of skin and bones

Question 30

Glucocorticoids: Nsg Considerations

Answer 30

STEROID TAPER (Addison Crisis) Take at same time each day Increase when stress or sick Wear medical alert bracelet Have back up doses TOXIC IN LARGE DOSES

Question 31

Mineralocorticoid: ALL

Answer 31

Fludrocortisone Salt wasting (inability to maintain Na and K levels despite good renal functions)

Question 32

Addison Disease: Pharmacotherapy

Answer 32

LIfelong corticosteroid replacement All patients required glucocorticoid (Hydrocortisone ) (Prednisone) (Dexamethasone) Dex or pred = mineral corticoid (Fludrocortisone)

Question 33

Why is hydrocortisone the drug of choice for addison's disease

Answer 33

Glucocorticoid and Mineralocorticoid effect

Question 34

Important Issues of Addison Pharmacotherapy

Answer 34

Dosing should mimic natural release of hormones (bed time) Never stop steroids abruptly (always taper) (Addison Crisis) Steroids will need to be increased during stress Always maintain emergency supply Wear a medic alert bracelet

Question 35

Prefered Treatment Pheochromocytoma

Answer 35

Surgery is how we want to treat Give alpha 1 blockers until the surgery happens (give pre-opp and after) (permanent) phenoxybenzamine

Question 36

SIADH: Pharmacotherapy

Answer 36

Pharm is not the first line of treatment Treat the underlying cause Can give loop diuretics only if sodium is above 125

Question 37

Neurogenic DI: Pharmacotherapy

Answer 37

ADH replacement (Desmopressin)

Question 38

Nephrogenic DI: Pharmacotherapy

Answer 38

Thiazide diuretics Paradoxical effect. Reduces polyuria?!?!

Question 39

Treatment of Hyperthyroidism

Answer 39

propylthiouracil Radioactive iodine treatment (more common) (taken up by gland and suppresses activation) Surgery (then need levothyroxine for life)

Question 40

Hypoparathyroidism: Treatment

Answer 40

Replace PTH Normalize Ca and Vitamin D If parathyroid is removed then treatment is life long

Question 41

Hyperparathyroidism: Treatment

Answer 41

Diuretics (Decrease calcium) Calcitonin (regulate ca and phos levels) Bisphosphonates (reduces bone breakdown) Vitamin D (helps calcium be absorbed) Surgical intervention

Question 42

Cushing Disease Preferred Treatment

Answer 42

Primary or Secondary = Surgery and radiations Exogenous = Steroid taper