L 38 Osteoporosis and Thyroid

Question 1

Levothyroxine sodium (Synthroid)

Answer 1

Essentially T4–converted to T3 peripherally
DOC for hypothyroidism
Carefully titrated to each individual

Question 2

Liothyronine sodium (Cytomel)

Answer 2

T3 used for initial therapy of hypothyroidism because faster onset until maintenance with Levothyroxine started

Question 3

Grave’s disease

Answer 3

Antibodies to TSH receptor

Causes increased gland stimulation and lots of thyroid hormones

Question 4

Thioamides

Answer 4

Decrease synth and release of T4

First line for Grave’s disease

Question 5

Propylthiouracil (PTU)

Answer 5

Treatment for hyperthyroidism

Not used because of severe liver injury

Question 6

Methimazole (Tapazole)

Answer 6

DOC for hyperthyroidism unless allergic or pregnant then PTU is used

Question 7

Iodide

Answer 7

Causes rapid decrease of synth and release of thyroid hormones
Only lasts for 2-8 weeks
Used for surgery to contract gland and devascularize it
Decreases thyroid storm

Question 8

Calcitonin (Miacalcin)

Answer 8

Calcitonin from salmon
Injected or nasal
For osteoporosis
Prevents resorption

Question 9

Teriparatide (Forteo)

Answer 9

Recombinant PTH
When administered intermittently it favors the growth of bone–only drug to do that
Actions decrease with time and can only be used 1-2 years

Question 10

Denosumab (Prolia)

Answer 10

Ab to RANK-L
Inhibits bone resorption
Injection once/6 months
Causes osteonecrosis of the jaw

Question 11

Alendronate (Fosamax)

Answer 11

Bisphosphanate
DOC for osteoporosis
Incorporated into bone instead of Phosphate and cannot be removed

Question 12

Bisphosphonates

Answer 12

Oral: Alendronate, Risedronate, Ibandronate, Etidronate

IV: Etidronate, Pamidronate, Zoledronic acid

IV versions can cause renal toxicity if given too fast

Question 13

Cinacalet (Sensipar)

Answer 13

Calcimimetic used to inhibit release of PTH in kidney disease and hyperparathyroidism