Pharmacology - Pituitary, Thyroid, Parathyroid Drugs (Exam 5) Flashcards
1
Q
What are the major endocrine glands?
A
Pituitary
Thyroid
Parathyroid
2
Q
What does thyrotropin do?
A
Stimulates thyroid to release thyroid hormone
3
Q
What is thyrotropin also called?
A
Thyroid-stimulating hormone (TSH)
4
Q
Which hormone is upstream of TSH?
A
Thyrotropin-releasing hormone (TRH)
5
Q
Which mechanism regulates hormone levels?
A
Negative feedback
6
Q
Which gland is called the “master gland” since it regulates other endocrine glands?
A
Pituitary
7
Q
What does the pituitary gland secrete?
A
Peptide hormones
8
Q
What effect does the pituitary gland have?
A
Tropic
(tells other glands to secrete their hormones)
9
Q
What happens if you don’t have any gonadotropins (LH, FSH)?
A
Entire reproductive system fails
10
Q
What happens if you don’t have growth hormone and thyrotropin?
A
Normal growth/development is not possible (dwarfism)
11
Q
Hypopituitariasm
A
Pituitary hormone deficiency
12
Q
What causes dwarfism?
A
Decreased growth hormone
13
Q
What causes hypothyroidism?
A
Increased thyroid-stimulating hormone (TSH)
14
Q
What causes decreased metabolism?
A
Decreased thyroid hormone
15
Q
What causes Addison Disease?
A
Decreased corticosteroids
16
Q
What causes loss of secondary sex characteristics?
A
Decreased LH & FSH
17
Q
What causes diabetes insipidus?
A
Decreased ADH
18
Q
What are the symptoms of hypopituitarism (pituitary hormone deficiency)?
A
Hypopigmentation
Thinning/softening of skin
Decreased libido
Retarded dental development
19
Q
What are 5 things associated with hypersecretion of pituitary hormones?
A
Sexual precocity
Acromegaly
Gigantism
Goiter
Cushing Disease
20
Q
What are goiters caused by?
A
Overactive thyroid
21
Q
What is Cushing Disease caused by?
A
Increased corticosteroids
22
Q
Which hormones are involved in the anterior pituitary (adenohypophysis)?
A
Growth hormone (GH, aka somatotropin)
Luteinizing hormone (LH)
Follicle-stimulating hormone (FSH)
Thyroid-stimulating hormone (TSH)
Adrenocorticotropic hormone (ACTH)
Prolactin
B-lipotropin
“FLAT PeG B”
23
Q
Anomalies associated with growth hormone (GH)
A
Deficiency: dwarfism
Hypersecretion: gigantism
24
Q
Anomalies associated with LH & FSH
A
Deficiency: loss of secondary sex characteristics
Hypersecretion: sexual precocity
25
Anomalies associated with TSH
Deficiency: hyperthyroidism
Hypersecretion: hypothyroidism
26
Anomalies associated with ACTH
Deficiency: Addison Disease
Hypersecretion: Cushing Disease
27
Anomalies associated with prolactin
Deficiency: failure to lactate
Hypersecretion: galactorrhea & infertility
28
What are natural and synthetic hormones of pituitary used as?
Pituitary hormone drugs
29
What can pituitary hormone drugs do?
Mimic or block actions
30
Which hormones are gonadotropins?
LH & FSH
31
What does FSH do?
Stimulate follicle growth
32
What does LH do?
Induce ovulation
33
What can LH & FSH be used to treat?
Infertility
34
What combo of hormones is a patient with infertility given? What is the outcome?
Gonadotropins (LH & FSH) + hCG -> superovulation (in vitro fertilization)
35
Which pituitary hormone drug is a recombinant growth hormone?
Somatotropin
36
What is somatotropin/GH used to treat?
Dwarfism
Wasting syndrome or anorexia cachexia syndrome (ex: in AIDS)
37
What is another name for growth hormone inhibiting hormone (GHIH)?
Somatostatin
38
Which pituitary hormone drug is an analogue of somatostatin?
Octreotide
39
What does Octreotide inhibit?
Inhibits release/production of GH
Inhibits release of serotonin & vasoactive substances
40
What does octreotide treat?
Acromegaly
41
Which pituitary hormone drug is a dopamine receptor agonist?
Bromocriptine
42
Bromocriptine is _______ soluble and penetrates the _______
lipid; BBB
43
What does Bromocriptine inhibit?
Prolactin release
44
What is Bromocriptine used to treat? (2)
Female infertility resulting from hyperprolactinemia (too much prolactin)
Parkinson's Disease
45
Which pituitary hormone drug is an antidiuretic hormone (ADH)?
Vasopressin
46
What does vasopressin cause?
Increased water retention
47
What is vasopressin used to treat?
ADH deficiency - diabetes insipidus (excessive thirst)
48
What is the suffix of the synthetic analogs of vasopressin?
"-pressin"
49
What does oxytocin induce and control?
Induce labor (contracts uterine muscle)
Induce postpartum lactation
Control postpartum hemorrhage
50
What is the root of oxytocin drugs?
"tocin"
(ex: pitocin, suntocinon)
51
What is the most common endocrine disorder?
Diabetes mellitus (type II)
52
What is the 2nd most common endocrine disorder?
Thyroid dysfunction
53
Low TSH causes what?
High thyroid hormone (due to negative feedback)
54
High TSH causes what?
Low thyroid homrone
55
Which disease?
Low TSH
High T4 thyroid hormone
Hyperthyroidism
56
Which disease?
High TSH
Low T4 thyroid hormone
Hypothyroidism (primary)
57
What are the 3 thyroid hormones?
T3
T4
Calcitonin
58
What is involved in T3 and T4 thyroid hormones?
Iodine
59
What do thyroid hormones regulate?
Energy metabolism
Growth/development
60
What does calcitonin regulate?
Calcium metabolism
61
What do thyroid hormones act on?
Every tissue/organ
62
What do increased levels of T3 and T4 thyroid hormones do in the heart?
Increase B1 receptor activity
63
What does an increase in B1 receptor activity due to increased T3 and T4 thyroid hormones cause?
Increased HR, contractility, and sensitivity to catecholamines
64
What are the general effects of increased T3 and T4 thyroid hormones?
Increased energy metabolism
Increased growth/development
65
What are the general effects of decreased T3 and T4 thyroid hormones?
Decreased energy metabolism
Decreased growth/development
66
T/F hypothyroidism is common, and it is more common in women than men
True
67
T/F hypothyroidism increases dramatically in women after 40
True
68
__________ hypothyroidism is common, especially among older women. This contributes to hyperlipidemia, cardiac dysfunction, osteoporosis, and carpal tunnel
Subclinical
(asymptomatic)
69
What disease?
Fatigue
Depression/mood swings
Hair loss/thin eyebrows
Bradycardia
Hypotension
Intolerance to cold
Difficulty handling stress
Decreased metabolism (weight gain)
Decreased development
Increased sensitivity to CNS depressants
Hypothyroidism
70
What disease?
Nervousness
Anxiety
Emotional liability
Tachycardia
Tremors
Osteoporosis of alveolar bone
Increased metabolism (weight loss)
Increased development
Decreased sensitivity to CNS depressants
Increased sensitivity to pain and epi
Hyperthyroidism
71
What 2 things cause hypothyroidism? Which one is most common in the US?
Iodine deficiency
Hashimoto's Disease (#1 cause in US)
72
Chronic inflammation of the thyroid affecting middle aged women
Hashimoto's Disease
73
How does hypothyroidism appear in children?
Cretinism
(mental defects, stunted growth)
74
How does hypothyroidism appear in adults?
Myxedema
75
What can happen when a pregnant women has hypothyroidism?
Child has large teeth
76
What disease?
Delayed tooth eruption
Malocclusion
Increased gingivitis/perio
Gingiva is inflamed or pale and enlarged
Poorly shaped teeth; large teeth
Caries
Hypothyroidism
77
What disease?
Accelerated tooth eruption
Early loss of deciduous teeth/early eruption of permanent teeth
Loss of alveolar process
Diffuse demineralization of jaw
Maxillary or mandibular or alveolar osteoporosis
Rapidly progressing perio destruction
Hyperthyroidism
78
What drugs are used for treating hypothyroidism?
1. Levothyroxine sodium (Synthroid) - T4
2. Liothyronine sodium - T3
79
What is the 1/2 life of Levothyroxine sodium (Synthroid)? How long does it take to reach steady state?
1/2 life = 7 days
Steady state = 1 month
80
What is the 1/2 life of Liothyronine sodium? What does this cause?
Shorter than Levothyroxine sodium (Synthroid)
Greater risk for cardiotoxicity
81
What are the associated diseases of hyperthyroidism?
Graves' Disease (diffuse toxic goiter)
Plummer's Disease (toxic nodular goiter)
Thyrotoxicosis
82
What disease presents with a diffusely enlarged, highly vascular thyroid gland that is common is young adults who have antibodies against thyrotropin (TSH) receptor?
Graves' Disease
83
What is the #1 cause of hyperthyroidism in the US?
Graves' Disease
84
What disease presents with nodules that secrete excessive hormones, while the rest of the tissue is atrophied, primarily in older patients?
Plummer's Disease
85
What disease presents with excessive heat production, increased SNS, increased neuromuscular activity, increased sensitivity to pain, ophthalmopathy (swelling), exophthalmos (protruding eyes), and anxiety?
Thyrotoxicosis
86
What are 2 ways to treat hyperthyroidism?
1. Radioactive iodine
2. Thyroidectomy
87
What is the risk of thyroidectomy to treat hyperthyroidism?
Excessive release of thyroid hormones
Acute thyrotoxicosis (life threatening)
88
What must patients take before treating hyperthyroidism to prevent excessive release of thyroid hormones and acute thyrotoxicosis?
Propylthiouracil
Methimazole
Propranolol
89
What do Propylthiouracil and Methimazole inhibit?
Synthesis of thyroid hormones
90
What happens after the thyroid is destroyed or removed when treating hyperthyroidism?
Pt develops hypothyroidism and is put on synthetic thyroid hormones
91
What are 3 anti-thyroid agents and their effects?
1. Iodine (decrease thyroid hormone synthesis)
2. Propanolol (decrease HR/contractility)
3. Diltiazem (decrease HR/contractility)
92
What 3 hormones are involved with Ca2+ homeostasis?
1. Parathyroid hormone (PTH)
2. Calcitonin (from thyroid)
3. Vitamin D
93
What does parathyroid hormone (PTH) stimulate?
Ca2+ absorption & bone resorption
94
What organs does PTH act on? What are the effects on these organs when Ca2+ levels are LOW?
Kidneys (prevents Ca2+ loss)
Bones (resorption)
Intestines (absorb more Ca2+)
95
What does PTH stimulate?
Bone turnover (resorption/formation)
96
What is the parathyroid hormone drug?
Teriparatide
97
What does Teriparatide cause when dose is constant?
Bone resorption
98
What does Teriparatide treat when doses are low and intermittent?
Osteoporosis
99
Increase in extracellular Ca2+ causes an _________ in calcitonin release
increase
100
What does increased calcitonin cause?
Decreases osteoclast activity/bone resorption
Increases urinary Ca2+ secretion
(to decrease plasma Ca2+ levels)
101
What is the calcitonin hormone drug?
Salmon calcitionin
102
What does salmon calcitonin treat?
Paget's Disease
Osteoporosis
103
What disease presents with excessive, disorganized bone remodeling, weak/misshapen bones, and bone fracture?
Paget's Disease
104
What are the vitamin D drugs?
Cholecalciferol (vitamin D3)
Ergocalciferol (vitamin D2)
105
What is formed in the skin from 7-dehydrocholesterol by action of UV radiation?
Cholecalciferol (vitamin D3)
106
What is the root in vitamin D drugs?
"calci"
107
What increases phosphate?
Vitamin D
108
What decreases phosphate?
PTH
109
Where is 85% of phosphate in the body?
Bone & teeth
