Pharm 38 - Drug List Flashcards

1
Q

○ Synthetic steroid with a structure identical to cortisol

○ Has glucocorticoid (major) and mineralocorticoid (minor) effects

A

Hydrocortisone

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2
Q

Hydrocortisone use

A

§ Primary oral use: adrenal insufficiency

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3
Q

Name other glucocorticoids

A

dexamethasone

prednisone

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4
Q

Why is hydrocortisone preferred over other glucocorticoids

A

Harder to titrate exact doses (to have the lower doses) that are needed to mimic physiologic cortisol levels - thus prefer hydrocortisone

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5
Q

Mineralocorticoid drug

A

Fludrocortisone

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6
Q

Designed to increase blood pressure and provide electrolyte support common in adrenal insufficiency

A

Fludrocortisone

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7
Q

§ USE: Prevents/treats:
□ Sodium loss
□ Vascular volume depletion
□ Hyperkalemia

A

Fludrocortisone

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8
Q

Fludrocortisone ADE

A

Similar to what happens with too much aldosterone:

□ Hypertension 
□ Edema
□ Cardiac enlargement 
□ Hypokalemia
□ Hypernatremia
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9
Q

Pharmacological thyroid hormones should be taken…

A

first thing in the morning at least 30-60 minutes before breakfast

4+ or more from GI medications that are cations

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10
Q

Common ADE of thyroid supplementation

A
○ Occur far more with T3 than T4
§ Can also occur if T4 dose is too high
○ Tachycardia
○ Angina
○ Tremors
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11
Q

MC used thyroid supplement

A

levothyroxine sodium (inactive T4)

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12
Q

thyroid supplement that causes far worse ADE of tachycardia, angina, tremors

A

Liothyronine

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13
Q

○ Original thyroid hormone product
§ A natural ground up porcine thyroid hormone
§ Combo of both T3 and T4

A

“Thyroid USP” or Dessicated Porcine Thyroid Extract

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14
Q

Thyroid synthesis inhibitors (2)

A
  1. Propylthiouracil (PTU)

2. Methimazole

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15
Q

Propylthiouracil (PTU) dosing and duration to effect

A

§ Short 1/2 life with TID dosing

§ Full benefits may take up 6 to 12 months

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16
Q

Propylthiouracil (PTU) use

A

Moderate to severe hyperthyroidism

17
Q

Propylthiouracil (PTU) ADE

A

§ Agranulocytosis
§ Not always able to establish a “euthyroid” state
□ May lead to hypothyroidism after 6 to 12 months of use
§ Concerns in pregnancy and lactation
§ Can cause severe liver damage
§ Readily cross placenta and is category D

18
Q

§ Agranulocytosis
§ Not always able to establish a “euthyroid” state
□ May lead to hypothyroidism after 6 to 12 months of use
§ Concerns in pregnancy and lactation
§ Can cause severe liver damage
§ Readily cross placenta and is category D

A

Propylthiouracil (PTU) ADE

19
Q

Methimazole dosing and time to effect

A

§ Once daily dosing

§ Takes 3 to 12 weeks for euthyroid state

20
Q

Methimazole use

A

§ Moderate to severe hyperthyroidism

§ Adjunct therapy to thyroid irradiation

21
Q

Methimazole ADE

A

§ MORE dangerous than PTU in first trimester of pregnancy and lactation
§ Agranulocytosis
§ Readily cross placenta and is category D

22
Q

§ MORE dangerous than PTU in first trimester of pregnancy and lactation
§ Agranulocytosis
§ Readily cross placenta and is category D

A

Methimazole ADE