Endocrine (pharm test 7)

Question 1

Growth hormone replacement stimulates

Answer 1

increased bone length, height, muscle cells, organ growth

Question 2

growth hormone will not effect

Answer 2

brain or eyes

Question 3

Growth hormone treatment should continue until

Answer 3

epiphyseal closure or response is no longer present

Question 4

Synthetic growth hormones timing (when are they administered?)

Answer 4

night (normally during sleeping hours)

Question 5

Can synthetic growth hormone be given PO?

Answer 5

No; only SC or IM because it is inactivated in GI tract

Question 6

Prolonged GH admin leads to

Answer 6

DM (reduces glucose utilization and antagonizes insulin)

Question 7

Opposes growth hormones

Answer 7

glucocorticoids

Question 8

Preferred treatment for acromegaly is

Answer 8

surgery, radiation, meds, but meds are not preference

Question 9

When are meds used for acromegaly?

Answer 9

large tumor or residual tumors following surgery or radiation

Question 10

How often do you x-ray children receiving GH?

Answer 10

monthly

Question 11

Somastatin Analog example

Answer 11

ocreotide (Sandostatin)

Question 12

Somatostatin MOH

Answer 12

natural GH inhibiting hormone
mimic suppressant action of somatostatin on pituitary decreasing GH release

Question 13

Pegvisomant MOA

Answer 13

growth hormone receptor antagonist

Question 14

ADH (vasopressin) causes

Answer 14

water elimination from kidneys
vasoconstriction

Question 15

DI is treated with

Answer 15

vasopressin
Desmopressin

Question 16

Vasopressin (pitressin) MOA, durration, and route

Answer 16

identical structrure to ADH

durration of 2-8 hrs

Admin IM/SC

causes vasoconstriction (raise BP, or cardiac resuscitation)

Question 17

DDAVP Duration, Route, MOA

Answer 17

duration: 8-20hr

admin via nasal spray, PO, SC, IV

Not an intense vasoconstrictor (like vasopressin) so choice drug for DI

Used for enuresis in low dose

Question 18

ADH drug ADR’s (vasopressin DDAVP)

Answer 18

water intoxication (kidney function, teach pt to decrease water intake)
excessive vasoconstriction (lead to angina, MI, gangrene)

Question 19

Vasopressin is contraindicated in pts with

Answer 19

CAD

Question 20

Drugs for hypothyroidism

Answer 20

Levothyroxine sodium
Liothyronine

Question 21

Levothyroxine and liothyronine are synthetic:

Answer 21

T4
T3

Question 22

Levothyroxine considerations:

Answer 22

narrow therapeuric range
take on empty stomach (30-60min before breakfast)

Question 23

How long does it take levothyroxine to reach therapeutic plasma levels?

Answer 23

4 half lives (7 days = one half life) so one month

Question 24

Levothyroxine will increase:

Answer 24

metabolic rate and O2 demand
(careful with cardiac and hypertensive pts)
may cause angina

Question 25

Treat myxedema coma with

Answer 25

IV levothyroxine

Question 26

Hyperthyroid treatment options

Answer 26

surgical removal radioactive iodine therapy antithyroid drugs (inhibit synthesis or release of T3 and T4)

Question 27

Antithyroid drugs:

Answer 27

Thionamides (methimazole and propylthiouricil)

Question 28

Why does it take longer to stabilized thyroid levels? (3-12 wks)

Answer 28

they do not destroy existing stores of thyroid hormone

Question 29

Adverse effects of antithyroid drugs

Answer 29

Hypothyroidism agranulocytosis (sore throat and fever, monitor WBC, treat with filgastrim)

Question 30

Can you use antithyroid drugs in pregnancy?

Answer 30

Yes, PTU

Question 31

Cushing syndrome treatment

Answer 31

underlying cause discontinue corticosteroids meds to suppress adrenal release of steroids (not first choice for treatment)

Question 32

Cushing syndrome meds:

Answer 32

Ketoconazole (actually antifungal)

Question 33

Ketoconazole MOA

Answer 33

Inhibits synthesis of adrenal steroid hormones

Question 34

Addisons disease drugs

Answer 34

hydrocortisone fludrocortisone

Question 35

Hydrocortisone admin

Answer 35

POr for chroinic replacement IV for acute

Question 36

Fludrocortixone indication

Answer 36

sodium loss and hypotension associated with adrenal cortical insufficiency

Question 37

Dexamethasone indication

Answer 37

inflammation from cerebral edema

Question 38

Corticosteroids ADR

Answer 38

for non endocrine disorders, with large doses, Cushing syndrome