PHARM 2

Question 1

Iodine pathway?

Answer 1

iodine–>ox to I2 (iodide) inside > ox by perox to make thyroglobulins and incorporated into MIT/DIT > T3 (active) and T4, deiodinase conv T4 to active T3

Question 2

amount of iodine needed per day?

Answer 2

150 mg

Question 3

Hypothyroidism (eg Hashimoto’s) sx

Answer 3

puffiness around eyes, autoimm, may or may not have goiters, can be from iodine deficiency, decreased met, thick skin/enlarged joints (example had fatigue and thinning hair)

Question 4

Levothyroxine Sodium (T4)
MOA

Answer 4

Converts T4 to active T3 via diodinase, T3 binds to R’s and alters gene expr and incr prots and stuff, so incr O2 consumption and incr BMR and met
-This T4 is the drug of choice for chronic hypothy tx!

Question 5

Levothyroxine Sodium T4 SxE and CxI

Answer 5

Nervousness, anxiety, heat intelorence, wt loss, arr (etc, things rel to T4 lvls)
CxI- given once daily bc long half life, met by P40 so interacts with phenytoin, rifampin, carbamezepine

Question 6

Some p450 drugs that stuff can interact with?

Answer 6

phenytoin, rifampin (abx) and carbamezepine

Question 7

Graves

Answer 7

hyperthyroidism (opp of hashimotos)

Question 8

Drugs for treating Hyperthyroidism

Answer 8

Methamazole, carbamiazole (Thioamides)

PTU

Question 9

Tx of thyroid storm

Answer 9

Propanolol
Potassium Iodide
Radioactive Iodine-131
and PTU!

Question 10

Methamizole

MOA

Answer 10

tx for hyperthyroidism (thioamide)
-prevents TH synth by inhibiting thyroid perox rxns and blocking iodine organification (similar to PTU but PTU also blocks diodinase D1 that conv T4 to T3)

Question 11

Methimazole sxe and cxi

Answer 11

AGRANULOCYTOSIS, maculopap rash, hep/chol jaundice

-cxi in preg/nursing, can cause fetal harm

Question 12

PTU (propylthiouracil)
MOA
use

Answer 12

prevents TH synth by inhib perox rxns n blocking org

• ALSO blocks coupling of iodotyrosines, and inhibs diodination of T4 conv to T3
• use for thryoid storm IV (in large doses)

Question 13

PTU sxe

Answer 13

RASH, agrnulocytosis, edema, hep/chol jaundice (same as methamazole)

Question 14

Potassium iodide

MOA

Answer 14

inhibs thryoid hormone release from gland, within hours, and inhibits perox (to decr TH synth), but WEARS OFF in a few weeks

Question 15

Radiactive Iodine-131

use/moa

Answer 15

inc into storage follicles, used for THRYOTXICOSIS (excess thyroid hormone which is multinodular) and toxic adenomas

Question 16

radioactive iodine 131 sxe and cxi

Answer 16

SxE: DELAYED HYPOTHYROIDISM
CxI: preg

Question 17

most tx for hyperthyroidism are cxi in?

Answer 17

pregnancy!

Question 18

Tx for primary and secondary syphilis

Answer 18

Benzanthine penecillin G single dose (2.4 mill units)

Question 19

alternative tx for 1 and 2 syphilis

Answer 19

doxy 2wk, or desensitize then give pcn

Question 20

tertiary syphilis tx (early vs late latent)

Answer 20

early latent <1 yr give benzathine pcn G single dose, for late latent/unknown give 3 x (1x per week) of same

Question 21

neurosyphilis tx

Answer 21

aqueous crystaline pcn G 2wk, then tx for late latent syphilis with benzathine pcn g (usual)

Question 22

neurosyphilis alternate

Answer 22

procaine pcn IM daily + oral probenecid, then tx late latent

Question 23

gonorrhea tx

Answer 23

IM CEFtriazone single dose + azithro oral single dose

Question 24

pharyngeal gonorrhea tx

Answer 24

CEFTRIAXONE

Question 25

alt tx for gonorrhea if no cef avail

Answer 25

tx with CEFIXIME oral single dose / azithro

Question 26

chalmydia tx

Answer 26

azithro (oral, single dose, BEST)
OR doxy (oral bid for 1wk)

Question 27

alternatives for chlamydia tx

Answer 27

erythro, erythro ehtylsuccinate, levofloxacin, ofloxacin

Question 28

types of IM depository preparations of pcn?

Answer 28

procaine pcn G (not used much anymore, 1x day)

benzathine pcn G (drug of choice, t1/2 longer, for days, and only need once a week) for chronic

Question 29

main syphilis test?

Answer 29

RPR (rapid plasma reagin)

Question 30

primary syphilis sx

Answer 30

chancre (ulcer) at site of infx (eg genetalia, mouth), usu nontender, MAY have lymphad

Question 31

secondary syphilis sx

Answer 31

chancre remission, org spreads so rash on palms and soles, alopecia, lymphad, MAY have menin

Question 32

tertiary syphilis sx

Answer 32

quarter of ppl with latent get this, involves CV and neuro issues (incl eye/visual issues)

Question 33

latent syphilis

Answer 33

spirochete is dormant, RPR positive but no sx

Question 34

alternative tx for teritary syphilis? (if non-neuro)

Answer 34

doxy

Question 35

exception to using doxy as alternative of tertiary syphilis?

Answer 35

if pregnant (or poor compliance), in which case do densisitization

Question 36

why would doxy be cxi in preg?

Answer 36

stained teeth, bone issues in fetus

Question 37

what skin issues would hpv show?

Answer 37

genital ulcers/warts

Question 38

gonorrhea sx?

Answer 38

burning and cloudy discharge (but no genital lesions)

Question 39

structure and gram stain of gonorrhea?

Answer 39

gram neg diplococci (tiny pink speckles)

Question 40

treat which two sti’s at same time?

Answer 40

gonorrhea and chlamydia

Question 41

which med is no longer recommended for GC infx?

Answer 41

cipro bc incr resistance

Question 42

which heart drug can cause hypothyroidism?

Answer 42

amiodarone!

Question 43

PTU vs methamizole?

Answer 43

methamizole has longer duration of action and fewer side effects, PTU better if preg or thyroid storm