Endocrine self-study

Question 1

WHat Hypothyroidism drug is used in myxedema coma?

Answer 1

Liothyronie (used in emergency)

Question 2

When on glucocorticoids for replacement therapy how many times are you supposed to take during times of stress?

Answer 2

May need to increase the dosage due to stress and take 3 times the usual does for 3 days

Question 3

What does the Anterior Pituitary ACTH stimulate?

Answer 3

stimulates glucocorticoids release

Question 4

What does the andreal gland secrete?

Answer 4

Secrete glucocorticoids and mineralocorticoids

Question 5

Adverse effects of glucocorticoids on the Cardiovascular, CNS, and endocrine symptom?

Answer 5

Cardiovascular:
-Heart failure, cardiac edema, hypertension
due to electrolyte imbalances (hypokalemia, hypernatremia), enhanced SNS

CNS:
-Convulsions, headache, vertigo, mood swings, nervousness, insomnia, “steroid psychosis,” others

Endocrine:
-Growth suppression, Cushing’s syndrome, menstrual irregularities, carbohydrate intolerance, hyperglycemia, others

GI: peptic ulcers

Integumentary: fragile skin, poor wound healing

Ocular: glaucoma, increased intraocular pressure

Question 6

Contradictions of use for glucocorticoids?

Answer 6

Serious infections,(systemic fungal infections) (this can produce a negative immunosuppressant and not help to heal)

these are only contradicted when used for replacement therapy….mainly only when used as an immunosuppressant

Question 7

What is the oral gulcocorticoid drug of choice for anti-inflammatory purposes?

Answer 7

Prednisone - most commonly use as Po, needs to be metabolised in order to see effects

Question 8

What are the primary reasons for hypothyroidism?

Answer 8

Primary: Abnormalitly to the thyroid gland itself

Secondary: When cause is other body system dysfunction

Question 9

Goiters can occur in?

Answer 9

Hypo and hyperthyroidism, both are an over stimulation of the thyroid gland

Question 10

What else can Desmopression used for outside of diabetes insipitus?

Answer 10

Used for clotting disorders (hemophila A)

Question 11

Client Implication for glucocorticoids?

Answer 11

Sudden discontinuations of glucocorticoids can precipitate an adrenal crisis
(low BP, dehydration, dizziness)

Question 12

Adverse effects of excess glucocorticoids? Symptoms?

Answer 12

Cushing’s Syndrome:
Moon face
Buffalo hump (fat deposits on neck)
Abdominal fat
Thin arms and legs
Stria (red markings)

Question 13

What do Glucocorticoids help to control? What do they inhibit?

Answer 13

Inflammatory and immune responses (alter the gene expression of many proteins)

Inhibit cytokine, COX, immune cell profusion

Question 14

What drug is used to treat acromegaly?

Answer 14

Octreotide (mimics somatostatin, which results in less GH release from the pituitary)

-Not a first-line treatment

Question 15

When given as a injection what does somatropin stimulate?

Answer 15

It stimulates skeleta growth in patients deficient in GH

-Injectable peptide growth hormone for hormone deficiency

Question 16

What is Vasopression and Desmopression used to treat?

Answer 16

Used to treat diabetes insipitus to reduce urinary output and severe thirst ‘

Desmopressin is preferred because it can be given PO

Question 17

How are oral glucocorticoids identified?

Answer 17

All end with “one”

Question 18

Growth hormone excess is called?

Answer 18

Acromegaly (excess growth hormone in adulthood, bones thicken)

Question 19

How are glucocorticoids adminsterd?

Answer 19

Inhalation: Ex asthma

Nasally: For rhinitis and to prevent the recurrence of polyps after surgical removal

Topically: For inflammations of eye, ear and skin

(Given locally and won’t have systematic effects)

Systemic: as hormone replacement and immunosuppression

Question 20

What is levothyroxine used for? how long does it take to see the effects? What is it the prefered treatment for?

Answer 20

It is used for the treatment of hypothyroidism.

-Preferred agent for maintenance therapy

-May take 4 - 6 weeks to see theraputic effects

Question 21

Mechanism of action/how do glucocorticoids work?

Answer 21

*Alter gene expression of many proteins (can change the cell’s ability to make new proteins) -True when glucocorticoids are used as a replacement therapy

Question 22

What drug is used to treat acromegaly?

Answer 22

Octreotide (mimics somatostatin, which results in less GH release from the pituitary)

-Not a first-line treatment

Question 23

Indications of use for glucocorticoids/ when do we use them? What kind of deficiency can they be used for?

Answer 23

-Chronic respiratory illnesses eg asthma and COPD

-Organ transplant - given to help stop organ rejection after a transplant

• Also used for adrenocortical deficiency (replacement therapy) - given for loss of body cortisol (physiological replacement to replace lost cortisol)

GI diseases and dermatological disease

Question 24

When treating hypothyroids what do patients need to report?

Answer 24

Chest pain or heart palpitations

Question 25

What does replacement therapy not cause?

Answer 25

Usually, replacement therapy does not produce Cushing’s syndrome

Question 26

Adverse effects of antithyroid drugs?

Answer 26

Very predictable!! cold intolerance, depression, edema

Question 27

How do glucocorticoids affect the body?

Answer 27

They promote glucose availably
-Protein metabolsim (fat breakdown)
Cardiovascular (supports SNS activity on blood vessels

Question 28

Two treatments for hyperthyroidism? When do they take effect? Ex?

Answer 28

1.) radioactive iodine (works by destroying the thyroid gland)

2.) Antithyroid drugs:
-methimazole (not used in 1st trimester of pregnacy)

-Both prevent thyroid hormone synthesis
-Takes 3 -12 weeks for full effects

Question 29

Hypothyroidsim symptoms?

Answer 29

-Intolerance to cold
-Weight gain

-Goiter (enlargement of the thyroid gland, results from overstimulated and from TSH)

Question 30

Glucocorticoids taken with NSAIDs can cause?

Answer 30

Stomach ulcers

Question 31

What do glucocorticoids do physiologically?
(protein metabolism, fat metabolism, cardiovascular) What are there effects on the various symptoms

Answer 31

Protein metabolism: Breakdown of proteins

Fat metabolism: Breakdown of fat (and redistribution)

Cardiovascular: Supports SNS activity on blood vessels

Question 32

Adverse effects of th

Answer 32

Usually, because of drug excess
-Cardiac dysrhythmias (tachycardia)

-Weight loss (sweating, heat intolerance)

Question 33

What does over secretion and under-secretion of adrenocortical hormones cause?

Answer 33

Over: Cushing Syndrome (collections of symptoms when there is to much glucocorticoid)

Under: Addison’s disease (can happen from surgery, autoimmune disorder, etc)

Question 34

When do you take levothyroxine?

Answer 34

30-60 min before breakfast (food decreases absorption)

-Other drugs may decrease absorptions (Antacids, PPls)

-It is a lifelong therapy

Question 35

With what patient must we use glucocorticoids cautiously? Why?

Answer 35

-Diabetes because these drugs will lead to hyperglycemia (glucocorticoids increase plasma glucose levels)

-Cautiously in patients with PUD (peptic ulcer disease)

-People with hypertension, heart failue

Question 36

Who do we have to be cautious with when giving glucocorticoids?

Answer 36

Diabetes because these drugs will lead to hyperglycemia (glucocorticoids increase plasma glucose levels)