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Pharmacology > Endocrine: Thyroid and Pituitary > Flashcards

Endocrine: Thyroid and Pituitary Flashcards

1
Q

TRH also known as

A

hypothalamic thyroptropin

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2
Q

TSH action is mediated by?

A

cAMP—- then leads to stimulation of iodine uptake by thyroid gland

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3
Q

what is the stored formed of thyroid hormone

A

Thyroglobulin

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4
Q

which is the active form of thyroid hormone we use in our ody

A

T3

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5
Q

T3 or T4 participates in neg feedback to AP/Hypothal

A

T3

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6
Q

what hormone blocks TSH

A

somatostatin

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7
Q

is t3/t4 bound?

A

yes, to thyroxine-binding globulin in plasma

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8
Q

what happens to T3/T4 once insdie target cell

A

T4 deiodinates to T3

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9
Q

another name for GH

A

somatotropin

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10
Q

highest levels of GH are released when

A

during sleep

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11
Q

what inhbits GH release

A

somatostatin

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12
Q

GH stimulates release of?

A

IGF-1 from liver

insulin-like growth factor 1

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13
Q

ACTH hormone also called?

A

Corticotropin

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14
Q

which hormone is used to differentiate Cushing syndrome from ectopic ACTH producing tumor

A

CRH

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15
Q

highest times ACTH is realease?

lowest?

A

morning

*lowest=evening

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16
Q

what stimulates ACTH realease? what inhibits it?

A

stim=stress

inhib=high levels of circulating cortisol via -feedback

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17
Q

where does ACTH bind?

A

rec on adrenal CORTEX

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18
Q

indications for corticotropin? (3)

A
  1. diagnostic tool for differentiation b/w primary addison dz (prim adrenal insuff) and secondary
  2. infantly spasms
  3. MC
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19
Q

indications for cosyntropin

A

PREFFERRED for diagnosis of adrenal insuff

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20
Q

which is pref for diagnosis of adrenal insuff

A

cosyntropin

21
Q

AP hormone replacment therapy is adminitered how

A

IM
SC
IN
because they are very delicate and easily destructed by enzymes in digestive tract

22
Q

Somatotropin

A

GH

23
Q

Somatotropin
MOA
Indications
Application

A

MOA: many physiologic effects of GH exerted via at its targets…ohers are mediated by SOMATOMEDINS (IGF-1 and 2)

used in tx of GH deficiency
growth failure in kids
treatment of HIV with cachexia
GH replacement in adults with confirmed deficiency

24
Q

GH administered to adults does what?

A

increases LEAN body mass, bone density, skin thickness and decreases adipose tissue

25
Q

somatostatin inhibits realease of? (5)

A 
GH 
TSH 
insulin 
glucagon 
gastrin
26
Q

where is somatostatin found

A 
all over
-intestine 
0stomach 
-pancreas 
-hypothalmamus
27
Q

name the synthetic analogs of somatostatin

A

Octreotide

Leuprolide

28
Q

Indications for Octreotide

A
  1. acromegaly
    * somatostatin analog
  2. bleeding esophageal varices (IV)
  3. Diarhhea/flushing episodes assoc with carcinoid tumors
29
Q

indications for Leuprolide

A

acromegaly
*somatostatin analog

Diarhhea/flushing episodes assoc with carcinoid tumors

30
Q

somatotropin is released in response to

A

GHRH

31
Q

PP hormones

A

oxytocin

ADH–vasopressin

32
Q

True false.. oxytocin has antidiruetic and pressor activities

A

TRUE

but less potent than ADH

33
Q

Vasopressin

  • effects?
  • binds to?
  • indications
A

antidiruetic and vasopressor effects
-travels to kidneys–binds to V2 receptors**–increases water permeability and reabsoprtion in the COLLECTING TUBULES

indication:
- DI
- sepsis
- controls bleeding due to esophageal varices

34
Q

drugs used in tx of bleeding esophageal varices

A

vasopresin
or
Octreotide (somatostatin analog)

35
Q

Desmopressin
MOA
indications

A

analog to vasopressin

first line for DI and nocturneal enuresis
longer acting than vasopresin

PO or intranasal

36
Q 
Levothyroxine 
MOA 
INds 
SE 
onset of action?
A

synthetic T4
Inds: replacement tx for non-functional hypothyroid (Hashimoto for ex)

MOA: T4 converted to its active metab–L-triiodothyronine aka T3— then T3 and T4 bind to thyroid receptor proteins in the cell nucleus—- exert metabolic effects thru control of DNA transcription and protein synthesis

onset takes 3-5 DAYS

SE

  • nervousness
  • palps
  • tachycardia
  • heat/cold interolerance
  • unexplained wt loss
37
Q

drugs used to tx thyrotoxicosis or hyperT

A

or graves dz

THIOAMIDES:
Propylthiouracil (PTU)
or
Methimazhole

38
Q

goal of therapy in graves?

A

to decrease synthesis and/or release of additional hormone

  • remove part of all of the thyroid gland (surgical)
  • inhib synthesis of the hormones (PTU/Methimazole)
  • blocking release of hormones from follicle (dose of iodide)
39
Q

PTU and Methimazole

MOA

A

MOA:
PTU: blocks peripheral conversion of T4–T3 (NOT M)
BOTH: block oxidative process req for iodination rxn to convert T4–3
*NO EFF ON THYROGLOBULIN already stored in gland

40
Q

why is Methimazole prefered over PTU

A

longer half life—letting it be dosed once daily and less SE

41
Q

why might clinical effects of Thioamides be delayed?

A

beacuse the drugs have no effects on the already stored thyroglobulin in the TG— so these stores need to be depleted before the treatment starts really showing

42
Q

hyperthyroidism and pregnancy tx?

A

PTU

*bc the M one is teratogenic

43
Q

SE for PTU

A

BBW: for liver toxicity

Others:

  • bleeding
  • alopecia
  • exfoliative dermatits
  • SJS TEN
  • Urticaria
  • ANCA+ vasculitis
  • Interstitial pneumonitis
44
Q

Methimazole SE

A 
edema 
drug fever 
drowsiness
alopecia
arthralgias 
nephritis 
Vertigo
45
Q

thryoid storm

  • causes?
  • S/S and onset
A 
first presentations of graves 
or already diagnoses and: 
-trauma 
-MI 
-Exposure to iodine (EX: arthrogram)

Life threatening—-10-25% of ppl develop HF and die

super fast onset
s/s= severe hyperthryoid symptoms

46
Q

TX for thyroid storm

A

BLOCK synthesis: PTU high dose (PO, NG or OG tube)

BLOCK release: iodine SSKI potassium iodide drops q6 hours

Block periphereal T4–T3 conversion: PTU

Block the HR: BBs—-> propranolol 1-2mg IV q15 minutes

Bp: hydrocortisone

Supplementary: hydrocortisone 100mg IV q6 hrs and IV fluids MUSTTTT

47
Q

why do we give hydrocortisone for thyroid storm tx?

A

help augment BP

48
Q

why do we give iodine in tx of hyperT

A

Iodine in PHARMACEUTICAL DOSES is administered to block the release of preformed thyroid hormone.

49
Q

drugs that can effect thyroid

A

AMIO–hypo or hyper
lithium—- hyPO
alpha interferon–HYPO

Pharmacology (28 decks)

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