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Pharma > Thyroid, Corticosteroids, Gonadal hormones > Flashcards

Thyroid, Corticosteroids, Gonadal hormones Flashcards

0
Q

Treatment for myxedema coma?

A

Levothyroxine IV

Plus IV Hydrocort if with adrenal or pituitary insufficiency

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1
Q

Medical emergency presenting as end stage of untreated HYPOthyroidism?
Hypogly, thermia, natremia, ventilation

A

Myxedema coma

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2
Q

DOC for pregnant hyperthyroidism?

A

PTU
Block TPO, dec organification.
Also inhibit peripheral conversion of T4 to T3

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3
Q

PTU given together with what drug during first 3-4 weeks for symptomatic relief?

A

Beta blockers

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4
Q

DOC for NONpregnant hyperthyroidism?

A

Methimazole
Taken OD - better compliance
PTU taken TID

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5
Q

Prenatal exposure to methimazole may cause?

A

“Met a CUTe guy!”
Aplasia cutis congenita
Congenital focal absence of epidermis

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6
Q

Thioamides PTU and Methimazole have this common side effect?

A

Agranulocytosis

Acute severe neutropenia

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7
Q

Treatment of thioamide induced agranulocytosis?

A

Discontinue drug

Give GCSF to accelerate recovery

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8
Q

Definitive treatment of hyperthyroidism, contraindicated in pregnant and nursing women?

A

RAI

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9
Q

Most common AE of RAI?

A

Permanent hypothyroidism

By destroying thyroid parenchyma

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10
Q

Used in preop thyroidectomy to decrease size and vascularity?

A

Potassium iodide (Lugol’s)

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11
Q

Lugol’s also used in?

A

Radiation prophylaxis

To prevent radiation-induced papillary thyroid cancer

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12
Q

Common AE of Lugol’s?

A

Iodism

Acneiform rash, swollen salivary glands, mucous membrane ulcerations

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13
Q

Prenatal exposure to KI causes?

A

Fetal goiter

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14
Q

Wolf Chaikoff vs Jod Basedow

A

WC: ingest iodine, dec TH via negative feedback
JB: ingest iodine, inc TH

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15
Q

What causes drug-induced HYPERthyroidism?

A

MAC

1. Methadone 2. Amiodarone 3. Clofibrate

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16
Q

Amiodarone causes hypothy (block t4 to t3) and hyperthy (inflamm, leak TH). Treatment?

A

Hypo: Levothyroxine
Hyper: PTU, Methimazole, Steroids (anti-inflamm)

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17
Q

Which drugs inhibit peripheral conversion of T4 to T3?

A
  1. PTU
  2. Propranolol
  3. Hydrocort
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18
Q

Treatment for thyroid storm?

A

PTU to block hormone synthesis (PTU first to prevent JB).
SSKI to retard release of TH.
Propranolol for symptomatic relief.
Hydrocortisone to protect against shock and to inhibit peripheral conversion

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19
Q

Criteria used for thyroid storm?

A

Burch Wartofsky

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20
Q

Short acting, low potenct GC used for acute adrenal insufficiency, contact derm, thyroid storm and status asthmaticus?

A

Hydrocortisone

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21
Q

GC used for brain swelling and post chemo emesis?

A

Prednisone

Used to dec ICP only if caused by brain tumor

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22
Q

GC used for fetal lung maturity?

A

Beta or Dexamethasone

High anti inflamm properties

23
Q

How to avoid adrenal insufficiency in patients with long term therapy?

A

Give stress doses during serious illness or before major surgery

24
Q

Mineralocorticoid that inc Na reabsorption, K and H secretion used for Addison’s? (CAI)

A

Fludrocortisone

25
Q

Fludrocortisone also used for?

A

Replacement therapy post adrenalectomy

Do not use with loops and thiazides, worsen hypoK

26
Q

Addison’s vs Conn’s

A

Addisons - ADDrenal insufficiency

Conn’s - Excess (Exconn)

27
Q

Squa ca vs Small cell lung ca?

A

SquaCa - PTHrp - hyperCa, hypoMg

SC - Inc ACTH - Ectopic cushing’s

28
Q

Drug abused by body builders to lower cortisol and prevent muscle loss? Also used for cushing’s and breast cancer

A

Aminoglutethimide

“AMINin mo nandaya ka!”

29
Q

MOA of Aminoglutethimide?

A

Inhibit desmolase

Block conversion of cholesterol to pregnenolone

30
Q

GC synthesis inhibitor also an azole antifungal used for cushing’s?

A

Ketoconazole

31
Q

Common AE of ketoconazole?

A

Gynecomastia

Some drugs produce awesome knockers

32
Q

DOC for pregnant cushing’s?

For pregnant hyperthyroidism?

A

Cush - Metyrapone

Hyperthy - PTU

33
Q

Use of ethinyl estradiol to dec DVT, osteoporosis and breakthrough bleeding leads to increase in risk of what cancer?

A

Endometrial and Breast cancer

34
Q

Prevention of cancer by ethinyl estradiol if given with?

A

Progestin

35
Q

Synthetic estrogen for atrophic vaginitis?

A

Diethylstilbestrol

DES

36
Q

Prenatal exposure of daughters to DES can cause?

A

Clear cell vaginal adenocarcinoma

37
Q

The progestin megestrol leads to what side effect?

A

Weight gain because it stimulates appetite

Mey ges! Kain ako nang kain!

38
Q

Combined OCP used for hypogonadism, acne, endometriosis, contraception causes what AE?

A

DVT - inc risk in smokers
Earlier onset breast Ca
Breakthrough bleeding

39
Q

Progestin-only OCP that causes hair loss and delayed return of fertility?

A

Medroxyprogesterone Acetate

Depo provera IM

40
Q

Postcoital contraceptive?

A

Levonorgestrel
“Leave no trace”
Take within 72hours - 4tabs now, 4tabs after 12 hours
Yuzpe regimen

41
Q

SERM used for ER PR(+) breast Ca?

Antagonist vs breast, agonist to uterus liver bone

A

Tamoxifen

42
Q

Tamoxifen prevents osteoporosis and dec atherosclerosis at the risk of causing?

A

Endometrial carcinoma

43
Q

SERM that inc FSH and LH used for induction of ovulation?

A

Clomiphene
Lead to multiple pregnancies
May lead to low grade ovarian ca

44
Q 
Effective drug against tamoxifen resistant breast Ca?
Inhibit aromatase (block pregnenolone to estrogen)
A

Anastroloze

45
Q

Antiandrogen used for endometriosis that is contraindicated in pregnant and nursing women?

A

Danazol

46
Q

GnRH analog for prostate Ca that cause tumor flare up?

A

Leuprolide

47
Q

GnRH antagonist that is also used for prostate Ca but does NOT produce tumor flare up?

A

Ganirelix

“Ganito dapat, walang flare up!”

48
Q

GC receptor antagonist for medical abortion?

A

Mifepristone RU486

49
Q

Mifepristone causes sepsis due to what organism?

A

Clostridium sordelli

50
Q

AE of testosterone in females? In males?

A

Females - virilization

Males - Paradoxical feminization due to suppression of endogenous testosterone

51
Q

Clinical use of testosterone?

A

Hypogonadism, RBC production, Muscle buildup, weight gain in AIDS

52
Q

Anabolic steroid used as illegal performance enhancing drug in athletes?

A

Oxandrolone

XANDRO! Lalaking lalaki

53
Q

Androgen antagonist for prostate Ca?

A

Flutamide (fake androgen - fluta)

Combined with leuprolide to avoid tumor flare up

54
Q

Androgen antagonist used to decrease sexual drive in men due to drugs like pralipexone?

A

Cyproterone

55
Q

Androgen antagonist DOC for BPH?

A

Finasteride
Five Alpha Reductase Inhibitor
FinAsteRIde

Pharma (27 decks)

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