Exam 4 Thyroid Hormone Flashcards
graves dx
Ab activating thyroid
primary hypothyroid
thyroid
secondary hypothyroid
pituitary
tertiary hypothyroid
hypothalamus
protirelin
thyroid hormone related drug. sensitive to TSH assay.
thyrotropin alfa
thyroid hormone related drug. used in thyroid CA, to stim radioactive iodine uptake
levothyroxine (T4)
some metabolized to T3, activates thyroid hormone receptors, feedback inhibits TSH release and or TRH release. Used for replacement, prevent cretinism, after thyroid removal, TSH suppression (reverse goiter).
thionamides general MOA
anti-thyroid. inhibition of thyroid peroxidase, inhibition of 5-deiodinase. used for thyrotoxicosis, graves
iodides (KI or Lugols solution) general MOA
anti-thyroid. inhibit thyroid hormone synthesis by blocking organification/thyroglobulin proteolysis also supplies iodine for thyroid hormone synthesis. used for thyroid store or iodine def.
radioactive iodides
taken up by thyroid and irradiates thyroid gland. used for thyrotoxicosis.
adult hypopituitarism
caused by tumor or hypophysectomy. causes atrophy of gonads, supp lactation, loss of libido, sensitive to stress, hypoglycemic.
kids hypopituitarism
caused by poor dvmt during embryogenesis. causes dwarfism, no sex dvmt, thyroid and adrenal hypoactivity. therapy usually only GH for effect on blood sugar
hyperpituitarism
caused by pit tumor. causes acromegaly, goiter, cushings, lactation. treat with sx
PTH
primary reg of Ca. secreted when Ca low. expression inhibited by VitD. activates osteoclasts. net increase Ca and decrease phos.
CT (calcitonin)
secondary regulator of Ca, produced in thyroid, secreted when Ca high. inactivates osteoclasts. net effect decrease Ca and decrease phos.
VitD
net effect increase Ca and increase in phos
osteoclast
Ca and phos high in plasma
osteoblast
Ca and phos low in plasma-moving into bone
secondary hyperparathyroidism
renal failure, use sensipar which lowers PTH
calcium acetate, calcium gluceptate/gluconate
supp serum Ca. used for any low Ca, tetany or osteoporosis.
ergocalciferol, cacliferol, calcitrol, dihydrochysterol
supplies agonist for vitD receptor to increase Ca in from gut, decrease secretion in kidney, stim osteoclast and suppress PTH secretions which decreases bone resorption. used for hypoCa, rickets or osteoporosis.
cinacalcet (sensipar)
increase sensitivity of Ca sensing receptors (CaR) on parathyroid cells that secrete PTH to reduce PTH medication resorption of bone. for hyperCa from parathyroid Ca or secondary hyperparathyroidism d/t CKD.
PTH (natpara), teriparatide (forteo)
supplies body with PTH agonist which decrease Ca excretion by kidney, stim osteoclast. used for vitD and Ca supplements for hypoparathyroidism. forteo only for osteoporosis
hyperCa
caused by hyperparathyroid usually tumor, lymphoma that secretes XS vitD. feel tired, thirsty, weak, arryth.
Na3PO4, EDTA, sensipar, bisphosphonates, calcitonin, gallium
tx hyper Ca
osteoporosis
Ca or protein leeched from bone. tx with increase in plasma Ca (teriparatide) OR decrease resorption with bisphosphonates, denosuma, calcitonin
Pagets Dx
abnormal XS bone remodeling. tx with bisphosphonates, calcitonin
inhibit bone resorption by raising Ca with
supp, vitD, teriparatide
inhibit bone resorption by lowering PTH with
cinacalcet, gallium
inhibit bone resorption by inhibiting osteoclasts with
bisphosphonates, calcitonin, denosumab
alendronate, risedronate, etidronate, tiludronate, pamidronate, zoledronate, ibandronate sodium
inhibit osteoclasts. used for hypercalcemia, osteoporosis, pagets dx.
Denosumab
binds receptor activator of nuclear factor kappa beta ligand to prevent activation of RANK, expressed on osteoclasts and activated T&B cells. used for osteoporosis, prevention of skeletal related events with bone mets from solid tumors.
Calcitonin
inactivate osteoclasts and increases Ca excretion at the kidney through CT receptor. used for pagets dx, hyperCa, osteoporosis.
Gallium nitrate
pagets dx, Ca related to hyperCa
