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Pharmacology > Pharm Quiz 5 - Moore TS > Flashcards

Pharm Quiz 5 - Moore TS Flashcards

1
Q

In the hypothalamic pituatary thyroid axis, what is secreted by each?

A

Hypothalamus - TRH
Ant. Pituatary - TSH
Thyroid - T3, T4

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2
Q

Thyroid hormone has negative feedback on what?

A

both TRH and TSH release

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3
Q

What is thyroid hormones backbone?

A

2 tyrosine molecules with ether linkage (MIT: 1 iodine, DIT: 2 iodines)

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4
Q

What linkages form T3?

A

DIT + MIT

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5
Q

What molecule is formed by DIT + MIT?

A

rT3

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6
Q

What linkages form T4?

A

DIT + DIT

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7
Q

What is the main thyroid hormone secreted by thyroid gland?

A

T4 (thyroxine)

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8
Q

What enzyme catalyzes T4 into T3?

A

Iodothuronine 5’ deiodinase

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9
Q

How do the three types of Iodothronine 5’ deiodinase differ? (action and location)

A

type 1 - serum in liver and kidneys
type 2 - intracellular (pituatary, brain, fat)
type 3 - converts T4 to rT3

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10
Q

What is the half life of T3 and T4 in humans and dogs?

A

human T3 - 1 day
dog T3- 5-6 hours
human T4- 6 days
dog T4 - 8-16 hours

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11
Q

Why do thyroid hormones in humans have longer half life?

A

more thyroid hormone bound to proteins, less degradation

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12
Q

What percent of T3 is from T4?

A

80%

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13
Q

Which thyroid hormone has greatest activity? by how much?

A

T3 has 4x activity of T4

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14
Q

What is the role of rT3?

A

no activity

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15
Q

What are the 3 proteins that bind to thyroid hormones?

A

Thyroxine binding pre-albumin
Albumin
TGB

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16
Q

What protein do humans have 3 times as much of compared to dogs?

A

TGB (thyroxine binding globulin)

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17
Q

What are the % thyroid hormones protein bound in humans and dogs?

A

Human T3: 99.8%
Human T4: 99.98%
Dog T3: 99%
Dog T4: 99%

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18
Q

What is cretinism?

A

thyroid deficiency - retarded dwarf

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19
Q

What are the calorgenic effects of thyroid hormone?

A

increased metabolism, increased body temp

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20
Q

Why does a hypothyroid dog have high serum cholesterol?

A

decreased lipolysis(?) and bile secretion

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21
Q

How would low thyroid levels affect the skin?

A

follicle atrophy, bilateral alopecia, myxedema, tragic face

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22
Q

How does low thyroid cause facial nerve paralysis?

A

decreased conduction velocity in CNS

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23
Q

What are GI signs of hypothyroidism?

A

decreased motility

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24
Q

What are the repro effects of hypothyroidism?

A

male - testicular atrophy

female - irregular cycles, abortion

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25
Q

What causes primary hypothyroidism? How many % of cases?

A

Lymphocytic thyroiditis (95%)

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26
Q

What causes secondary hypothyroidism? How many % of cases?

A

destruction of thyrotrophs in pituatary by tumor (5%)

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27
Q

Which replacement thyroid hormone is used in dogs?

A

T3 (L-thyroxine)

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28
Q

Serum T4 levels should be checked how often in patients on Thyroxine?

A

1-2x per year

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29
Q

What is the most common cause of hyperthyroidism in cats?

A

thyroid adenoma

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30
Q

How does methimazole decrease thyroid synthesis?

A

inhibits peroxidase (iodination and coupling of thyroglobulin)

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31
Q

Why would it be a good idea to reversibly treat hyperthyroidism initially? (using methimazole)

A

in case kidneys cant handle decreased BP

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32
Q

What does the blood work of a hypothyroid dog look like?

A

normocytic, normochromic, non regen anemia, hypercholesteremia

33
Q

What are the discharge instructions for cats treated with radioiodine?

A

special handling of feces and urine

keep away from pregnant women and children

34
Q

What are some concerns with surgical thyroidectomy?

A

parathyroid gland

35
Q

What kind of drug can alleviate some of the symptoms of hyperthyroidism?

A

beta blockers

36
Q

What do alpha, beta, and delta cells secrete? effect on glucose levels?

A

alpha: glucagon - increase
beta: insulin and amylin –>decrease
delta: somatostatin

37
Q

What glucose transporters is in all mammalian tissue?

A

GLUT 1and GLUT 3

38
Q

What glucose transporter is in the liver and pancreas B cells?

A

GLUT 2

39
Q

What glucose transporter is located in muscle and fat cells?

A

GLUT 4

40
Q

What glucose transpporter is in small intestines?

A

GLUT 5

41
Q

What happens to beta cells when they are stimulated?

A

depolarized

42
Q

What are the 4 stimulators of insulin secretion?

A

glucose, AA, fatty acids, GI hormones

43
Q

What are the 2 inhibitors of insulin secretion?

A

somatostatin

alpha 2 agonists

44
Q

What causes the central form of diabetes insipidus?

A

decreased ADH from posterior pituatary

45
Q

What causes the nephrogenic form of diabetes insipidus?

A

cells in kidney cant respond to ADH

46
Q

What defines type 1 diabetes?

A

insulin dependent, doesnt produce insulin

47
Q

What defines type 2 diabetes?

A

insulin resistance - cats

48
Q

What are the steps in ketoacidosis?

A

insulin deficiency –>metabolism of triglycerides/muscle –>FFA –>ketones

49
Q

What are normal blood glucose levels?

A

80-120 mg/dl

50
Q

What are 2 consequences of chronic hyperglycemia?

A

glycated proteins – nerve and bv damage

neural and ocular damage (sorbitol)

51
Q

What is the diet recommended for dogs with diabetes? cats?

A

dog - high fiber, complex carbs

cat - high protein, low carbs

52
Q

Which insulin type can be given to cats to put them in remission from diabetes?

A

Glargine insulin

53
Q

What is insulins effect on carb metabolism?

A

increase glucose uptake/glycogen synthesis
increased glycolysis
decreased gluconeogenesis

54
Q

How does insulin effect fat metabolism?

A

increased storage, increased lipogenesis, decreased lipolysis

55
Q

How does insulin effect protein metabolism?

A

increased AA uptake, synthesis and decreased degradation

56
Q

What receptor is associated with glucose uptake in fat cells?

A

tyrosine kinase receptor

57
Q

How does insulin affect potassium in the body?

A

activated Na/K ATPase, increased K intracellularly

58
Q

What insulin is most similar to dog insulin?

A

hog

59
Q

What insulin is most similar to cat insulin? How much do they differ?

A

Bovine - differ by 1 AA in A chain

60
Q

Cattle, sheep, horses, and dog insulin differ in how many AA?

A

3 AA in A chain

61
Q

How many units of insulin per mL are held in a U-40 syringe? U-100 syringe?

A 
U-40 = 40 units/mL
U-100 = 100 units/mL
62
Q

Why is insulin crystalized?

A

zinc helps crystallization???

63
Q

What insulin has a double peak in dogs? What hours does it happen?

A

porcine insulin zinc suspension - 4 and 11 hours

64
Q

What are the 2 long acting insulins?

A

protamine zinc insulin

Glargine/Lantus

65
Q

What are the 2 intermediate acting insulins?

A 
isophane insulin(NPH insulin)
porcine insulin zinc suspension
66
Q

In what 3 ways can effectiveness of DM management be assesed?

A

Glycosylated hemoglobin - not really used
Fructosamines - shows past 2-4 weeks
Glucose curve

67
Q

What is it called when dose of insulin that is too high (rebound hyperglycemia)?

A

somogyi effect - detected by glucose curve

68
Q

What type of glucose decrease will give “central” neural signs of hypoglycemia?

A

slow decrease

69
Q

What is the MOA of sulfonylureas?

A

stimulate release of insulin from B cells

70
Q

What is an example of a sulfonylurea? how is it administered?

A

Glupizide, Glimepiride - oral BID

71
Q

What is the source of biguanide drugs?

A

Galega officinalis (Goats rue)

72
Q

What is an example of a biguanide?

A

metformin - decrease GI uptake of glucose

73
Q

What type of drug is acarbose? why isnt it used as much in humans?

A

alpha-glucosidase inhibitor - many GIT SE

74
Q

What are incretins secreted from? What stimulates their secretion?

A

Secreted from GIT, stimulated by food

75
Q

What are 2 major incretins?

A

GLP-1 - increase insulin, decrease glucagon

GIP - increase insulin release

76
Q

Exenatide is derived from what?

A

gila monster saliva

77
Q

How is DPP-4 related to GLP-1?

A

DDP-4 =degrades incretins

78
Q

What is an amylin agonist analogue example?

A

pramlintide

79
Q

What 3 things does pramlintide do in humans?

A

slows gastric emptying, prevents rise in glucagon, satiety

Pharmacology (21 decks)

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