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pharms > Endocrine Pharms > Flashcards

Endocrine Pharms Flashcards

1
Q

Hydrocortisone

A
  • Rapid-acting
  • Mineralo-and glucocorticoid activity
  • Used for acute adrenal insufficiency and shaock
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2
Q

Prednisolone

A
  • Short acting
  • Allergic pruritis, auto-immune disorder
  • Lowest dose possible, taper!
  • Immunosuppressive dose is 2mg/kg
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3
Q

Dexamethasone (dexafort, Clovasone)

A
  • Long acting, potente glucocorticoid
  • Allergies and shock (small animal)
  • Ketosis and parturition induction (sheep, cattle)
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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
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5
Q

Fludrocortisone

A
  • Mineralocorticoid action

- Treatment of hypoadrenocorticism

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6
Q

Triamcinolone

A
  • Deep intra-lesional injection or intra-articular use

- Treatment of strictures

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7
Q

Isoflupredone

A
  • Ketosis, M/S conditions, allergies, shock and endotoxicity
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8
Q

Methylprenisolone

A
  • Long acting
  • Often misused in cases of atopy
  • Auto-immune disorders in cats
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9
Q

Betamethasone

A
  • Potent glucocorticoid
  • Topical use common
  • Most commonly used in otic, ocular and skin formulations
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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
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11
Q

Trilostane

A
  • inhibits the synthesis and release of cortisol from the adrenal gland
  • Safer drug
  • Currently avail compounded from Kyron
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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
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13
Q

Carbimazole

A
  • Inhibits hormone synthesis in the thyroid
  • SE: GIT sings, BM suppression, hepatotoxicity
  • Long term control, monitoring and dose titreing needed
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14
Q

Synthetic thyroxine or levothyroxine

A
  • Tablets or solution
  • Daily supplementation; regular monitoring needed
  • Storage NB; below 25 degrees, no moisture or sunlight
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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
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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

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