Endocrinology Treatments Flashcards
Addison’s
primary renal insufficiency, lack of cortisol and aldosterone
Hydrocortisone
Fludrocortisone
Conn’s syndrome
primary hyperaldosteronism
Adrenalectomy if unilateral
Spironolactone to reduce BP if bilateral hyperplasia
Cushing’s syndrome
excess cortisol
Surgical treatment (adrenalectomy)
Metyrapone
Ketoconazole
Pasireotide
Phaeochromocytoma
secretes catecholamines
Full alpha and beta blockade.
Phenoxybenzamine and propranolol/atenolol/metaprolol
Laparoscopic removal +/- chemo
Osteoporosis
Calcium and vitamin D supplements Bisphosphonates - alendronate and risedronate (osteonecrosis of jaw) Strontium post-menopause Denosumab Teriparatide Hormone replacement therapy Selective oestrogen receptor modulators Testosterone
Paget’s disease of bone
Analgesia
Bisphosphonates
Hypercalcaemia (acute management)
Fluids
Loop diuretics once rehydrated
Bisphosphonates
Acute hypocalcaemia
IV calcium gluconate (10ml, 10%)
same treatment as hyperkalaemia!
Hypoparathyroidism
Calcium supplement and Vitamin D
Rickets and Osteomalacia
Vitamin D (D3 tablets, calcitrol) or combined calcium and vitamin D (adcal D3)
Vitamin D-resistant Rickets
Phosphate and vitamin D
Type 1 Diabetes
Insulin
Type 2 Diabetes
Biguanides (Metformin) Sulfonylureas (Gliclazide, Glibenclamide) Glinides (Repaglinide) Thiazolidinediones (Pioglitazone) GLP-1 receptor agonists (Exenatide) DPP-4 inhibitors (Sitagliptin) SGLT-2 inhibitors (Empagliflozin) Alpha-glucosidase inhibitors (Acarbose)
Type 3 Diabetes (gestational)
Dietary advice
Insulin might be needed
MODY
C-peptide still measured as endogenous insulin still produced
Glucokinase mutation - no treatment (stable hyperglycaemia)
Transcription factor mutation - sulfonylureas
Gestational diabetes
Metformin or insulin
Permanent neonatal diabetes
Insulin or sulfonylureas
Alcohol-induced ketoacidosis
Pabrinex (thiamine) and IV fluids (dextrose)
Potassium supplementation
Diabetic ketoacidosis
IV fluids (0.9% sodium chloride)
IV insulin infusion
Continue established subcutaneous insulin therapy
Once glucose falls below 14mmol/l, IV glucose 10%
Hyperglycaemic Hyperosmolar Syndrome
Fluid replacement
Lactic acidosis
Treat underlying cause (fluids and antibiotics)
Polycystic Ovarian Syndrome
Weight loss, lifestyle modifications, folic acid. Metformin Clomifene citrate Gonadotrophin therapy Laparoscopic ovarian diathermy
Premature Ovarian Failure
Hormone replacement therapy
Acromegaly
trans-sphenoidal pituitary surgery +/- external radiotherapy.
