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Pharmacology > Thyroid drugs & Others > Flashcards

Thyroid drugs & Others Flashcards

1
Q

What is the function of thyroid peroxidase?

A

oxidizes iodide –> iodine

coupling go tyrosine residues

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2
Q

How are T3 & T4 formed ?

A

cleaved from thyroglobulin in follicular cell

T3 is more potent

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3
Q

What forms T3 from T4 ?

A

5’ deiodinase in the peripheral converts T4 to T3

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4
Q

What is the relationship between thyroid and catecholamines?

A

thyroid hormones increases the sensitivity to peripheral tissues to catecholamines by increase beta-adrenergu receptors

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5
Q

Radioactive iodine (131-I)

A

tx : hyperthyroidism in graves

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6
Q

What are the side effects of radioactive (131-I)

A

hypothyroidism
exacerbate graves opthalmopathy
exacerbate hyperthyroidism

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7
Q

Propythiouracil

A

tx: hyperthyroidism by binding directly to TPO
1st trimester & methimazole reaction
inhibit 5 deiodinase –> decrease conversion of T4 to T3

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8
Q

What are the side effects of propythiouracil ?

A 
hepatotocity 
liver failure
maculopapular rash 
ANCA- associated vasculitis 
lupus
aplastic anemia 
agranulocytosis
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9
Q

Methimazole

A

hyperthyroidism by inhibiting TPO

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10
Q

What are the side effects of methimazole ?

A 
should not be given in the 1st trimester 
agranulocytosis 
lupus 
ANACA- associated vasculitis 
aplastic anemia
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11
Q

B- blockers

A

tx: hyperthyroidism - hypeadrenergic

inhibit 5’ deiodinase conversion T4–>T3

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12
Q

Glucorticoids

A

inhibit 5’ deiodinase that converts T4–> T3

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13
Q

Hypothyroidism

A

decrease BMR , cold intolerance , brittle hair, lethargy

= hashimotos thyroiditis

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14
Q

Levothyroxine

A

tx: hypothyroidism
SE: can cause hyperthyroidism

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15
Q

Teriparatide

A

tx: osteoporosis
increases maturation of osteoblast
increase Ca from the kidney

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16
Q

What triggers the release of PTH?

A

high serum Ca levels

17
Q

What is the function of PTH ?

A

PTH stimulates osteoblasts to release receptor activator of nuclear factor kappa-B ligand –> activate osteoclasts

RANKL binds to RANK to increase bone reabsorption

PTH increase Ca resorption by the kidney , increase conversion to vitamin D3

18
Q

Teripratide

A

tx: osteoporosis
stimulate maturation of osteoblasts
increase Ca resorption by the kidney
increase production of 1, 25- dihydroxyvitamin D

19
Q

Calcitrol

A

stimulates reabsorption of Ca & phosphate by kidney & intestine
stimulates osteoblasts to release RANKL–> increase osteoclast
inhibit PTH
matures osteoblasts

tx: chronic kidney disease
hypoglycaemia

20
Q

Vitamine D

A

tx: osteoporosis

psoriasis

21
Q

Hypocalcemia

A

causes parathesisa , muscle cramps, tetany, change in mental status

causes seizures

22
Q

Cinacalet

A

activates calcium sensing receptor on Parathyroid gland –> decrease production PTH

23
Q

Sevelamer

A

decrease absorption of phosphate in GI

24
Q

Dexamethasone, fludocortisone, prednisone are ?

A

glucocorticoids

25
Q

What is the 5 function of glucocorticoids?

A

GC bind into the cytoplasm –> enter the nucleus and regulates gene transcription

inhibit phospholipase A2 in the arachidonic acid –> decrease prostaglandins( COX) & leukotrienes(LOX)

inhibit NF-KB –> decrease cytokines–> prevent T & B cells

decrease production of neutrophil adhesion molecules

reduce peripheral eosinophil counts

26
Q

What are glucocorticoids used to treat?

A

inflammatory disorders
immunosuppressive
adrenal insuffiency

27
Q

What are the side effects of glucocorticoids ?

A 
insulin resistance--> hyperglycaemia 
gluconeogenesis
increase hepatic glycogen storage 
proteolysis
lipolysis
Cushings syndrome 
central adiposity 
muscle wasting 
inhibit fibroblast --> impaired would healing 
psychosis 
decreased bone mass
28
Q

What is a consequence of exogenous glucocorticoids

A

adrenal cortical atrophy

29
Q

What does ADH / vasopressin cause?

A

vascular endothelium to release von Willebrand factor –> increased platelet aggregation

30
Q

Desmopressin acetate treats?

A

von Willebrand disease
hemophilia A
esophageal variceal

31
Q

SIADH

A

overproduction of ADH by ectopic lung cancer, CNS disorders, trauma, some drugs

32
Q

Conivaptan , tolvaptan

A

tx: SIADH
promote free water excretion
SE: hypernatremiam central pontine myelinolysis

Pharmacology (15 decks)

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