Endocrine Pharmacology Flashcards
Adrenocorticosteroids
Notes: What is the name of the condition in which too much cortisol? Cushions Syndrom
Symptoms:
- Moon face
- Buffalo hump
- Midsection girth
What is the name of the condition in which too little cortisol? Addisons disease
Mechanism of action
–Supplementation of endogenous cortisol
Use
–Inflammatory processes
- Asthma
- Allergy
- Rheumatoid Arthritis
–Aphthous stomatitis
–Adrenal insufficiency
Adverse effects when taking ______ is osteoporosis (muscle wasting), increased risk of infection (decreased wound healing), hyperglycemia, water retention and increased gastric acid.
Patient care considerations are risk of adrenal crisis with abrupt withdrawal; thre is Increased adverse effects with use of ______
Adrenocorticosteroids; NSAID’s
Treatment for _____ stimulates insulin production, reduces cellular insulin resistance, decreases hepatic glucose production, increases cellular sensitivity to insulin, inhibits breakdown of ingested carbohydrates, mimics the action of incretin hormones, and inhibits the breakdown of incretin hormones.
Examples: Actos, *Metformin: they ______ insulin resistance)
type 2 diabetes; shut off
Metformin shuts off ______. It’s easy to become hypoglycemic.
gluconeogenisis
Antidiabetic Agents
Treatment of Diabetes Type II (T2DM) (continued) –Inhibit re-absorption of renal filtered glucose
• SGLT2 Inhibitors –dapagliflozin (Farxiga) –canagliflozin (Invokana) –empagliflozin (Jardiance)
The mechanism of action for _____ is the replacement of endogenous insulin. It can lead to hypoglycemia and weight gain.
Insulin
Short Acting
Humulin R
Insulin aspart (Novolog) Insulin lispro (Humalog) Insulin glulisine (Apidra)
Insulins
Intermediate Acting
Humulin N Humulin L Humulin 70/30 Humalog Mix
75/25
Long Acting
Humulin U
Insulin degludec (Tresiba) Insulin detemir (Levemir) Insulin glargine
(Lantus, Toujeo)
______ is the inability of the thyroid gland to secrete enough (too little thyroid hormone). The diagnosis is ____ TSH (thyroid stimulating hormone).
Symptoms are fatigue, and _____ intolerance.
Treatment: Levothyroxine (T4) (Synthroid) • Liothyronine (T3) (Cytomel)
Hypothyroidism (T4); elevated; cold
_____ is excessive production of thyroid hormone. Symptoms of this are heat intolerance, increased sensitivity to pain, and excessive sympathetic activity.
Treatment
Examples: Propylthiouracil (PTU), Methimazole (Tapazole)
Hyperthyroidism
Use caution for patients who have hyper thyroidism when using anesthetic with ____.
If they have uncontrolled hyperthyroidism, they cannot he given ______ because this may lead to a possible “thyroid storm”.
Treatment: PTU, Tapazole
epinephrine; epinephrine
Adverse effects for ___ are GI upset, edema, weight gain, hypertension, increased risk of some cancers, thromboembolic disorders (esp if a smoker).
estrogen
As an anti-osteoporosis drug _______,
decreases bone resorption.
Selective Estrogen Receptor Modulators (Evista) –Mechanism of Action
Mimic estrogen activity at receptors on bone
Estrogen Replacement Therapy (ERT)
Anti-osteoporosis Agents
Teriparatide (Forteo) –Mechanism of Action
• Recombinant human parathyroid hormone
Denosumab (Prolia) –Mechanism of Action
• Inhibits osteoclasts (RANK-L inhibitor)
_______ shut off osteoclast activity and causes increased bone density. This led to retained in bone to reduce bone turnover.
Alendronate (Fosamax) used to treat osteoporosis
Isedronate (Actonel)
Ibandronate sodium (Boniva)
Zoledronic acid (Reclast) once a year injection
Bisphosphonates
Anti-osteoporosis Agents
Bisphosphonates (continued) –Patient care considerations
- Osteonecrosis of the jaw
- Atypical femur fractures
- Esophagitis and esophageal cancer
Antineoplastic Agents
Mechanism of action
–Interfere with reproductive cycle of malignant cells –Have effects on “normal” rapidly growing cells
Adverse Effects
–Gastrointestinal distress
– Alopecia
–Bone marrow suppression
–Decreased immunity/increased risk of infection
Antineoplastic Agents
Patient care considerations –Many dental effects
- Oral ulcerations
- Altered taste
- Gingival bleeding • Xerostomia
- Candidiasis
- Oral mucositis
–Also used to treat various autoimmune diseases • Rheumatoid Arthritis
• Crohn’s Disease
Anti-rheumatic Agents
Disease Modifying Anti-rheumatic Drugs (DMARDs) –Mechanism of action
• Suppress overactive T-cell response and inflammation
- Reduce and prevent joint damage
- Preserve joint structure and function
Anti-rheumatic Agents
DMARDs (continued) – Types
- Antimalarials –hydroxychloroquine (Plaquenil)
- Methotrexate
- Adrenocorticoids
- Tumor necrosis factor alpha-blockers –adalimumab (Humira)
Anti-rheumatic Agents
DMARDs (continued) –Patient care considerations
- Increased susceptibility to infection
- Increased risk of bone marrow suppression
Never abruptly discontiune the use of a ______.
steroid
What drug fools your kdiney from getting rid of glucose?
ex: jardiance
SGLT2 inhibitors
Treatments for patients with problematic ______are surgery, kill the thyroid by chemotherapy or radioactive iodine, leave it alone as long as possible.
hyperthyroidim
_____ supplemenent endogenous female hormones.
estrogen
_____ are used for menopause treatment, osteoporosis, and contraception.
Estrogen
Good to know
If a woman has a high risk of cancer and cannot use estrogen supplements like black cohash (phytoestogen) can help.
As an anti-osteoporosis agent _____ inhibits osteoclasts, stimulates osteoblasts.
Miacalcin (calcitonin)
_______designed to treat bone cancer.
Bisphosphonates
