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CLIN PHARM > II - Endocrine Small Animal > Flashcards

II - Endocrine Small Animal Flashcards

1
Q

________ hormones diffuse through cell membranes and work directly on the nucleus to regulate gene expression and resulting protein synthesis.

A

Steroid

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2
Q

______ hormones interact with cell membrane receptors and work through second messenger systems.

A

Peptide

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3
Q

Diabetes mellitus: what happens in dogs?

A

Combination of factors leads to irreversible beta cell destruction and lack of insulin production

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4
Q

Diabetes mellitus: what happens in cats?

A

combination of factors (including amyloid deposition) leads to either irreversible beta cell loss or more commonly, significant insulin resistance and beta cell dysfunction which can be reversible

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5
Q

Insulin stimulates what three things?

A

Glycogen synthesis
Lipolysis
Protein synthesis and storage

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6
Q

Insulin inhibits what three things?

A

Glycogenolysis
Lipolysis
Protein catabolism

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7
Q

What is the somogyi effect?

A

Insulin-induced hyperglycemia

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8
Q

Which species is more prone to forming antibodies to insulin?

A

Dogs

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9
Q

Insulin of choice for DKA, hyperkalemia
Shortest acting (1-2 hours)
Used in dogs and cats

A

Regular insulin - Humilin R, Novalin R

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10
Q

Insulin of choice for dogs
FDA approved for cats
Intermediate duration of action

A

Vetsulin, a porcine lente insulin
Shake thoroughly before drawing up!

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11
Q

Commonly used insulin for dogs if vetsulin is not an option
Can also be used in cats

A

NPH insulin, human recombinant:

Novolin-N, Humilin-N

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12
Q

Insulin typically used in dogs - NOT cats
More potent - canine insulin receptors four times more sensitive to this insulin than humans

A

Detemir (Levemir), a human recombinant, insulin analog

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13
Q

Most commonly used insulin for cats
Potentially long acting (12-24 hours)
Pens good for one month in refrigerated
Vials good for up to six month in refrigerator

A

Glargine (Lantus): human recombinant, insulin analog

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14
Q

Insulin FDA approved for cats
40 U/mL - use U-40 syringes
PZI insulin, human recombinant

A

ProZinc

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15
Q

2 oral hypoglycemic drugs

A

Acarbose - inhibits intestinal enzymes that convert starches to simple sugars which slows the digestion of carbs and delays glucose absorption; dogs with poor glycemic control with unknown cause

Glipizide - stimulates beta cell secretion of insulin; cats with type II DM

Caution with both: kidney and liver disease

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16
Q

Differentials for hypercalcemia

A

H - hyperparathyroidism (primary)
O - Osteolytic
G - granulomatous disease
S - spurious

I - idiopathic (cats), iatrogenic
N - neoplasia

Y - young
A - Addison’s disease (hypoadrenocorticism)
R - renal disease
D - Vitamin D toxicosis

17
Q

Differentials for Hypocalcemia

A

P = phosphate enemas
E = eclampsia
A = albumin decrease
C = chronic renal disease
E = Ethylene glycol toxicity/AKI

P = PTH deficiency
A = Acute pancreatitis
I = Intestinal malabsorption
N = Nutritional (vitamin D deficiency)

18
Q

Treatments for hypercaclemia

A
  1. Physiologic saline diuresis
  2. Furosemide
  3. Glucocorticoids
  4. Bisphosphonates
  5. Cinacalcet
  6. Calcitonin (exists)
19
Q

Hypercalcemia Tx MOA:

  • Corrects dehydration if present (dehydration reduces GFR)
  • Causes hemp concentration which increases relative calcium plasma concentrations
  • Decreases renal tubular calcium reabsorption; more calcium is excreted
A

Physiologic saline diuresis

20
Q

Hypercalcemia treatment MOA:

  • Inhibits the Na-K-2Cl symporter
  • inhibits calcium reabsorption in the thick ascending loop of Henle
A

Furosemide
* animal must be hydrated prior to use

21
Q

Hypercalcemia tx MOA:

  • reduce bone absorption
  • increase renal calcium excretion
  • decrease intestinal absorption of calcium
  • cytotoxic to neoplastic lymphocytes
A

Glucocorticoids
- prednisone
- prednisilone
- dexamethasone

  • delay use of these drugs until a dx of lymphoma has been established/ruled out
22
Q

Hypercalcemia tx MOA:

  • inhibits osteoclast activity and bone resorption
  • promotes apoptosis and inhibits osteoclastogenesis, angiogenesis, and cancer cell proliferation
  • generally slow acting
A

Bisphosphonates
- alendronate
- pamidronate (renal tox)
- zeledronate (only for dogs) (renal tox)

23
Q

Hypercalcemia tx MOA:

  • calcimimetic agent, increases the sensitivity of calcium-sensing receptors (on chief cells) to activation by extracellular calcium
  • triggers negative feedback and suppression of PTH release
A

Cinacalcet (Sensipar, Mimpara)

24
Q

Treatments for hypocalcemia

A
  1. Calcium gluconate 10% solution - emergency
  2. Calcium carbonate (Tums) - chronic
  3. Calcitriol - chronic
25
Q

Most common cause of chronic hypocalcemia

A

Hypoparathyroidism - lack of PTH production

Without PTH, vitamin D is not activated in the kidneys; intestinal absorption, bone release, and renal retention of calcium are reduced

26
Q

Adverse effects of this treatment for hypocalcemia include tissue mineralization.

A

Calcitriol - do not give to animals with Ca/Phos product >70

27
Q

Diabetes insipidus treatments

A

DDAVP (desmopressin acetate)
Thiazide diuretics (chlorothiazide, hydrochlorothiazide)

CLIN PHARM (13 decks)

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