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REGUB > L30: Agents to Treat Endocrine Disorders > Flashcards

L30: Agents to Treat Endocrine Disorders Flashcards

1
Q

What radioactive iodine isotope is used for imaging of the thyroid to see if hyperthyroidism is present?

A

123 Iodine

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2
Q

What is the use of 123 Iodine in hyperthyroidism?

A

used for radioactive imaging of the thyroid

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3
Q

What are the 3 main treatment options for treating hyperthyroidism?

A
  1. Radioactive Iodine
  2. Surgery (subtotal or total)
  3. Thioureylenes
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4
Q

What radioactive iodine isotope is used to reducing the level of thyroid hormone in hyperthyroidism?

A

131 Iodine

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5
Q

How does 131 Iodine work in treating hyperthyroidism?

A
  • radioactive isotope taken up and incorporated into thryoglobulin
  • emits gamma + beta rays
  • exerts cytotoxic action (kills cells)
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6
Q

What are some side effects of 131 iodine?

A
  • hypothyroidism

- nausea

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7
Q

What is the MOA/effect of thioureylenes in the treatment of hyperthyroidism?

A

reduces the levels of thyroid hormones

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8
Q

What are thioureylenes? Give 3 examples

A
  • used to treat hyperthyroidism
  • reduces the levels of thyroid hormones
  1. Carbimazole
  2. Methimazole
  3. Propylthiouracil
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9
Q

What class of drugs do Carbimazole and Methimazole belong to? What is their MOA?

A

Thioureylenes: used to treat hyperthyroidism

MOA = inhibits thyroperoxidase

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10
Q

What class of drugs does Propylthiouracil belong to? What is its MOA?

A

Thioureylenes: used to treat hyperthyroidism

MOA = inhibits thyroperoxidase + inhibits enzyme 5’-deiodinase

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11
Q

What is the function of the enzyme 5’-diodinase in thyroid hormone production?

A

converts T4 to its active form, T3

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12
Q

List some of the adverse effects of thioureylenes

A
  • granulocytopenia*
  • skin rash; itching
  • hair loss
  • upset stomach
  • loss of taste
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13
Q

List 2 adjunctive therapies that may be given to help treat the symptoms of hyperthyroidism. Explain what each treats

A
  1. Beta-Adrenoceptor Antagonists
    - treats tremors, palpitations, heat intolerance, nervousness
    - e.g. Propranolol
  2. Corticosteroids
    - anti-inflammatory
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14
Q

Give an example of a beta-adrenoceptor antagonist that may be used as adjunctive therapy for hyperthyroidism

A

Propranolol

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15
Q

What is the treatment/medication given to treat hypothyroidism?

A

Synthetic Thyroxine Derivative

- e.g. Levothyroxine, Liothyronine

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16
Q

List some adverse effects of synthetic thyroxine derivatives which are given to treat hypothyroidism

A
  • palpitations
  • nervousness
  • headache
  • difficulty sleeping
  • swelling of legs + ankles
  • weight loss + increased appetite
17
Q

In hyperparathyroidism, what will happen to the state of a patient’s bones?

A

increase PTH = increased serum calcium

- leads to osteoporosis (brittle bones)

18
Q

In hypoparathyroidism, what will happen to the state of a patient’s bones?

A

decrease PTH = decreased serum calcium

- leads to osteomalacia (soft bones)

19
Q

Osteoporosis occurs due to which parathyroid pathology?

A

hyperparathyroidism

20
Q

Osteomalacia occurs due to which parathyroid pathology?

A

hypoparathyroidism

21
Q

What are the 2 main treatment options for treating hyperparathyroidism?

A
  1. Surgery

2. Drug Therapies (Calcimimetics, Bisphosphonates, Calcitonin)

22
Q

What is the treatment of choice (first line treatment) of hyperparathyroidism?

A

Surgery

23
Q

What are calcimimetics? What are they used for?

A
  • used for hyperparathyroidism
  • mimics calcium circulating in blood to trick parathyroid to not produce PTH

e.g. Cinacalcet

24
Q

What is Cinacalcet? What is it used for?

A

Calcimimetic - used to treat hyperparathyroidism

25
Q

What are bisphosphonates? What are they used for?

A
  • used for hyperparathyroidism
  • inhibits recruitment of osteoclasts (stops bone breakdown)

e.g. Alendronate, Risedronate

26
Q

What are Alendronate and Risedronate? What are they used for?

A

Bisphosphonates

- used for hyperparathyroidism

27
Q

What is calcitonin used for? How does it work? How is it typically given?

A
  • used for hyperparathyroidism
  • directly inhibits osteoclasts by binding to and inhibiting the calcitonin osteoclast receptor (CtR-Gs)
  • given via IV
28
Q

List 3 classes of drugs that may be given to treat hyperparathyroidism

A
  1. Calcimimetics
  2. Bisphosphonates
  3. Calcitonin
29
Q

What adjunctive therapy may be given to help treat the symptoms of hyperparathyroidism?

A 
simple analgesics (NSAIDs, ibuprofen, aspirin)
- these will treat pain only
30
Q

List the 3 possible treatments for hypoparathyroidism

A
  1. Calcium Salts
  2. Vitamin D
  3. Teriparatide
31
Q

What are Calcium Salts? What are they used for?

A
  • used in hypoparathyroidism
  • replaces calcium in the body
  • oral solution (NOT IM)
32
Q

Why can’t calcium salts be given intramuscularly?

A

this will cause extreme contraction of the muscle at te site which is painful

will also cause cell death - necrosis

33
Q

List the side effects of calcium salts, a treatment for hypoparathyroidism

A
  • constipation
  • chronic kidney disease
  • kidney stones
34
Q

Why is vitamin D used to treat hypoparathyroidism?

A
  • promotes calcium absorption in the intestines

- strengthens bones

35
Q

List some side effects of vitamin D, a treatment for hypoparathyroidism

A
  • allergic skin reactions from build-up of calcium in arteries
  • changes in cholesterol levels
  • daytime sleepiness
36
Q

What is Teriparatide? What is it used to treat?

A
  • used to treat hypoparathyroidism
  • prefilled pen (thigh/abdomen)
  • recombinant form of PTH
  • stimulates bone formation + strengthens bone
37
Q

What is the 1 major adverse effect of teriparatide, a drug that is used to treat hypoparathyroidism

A

osteosarcoma

38
Q

What are 2 contraindications of using Iodine-131?

A
  • pregnancy

- severe Graves’ opthalmopathy

REGUB (22 decks)

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