Exam 1 - endocrine Flashcards
Hormones used for diagnostic testing only?
TSH, TRH, ACTH, GHRH, CRH
growth hormone analogue?
somatotropin
MOA of somatotropin
- increase bone length, organs, and mm
- stimulates erythropoietin
- increases lipolysis
- reg. nutrients
dosing of GH
3-7x per week SQ
SE of somatotropin
kids - arthralgia, HA, edema, growing pains
Adults - arthralgia, stiffness, back pain, carpal tunnel, edema, HA, URIs
critically ill - increased mortality
somatostatin analogue
octreotide (GH antagonist)
MOA of octreotide
inhibit release of insulin, glucagon, GH, & gastrin
Uses of octreotide
- gastrinoma
- insulinoma
- rare diarrhea
- esophageal varices bleed
- acromegally
- pituitary adrenoma
SE of octreotide
- hypoglycemia
- hypothyroidism
- arrythmias
- biliary tract disorders
- GI (+ malabsorption)
FSH analogue
hCG
MOA of hCG
stimulates ovulation & spermatogenesis (IVF)
GnRH analogs (4)
- leuprolide
- goserelin
- histrelin
- nafarelin
MOA of GnRH analogs
decrease FHS = decrease testosterone & estrogen
uses of GnRH analogs
- prostate/ovarian/breast cancer (goserelin & leuprolide)
- controlled ovarian hyperstimulation
- endometriosis & fibroids (nafarelin)
ADRs of GnRH analogs
- HA
- light-headed
- nausea
- flushing
- menopause/androgen deprivation Sx
Dopamine analogs
- bromocriptide
- cabergoline
- pergolide
uses of dopamine analogs
- hyperprolactinemia
- acromegaly
ADRs of dopamine analogs (6)
- HA
- light headed
- constipation
- nausea
- orthostatic hypotension
- fatigue
posterior pituitary analogs
oxytocin
vaspopressin
desmopressin
uses of oxytocin
- induce labor
- augument protracted labor
- control post-partum uterine hemmorage
ADRs of oxytocin
- fetal distress
- placenta abruption
- uterine rupture
- vasopressin stimulation (fluid retention, hypotension, & water intoxification
contraindications of oxytocin
- fetal distress
- pre-me
- abnormal fetus
- cephalopelvic disproportion
MOA of pituitary hormone analogs vasopressin & desmopressin
- increase cAMP in renal tubules
- increases water retention
- increase vWF and tPA
- decreases aPTT & BT
- increases BP
uses for vasopressin & desmopressin
- diabetes inspidious
- ACLS protocol (increase BP)
- esophageal or diverticular bleed
- hemophilia A
- von Willebrand’s disease
- DDAVP: nocturnal enuresis
SE of vasopressin and desmopressin
- HA
- nausea
- abdominal cramps
- agitation
- allergic rxn
contraindications of vasopressin and desmopressin
- hyponatremia
- seizures
- renal disease
- CAD
Synthetic thyroid supplements
- levothyroxine/Synthroid* (T4)
- liothyroxine (T3)
- liotrix (T4/T3)
desiccated thyroid
armour thyroid
natur-thyroid
anti-thyroid supplements
methimzazole
propylthiouracil
use of thyroid hormone supplements (T3, T4, desiccated)
hypothyroidism
monitoring TSH?
high TSH = low T3
low TSH = high T3
check 4-8 wks after dose change
ADRs of T3/T4/dessicated?
- hyperthyroidism
- cardiac (arrythmias, MI, angina)
- osteoporosis
- allergic rxn (desiccated)
when to use T3?
when T4 isn’t working = poor converter
anti-thyroid hormones
methimazole
propylthiouracil
MOA of methimazole & PTU
inhibit iodination & synthesis of thyroid hormone
PTU: blocks conversion of T4 to T3 in periphery
how long for methimazole & PTU to take max effect?
4-6 months
ADRs of methimazole and propylthiouracil?
- PTU: hepatotoxicity (baseline LFTs)
- agranulocytosis (baseline CBC, with fever, or pharyngitis)
- fetal hypothyroidism (with pregnancy)
- fever
- arthralgia/lupus-like symptoms
- rash
drugs that decrease hyperthyroidism symptoms
propanolol & nadolol
effects of propranolol & nodal on thyrotoxicosis
stops:
- palpitations
- tachycardia
- anxiety
- tremors
