Exam 2: Endocrine drugs Flashcards
What is the goal of therapy of hypothyroidism in dogs>
Replace hormone the body is not producing
How is levothyroxine typically dosed>
mg/kg
How is levothyroxine dosed in large dogs
mg/m^2
How do you monitor Levothyroxine levels ind dogs
Measure T4 levels
What is the goal of thearapy of Hyperthyroidism in cats
Stop excessive hormone production
What are the 4 therapy options for tx of hyperthyroidism in cats
- Sx
- Radioactive iodine
3 Diet - Methimazole
What is the MOA of methimazole
Inhibit thyroid hormone synthesis
C/S of acute hypocalcemia
- Tremors
- Pawing at face
- Flaccid paralysis
- Seizures
What is an example of acute hypocalcemia in cows
Milk fever/eclampsia
What is the therapeutic goal of acute hypocalcemia
replace the calcium deficit until the patient can catch up
What are the 2 options for tx of acute hypocalcemia
- Ca Gluconate
2. Ca Chloride
Which tx option of acute hypocalcemia can never be given SQ or IM due to its caustic nature
Ca Chloride
T/F. Ca Gluconate should be diluted if given SQ
T
Why must you monitor Ca administration with ECG
Can cause arrhythmias if given too quickly
What are the 2 tx options for Chronic Hypocalcemia (Hypoparathyroidism)
- Ca Carbonate
2. Ca Propionate
_____ results in inability of the body to convert Vit. D to its active form (calcitriol)
Hypoparathyroidism
The most potent, activated form of Vit. D
Calcitriol
What is the best choice for parenteral tx of acute hypocalcemia?
Ca Gluconate
Mobilizes glucose from liver stores
Glucagon
What is the primary goal of therapy for DM?
Address the insulin deficiency, not just to bring down the blood glucose
Produced by the beta cells in the islets of langehans in the endocrine pancrease
Insulin
What are the 3 categoris of insulin
- Short- acting
- intermediate -acting
- Long- acting
What type of inlsulin in in the short acting category
Regular insulin
WHat is regular insulin used for?
hospitalized patients
What is the only type of insulin that can go IV
Regular
What type of insulin is in the intermediate category
NPH
What is added to intermediate insulin that delays absorption to extend clinical effect
Zinc
What type of insulin is in the long acting category
PZI
Oral medication used to tx Diabetes in cats
Glipizide
What are the 2 types of corticosteroids?
- Glucocorticoids
2. Mineralcorticoids
Where are Glucocorticoids produced
Zona Fasiculata
Where are Mineralcorticoids produced?
Zonaglomerulosa
What is the endogenous hormone of Glucocorticoids
Cortisol
What is the goal of Glucocorticoids
suppress IR Inc. Ca excretion Dec. fever Allergies Anti-inflam
What dz. does Glucocorticoid tx treat?
Hypoadrenocorticism
What are the 4 Glucocorticoids?
- Prednisone
- Dexamethasone
- Triamcinolone
- Methylprednisolone
What are thee 4 clinical uses of Glucocorticoids?
- Diagnostic testing
- Physiologic replacement therapy
- Anti-inflam
- Immunosuppressive
What are the 2 salt esters that can be added to glucocorticoids to inc. stabilization
Succinate and phosphate
What are the 3 insoluble esters that can be added to glucocorticoids to inc. stabilization?
Pivalate
Acetate
acetonide
What makes glucocorticoids suitable for Iv admin?
succinate and phosphate
T/F. Na succinate and Na phosphate offers a faster onset and longer duration to glucocorticoids
F. onset is faster, but duration is unchanged
Sodium phsphate is known as:
Dexamethasone
Sodium succinate is known as: Methylprednisolone
Methylprednisolone
which glucocorticoid has the longest duration of effect? which has the Shortest?
Longest: Triamcinolone
Shortest: Prednisolone
What are the 2 mineralocorticoids
- DOCP
2. Fludrocortisone
What is the Endogenous hormone of mineralocorticoids
Aldosterone
What do mineralocorticoids do?
Regulate Na retention and K excretion by the kidney
cushings Dz
Hyperadrenocorticism
Addison’s Dz
hypoadrenocorticism
What are the 2 ways you can develop cushings Dz
- Adrenal cortex mass
2. Pituitary mass
Cytotoxic to adrenal fasciculata cells
Mitotane
T/F. when using Mitotane you should start with a low dose and gradually inc. it?
F. start with high dose and gradually lower
How do you monitor Mitotane?
ACTH stim test
What is the MOA of Trilostane?
Inhibits enzymes of the cortisol production pathway
Most commonly used drug to tx cushing’s dz
Trilostane
How do you monitor Trilostane
ACTH Stim
What is the moa of Ketoconazole?
inhibit enzymes in the steroid synthesis pathway
What two drugs target the anterior pituitary in Cushings tx
- Pergolide
2. Selegiline
What is the moa of pergolide
Dopamine agonist, suppress production of ACTH
What does Peroglide tx in horses
PPID (pituitary Pars intermedia dysfuncion)
What is the moa of selegiline
Inhibits MAO-B which inc. dopamine
What drug can you use to tx ccd
Selegiline
what are the 2 types of Addison’s Dz
- Typical
2. atypical
What is typical addison’s dz?
Lacking both glucocorticoids and mineralocorticoids
how do you tx typical addison’s
prednisone and either DOCP or Fludrocortisone
what is Atypical addison’s
Lacking only glucocorticoids
How do you Tx atypical addison’s
Prednisone
Sodium ____ is an excipient that will make glucocorticoid soluble but will not alter its duration of action
Succinate
A hormone that inc. blood glucose through its action on the liver
Glucagon
____ and vetsulin are both intermediate acting insulin types
NPH
Ca ____ should only be given IV due to its irritating nature
Chloride
An oral anti-diabetic drug that can be used in cats
Glipizide
Pergolide is uded in horse to tx PPID b/c it is an agonist at _____ receptors
Dopamine
PZI, glargine and detemir are all considered _____ acting
Long
This drug blocks 3-B hydroxysteroid dehydrogenase in the adrenal gland, reducing cortisol production
Trilostane
The specific protein carrier for glucocorticoids?
Transcortin
Detemir is _x more potent than other insulins when used in dogs
4
DOCP and Fludrocortisone are used to minic the effects of this endogenous hormone
Aldosterone
The most potent form of vit D. used in tx of hypoparathyroidism
Calcitriol
Veterinary and human insulins have diff _____
Concentration
If giving dextrose as a contiuous infusion, conc. greater than 5% can lead to ____
Phlebitis (irritation)
Felimazole and Tapazole are products which contain the active ingredient
Methimazole
This drug is cytotoxic to the faciculata cells of the adrenal cortex
Mitotane
_____ insulin is the shortest acting and can be given IV
Regular
Glucocorticoids, phenobarbital, quinidine, and certain other durgs can alter ____ values on labwork.
Thyroid
Overdosing levothyroxine chronically can lead to this
Thyrotoxicosis (excessive T4)