Endocrine pharm FA (no insulin) Flashcards
what are thionamides?
propylthiouracil, methimazole
what inhibits propylthiouracil and methimazole?
THYROID PEROXIDASE -> oxidation of iodide, organification, coupling of iodine –> inhibition of thyroid hormone synthesis
What additionaly blocks PTU, but not methimazole?
5’-deiodinase
what does 5’-deiodinase?
peripheral conversion of T4 -> T3
Indication for thionamides?
Hyperthyroidism
What medication is used in primary trimester for hyperthyroidism? why?
PTU.
methimazole is theratogenic
What medication is used in secondary and tertiary trimester for hyperthyroidism? why?
Methimazole.
PTU can cause hepatoxocity
Do thionamides used to treat Graves ophthalmopathy?
NO
it is treated with corticosteroids
adverse. Methimazole and pregnancy?
Theratogenic. Can cause aplasia cutis
Thionamides - adverse?
Maculopapular rashes.
AGRANULOCYTOSIS - buvo UW klausimas
Aplastic anemia
Hepatotoxic (PTU) - incr. transaminases
Methimazole-induced cholestatic jaundice - in first trimester
Why PTU in pregnancy?
it is more strongly protein bound, therefore less cross placenta
What is levothyroxine? zymejimas
T4
What is liothyronine/trijodtironinas? zymejimas
T3
Mechanism of T3 and T4?
thyroid hormone replacement
Clinical use of T4 and T3?
Hypothyroidism, myxedema.
T4 and T3 can be used to abuse what?
abused for weight loss
how to differentiate endogenous and exogenous hyperthyroidism?
TSH receptor antibodies, radioactive iodine uptake, blood flow on ultrasound
ADH antagonists?
conivaptan, tolvaptan
conivaptan, tolvaptan group?
ADH antagonists
Clinical use of ADH antagonists?
SIADH
ADH antagonists blocks what?
V2 receptors - that are in kidney
Desmopressin clinical use?
Central DI, von Willebrand diseases, sleep enuresis, hemophilia A (VIII)
Central DI?
Desmopressin
von Willebrand disease?
Desmopressin
Sleep enuresis?
Desmopressin
Hemophilia A (VIII)?
Desmopressin
GH clinical use?2
GH deficiency, turner syndrome
Oxytocin clinical use?
labor induction (stimulates uterine contractions), controls uterine hemorrhage (decrease)
elicits milk ejection
Oxytocin half life?
5 min
Somatostatin analog?
octreotide
Somatostatin analog (octreotide) use?
Acromegaly, carcinoid syndrome, gastrinoma, esophageal varices
Acromegaly?
Somatostatin analog (octreotide)
carcinoid syndrome?
Somatostatin analog (octreotide)
gastrinoma?
Somatostatin analog (octreotide)
esophageal varices?
Somatostatin analog (octreotide)
Demeclocycline mechanism?
ADH antagonist (member of tetracycline family)
ADH antagonist (member of tetracycline family)?
demeclocycline
Demeclocycline use?
SIADH
Demeclocycline clinical use?
Nephrogenic DI, photosensitivity, abnormalities of bone and teeth
what drug may lead to Nephrogenic DI?
Demeclocycline
what drug may lead to photosensitivity?
Demeclocycline
what drug may lead to abnormalities of bone and teeth?
Demeclocycline
Fludrocortisone group?
Synthetic aldosterone analog WITH LITTLE Glucocorticoid effects
Synthetic aldosterone analog WITH LITTLE Glucocorticoid effects?
Fludrocortisone
Fludrocortisone use?
Mineralcorticoid replacement in primary adrenal insufficiency
Mineralcorticoid replacement in primary adrenal insufficiency?
Fludrocortisone
Fludrocortisone adverse?
similar to glucocorticoids. also edema, exacerbation of heart failure, hyperpigmentation
adverse: similar to glucocorticoids. also edema, exacerbation of heart failure, hyperpigmentation?
Fludrocortisone
Fludrocortisone adverse to skin?
hyperpigmentation
Cinacalcet - mechanism?
sensitizes Ca2+-sensing receptor (CaSR) in parathyroid glands to circulating Ca -> decr. PTH
what body part is affected by cinacalcet?
parathyroid glands
cinacalcet use?
2 hyperparathyroidism in CKF.
Hypercalcemia in 1 hyperparathyroidism (if parathyroidectomy fails)
In parathyroid carcinoma
cinacalcet adverse?
hypocalcemia
Sevelamer mechanism?
nonabsorbable phosphate binder that prevents phosphate absorbtion from the GI tract
nonabsorbable phosphate binder that prevents phosphate absorbtion from the GI tract?
Sevelamer
Sevelamer use?
hyperphosphatemia in CKD
sevelamer adverse?
hypophosphatemia, GI upset