Endocrine Pharms Flashcards
1
Q
Hydrocortisone
A
- Rapid-acting
- Mineralo-and glucocorticoid activity
- Used for acute adrenal insufficiency and shaock
2
Q
Prednisolone
A
- Short acting
- Allergic pruritis, auto-immune disorder
- Lowest dose possible, taper!
- Immunosuppressive dose is 2mg/kg
3
Q
Dexamethasone (dexafort, Clovasone)
A
- Long acting, potente glucocorticoid
- Allergies and shock (small animal)
- Ketosis and parturition induction (sheep, cattle)
4
Q
Aldosterone
A
- Synthesised in the medullary cortex by action of Angiotensinogen 2
- MR receptors occurs in the distal tubule and collection ducts of the nephron
- Regultaesblood pressure
- Increased H+ and potassium excretion
- Aldosterone inhibitors
o Used in CHF patients to reduce preload and afterload
5
Q
Fludrocortisone
A
- Mineralocorticoid action
- Treatment of hypoadrenocorticism
6
Q
Triamcinolone
A
- Deep intra-lesional injection or intra-articular use
- Treatment of strictures
7
Q
Isoflupredone
A
- Ketosis, M/S conditions, allergies, shock and endotoxicity
8
Q
Methylprenisolone
A
- Long acting
- Often misused in cases of atopy
- Auto-immune disorders in cats
9
Q
Betamethasone
A
- Potent glucocorticoid
- Topical use common
- Most commonly used in otic, ocular and skin formulations
10
Q
Cyclosporin
A
- Inhibition of calcineurin, reduced cytokine production in T-cells
- Used to treat dermatological conditions such as atopy in dogs
- Lag time of 5-7 days
- SEs: decreased with citicosteroids, weight loss, gingivalhyperplaisa, hypertrichosis, cota sheddin
11
Q
Trilostane
A
- inhibits the synthesis and release of cortisol from the adrenal gland
- Safer drug
- Currently avail compounded from Kyron
12
Q
Mitotane (lysodren)
A
- Causes necrosis of the adrenal gland cortex
- Cytotoxin – care with handling
- Strict dosage regimes (rick of Addisons)
- Commonly used for the pituitary-dependant form of Cushing’s
- Needs a section 21 licence in SA
13
Q
Carbimazole
A
- Inhibits hormone synthesis in the thyroid
- SE: GIT sings, BM suppression, hepatotoxicity
- Long term control, monitoring and dose titreing needed
14
Q
Synthetic thyroxine or levothyroxine
A
- Tablets or solution
- Daily supplementation; regular monitoring needed
- Storage NB; below 25 degrees, no moisture or sunlight
15
Q
Oclacittinib (apoquel)
A
- Jak inhibitor
- Control of pruritis associated with allergic skin disease
- Doggs faster onset and cause less GIT issues that cyclosporin
- SE: vomiting and diarrhoea
16
Q
Synthetic thyroxine or levothyroxine
A
- Tablets or solution
- Daily supplementation; regular monitoring needed
- Storage NB; below 25 degrees, no moisture or sunlight
17
Q
Exogenous Insulin
A
-Rapid acting solutions o Actrapid o Used in emergencies o IV o DOA 4 hours -Intermediate acting suspensions o 2 concentrations available o Most commonly used fro long term-managing of diabetes mellitis o Used appropriate syringe o SC or IM o Size of zinc-insulin crystals determines DOA -Long Acting o Protamine zinc o Glargine o Ultratard o DOA 24 to 36 hours o Could ease treatment in some cats
18
Q
Insulin sources and deposition
A
• Natural, semi-synthetic and synthetic o Biosynthetic o Recombinant – most commonly used • Parenteral admin ONLY o Solutions (IV) and suspensions (IM or SC) o Rapid metabolism by liver and kidneys
19
Q
Insulin Functions
A
• Glucose homeostasis (along with glucagon)
o Activates GLUT 4 cell wall transporters and facilitates the intracellular movement of glucose EXCEPT CNS
• Anabolic
o Promotes the uptake and storage of glucose into fat and muscle (glycogen synthesis)
o Promotes protein synthesis and lipogenesis
• Increased potassium uptake
20
Q
Uses of insulin
A
Management of:
- diabetes mellitus
- Hyperkalaemia
- Ketosis in ruminants
21
Q
Using Insulin
A
- The ideal insulin dose is determined by doing a glucose curve
- The blood glucose levels may take up to 8 weeks to stabilize
- It is NB to combine insulin therapy with diet changes
- If the animals is not eating or vomiting the owner must contact the clinic
o Giving insulin if the blood glucose is already low can be very dangerous - Always store insulin in the fridge
- Roll gently before drawing insulin into a syringe
- Injection technique: correct placement, sterile technique
- Owner must understand signs associated with underdosing and overdosing
22
Q
Oral Hypoglycemics
A
- Sulphonyluraes
- Biguanide metformin
- Increase insulin production, glucose production and insulin sensitivity
- Can be used in early NIDDM in cats
- Most animals diagnosed when already insulin dependent
- Can cause diarrhea
23
Q
Glucagon
A
- Rarely used to treat insulin-induced hypoglycemia
- Only if dextrose is not available
- Short DOA
- SE: vomiting, anaphylaxis, need to carefully monitor blood glucose
