Exam 2: Endocrine drugs Flashcards by Victoria Smith

What is the goal of therapy of hypothyroidism in dogs>

Replace hormone the body is not producing

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How is levothyroxine typically dosed>

mg/kg

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How is levothyroxine dosed in large dogs

mg/m^2

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How do you monitor Levothyroxine levels ind dogs

Measure T4 levels

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What is the goal of thearapy of Hyperthyroidism in cats

Stop excessive hormone production

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What are the 4 therapy options for tx of hyperthyroidism in cats

Sx
Radioactive iodine
3 Diet
Methimazole

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What is the MOA of methimazole

Inhibit thyroid hormone synthesis

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C/S of acute hypocalcemia

Tremors
Pawing at face
Flaccid paralysis
Seizures

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What is an example of acute hypocalcemia in cows

Milk fever/eclampsia

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What is the therapeutic goal of acute hypocalcemia

replace the calcium deficit until the patient can catch up

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What are the 2 options for tx of acute hypocalcemia

Ca Gluconate

2. Ca Chloride

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Which tx option of acute hypocalcemia can never be given SQ or IM due to its caustic nature

Ca Chloride

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T/F. Ca Gluconate should be diluted if given SQ

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Why must you monitor Ca administration with ECG

Can cause arrhythmias if given too quickly

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What are the 2 tx options for Chronic Hypocalcemia (Hypoparathyroidism)

Ca Carbonate

2. Ca Propionate

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_____ results in inability of the body to convert Vit. D to its active form (calcitriol)

Hypoparathyroidism

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The most potent, activated form of Vit. D

Calcitriol

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What is the best choice for parenteral tx of acute hypocalcemia?

Ca Gluconate

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Mobilizes glucose from liver stores

Glucagon

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What is the primary goal of therapy for DM?

Address the insulin deficiency, not just to bring down the blood glucose

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Produced by the beta cells in the islets of langehans in the endocrine pancrease

Insulin

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What are the 3 categoris of insulin

Short- acting
intermediate -acting
Long- acting

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What type of inlsulin in in the short acting category

Regular insulin

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WHat is regular insulin used for?

hospitalized patients

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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?

1. 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?

1. Prednisone 2. Dexamethasone 3. Triamcinolone 4. Methylprednisolone

What are thee 4 clinical uses of Glucocorticoids?

1. Diagnostic testing 2. Physiologic replacement therapy 3. Anti-inflam 4. 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

1. 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

1. 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

1. 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

1. 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

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)