thyroid

Question 1

Vasopressin

ADH

Answer 1

MOA: V1 and V2 receptor agonsit
Use: vasoconstriction and free water retention, diabetes insipidus
Notes: Short HL, Excess SIADH
Route: IV only

Posterior, V1 blood vessels, V2 kidney

Question 2

Desmopressin

DDAVP

Answer 2

MOA: V2 receptor agonist (vasmopressin analog)
Use: water retention only bc no V1, Diabetes Insipidus
Note: Long HF not code med
route: all

Question 3

Tolvaptan

Answer 3

MOA: V2 only antagonist
Route Oral
limited for SIADH resitance to fulid restriction

Question 4

Conivaptan

Answer 4

MOA: V1 and V2 antagonist
Route: IV
note: theory with HF by decrese cardiac remodel

Question 5

oxytocin

Answer 5

MOA: Uterine contraction and lactation
Route: IM, IV and nasal
Use: indution of labour, placental delivery, Postpartum bleeding

Posterior

Question 6

Haloperidol

Antipsychotics

Answer 6

MOA: Dopamine inhibitors
AD: lactation and nipple tenderness ( usually only long term)

prolactin suppressed by dopamine but a blocker with trigger

Question 7

Levothyroxine

thyroid

Answer 7

MOA: T4
Notes: risk can be lower, gradual onset, 50% bio avaible, HL 7 days (need to wait months to manage)
DDI: decrease food and drugs so take on empty stomach

Question 8

liothyronine

Thyroid

Answer 8

MOA: T3 (more pontent)
Note: can be a little faster, 4hr onset, 95% availbe, HL .75 days, faster withdraw

Question 9

Desiccated thyroid

Thyroid

Answer 9

MOA: combo T4 and T3

Question 10

propylthiouracil

PTU

Anti-thryroid med

Answer 10

MOA: block step 2 and 4
Use: OD on SSKI to fix
notes: protein bound and LESS excreted in milk and placental, only for mothers bc only 8 hr so a lot more frequecnt dosing

Question 11

Methimazole

Answer 11

MOA block step 2 anti thy
Note: a lot in milk and crosses placenta, long HL =better for everyone else

Question 12

Potassium Iodide

Answer 12

SSKI super concentrated
Lugols solution a lot less I
Use: only for short term use
Dose: NEED TO BE in Combo with anti-thyroid

Question 13

Hypothyroid

absense of stimulant

Answer 13

CNS: depression mental slowing, lethargy
Cardio: lower HR, HF, Hypo
GI: constipation
M: pain weakness
Skin: brittle hair/ dry skin
Met: weight gan and cold

Question 14

Hyperthyroid

a stimulant

Answer 14

CNS: irritable, anxiety, insomnia, conctraiting
Cardio: heart rate, paplt, HTN
GI: constipation
M: Decreaed bone
Skin: hair loss, sweating, itchy, (room too hot)
Met: weight loss and hight temp

Question 15

Primary hypo

Answer 15

T4 and T3 low **T4 [.8-1.4] **
TRH TSH high TSH [ .5-4.1]

Question 16

Primary Hyperthyroidism

Answer 16

High T4 and T3
Low TSH

Question 17

Wolff-Chaikoff Effect

Answer 17

iodine load - stores in folicles and turns itself off for a 10-14 days
After 10-14 will escape and send you into hyperthyroidism

Question 18

Thyroid synthesis

Answer 18

1. (NIS) uptakes Iodine (Potassium idodine floods with Idodine and inhibits)
2. TPO take iodide to Iodone and couple to Tg to make MIT or DIT. TPO takes DIT and MIT to make t3 or t4
   All anti thyroid inhibit TPO ( meth, propylthioruacil, potassium iodide)
3. activation and release ( inhibited by potassium idodie)
4. peripheral conversion by PTU