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51 Cards in this Set
- Front
- Back
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Propylthiouracil
MOA: uses: toxicity: |
MOA:
1) inh organification and coupling of thyroid hormone synthesis. 2) dec peripheral conversion of T4 to T3 uses: hyperthyroidism toxicity: skin rash, agranulocytosis, aplastic anemia, autoimmune hemolytic anemia, oral ulcers |
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Methimazole
MOA: uses: toxicity: CI: |
MOA:
1) inh organification and coupling of thyroid hormone synthesis. uses: hyperthyroidism CI: pregnancy toxicity: skin rash, agranulocytosis, aplastic anemia, scalp defects (abnl hair loss), cholestatic jaundice |
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GH can be used to treat...
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1) GH deficiency
2) Turner's syndrome |
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Somatostatin (octreotide) can be used to treat...
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1) Acromegaly (inh GH)
2) carcinoid (suppresses release of seritonin) 3) gastrinoma 4) glucagonoma 5) VIPoma (suppresses release of peptides) 6) esophageal varicies |
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Oxytocin can be used for...
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1) stimulate labor
2) uterine contractions 3) milk let-down 4) CONTROLS UTERINE HEMORRHAGE |
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ADH/ DDAVP/ desmopressin can be used to treat...
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central DI, vWdz, urinary incontinence
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How do we treat nephrogenic DI?
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1st line: HCTZ, Amiloride (might be better bc its K-sparing, pt wont get low K)
2nd line: Indomethecin, NSAIDS |
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What drugs have nephrogenic DI as a side effect?
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Demicocycline, Li
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What class of drugs is Demicocycline?
What does Demicocylcine treat? Demicocycline side effects... |
Tetracyclines
SIADH S/E: Nephrogenic DI, photosensitivity, abnormalities of bone and teeth |
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Treatment for Conns syndrome
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spirinolactone, adrenalectomy
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Treatment for Addisson's dz
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Hydrocortisone
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Finasteride
MOA: uses: |
MOA: 5 alpha reductase inh
uses: BPH, male pattern baldness |
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Treatment for prostate cancer...
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DOC: leuprilide (GnRH analogue the eventually desensitizes the receptor for GnRH on LH/FSH)
#2: flutamide (blocks DHT receptor) ***often used conjunctively, briefly... then flutamide is d/c'd |
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so both raloxifene and tamoxifene are agonist at bone and antagonists at breast. so whats the difference bw these 2?
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tamoxifene is agonist at uterus. (inc risk for uterine cancer)
raloxifene is antagonist at uterus (dec risk for uterine cancer) |
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Treatment of SIADH
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1) fluid restrict
2) Democycline or Li *** if Na < 120, give 3% NS |
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Treatment of Conn's syndrome
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1) ACE- I to raise K
(ACE-I blocks formation of aldosterone, which decreases K wasting) 2) Spirinolactone (blocks aldosterone rec) 3) Adrenalectomy |
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Addisson's
1) test 2) treatment |
1) Corsyntropin (inject cortisol)
2) Hydrocortisone |
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Adissonian crisis treatment
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Hydrocortisone
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Pheo
1) test 2) treatment 3) Pre-op 4) Operative 5) CI |
1) Phentolamine (short acting alpha nonspecific blocker)
2) Phenoxybenzamine (irriversible alpha nonspecific blocker) 3) pre-op: 14 days of Phenoxy, fluid load, high Na diet 4) Operative: Phentolamine--> Adrenalectomy 5) CI: Beta-blockers ***if there are complications in surgery, and NE/Epi spills, patient will go into hypertensive crisis.... Now you can give Beta-1 blockers (leave Beta-2 receptors unblocked, so pt can maintain vasodilation) you are now depending of IV fluids to maintain BP |
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Treatment for insulinoma
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remove
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Treatment for nessidioblastosis
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nessidioblastosis= insulinoma in infant
Rx: subtotal pancreatectomy |
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HONK
1) serum Osm 2) treatment |
1) serum Osm > 320
2) Rx: 10L NS, insulin drip, replace electrolytes and bicarb ***in this order |
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DKA treatment
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1) Insulin drip (until ketones disappear, and to help put K in cell)
2) NS to dilute K (additive effort with #1) 3) KCl to maintain K levels when K falls to 4.5 4) D5 1/2 NS when glucose= 250 and ketones=0 |
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Dawn phenomenon Rx
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increase PM's NPH insulin or
move PM insulin closer to bedtime or inc AM's regular insulin |
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Treatment of Somogyi effect
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dec evening NPH
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Erythrasma
s/s: cause: Rx: |
s/s: diabetic with rash in skin folds that shines coral-red under Woods lamp
Cause: Corneybacterium minute Rx: Erythromycin |
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Metabolic Syndrome
1) def 2) treatment |
def: "FAT Body Habitus"
Fasting gluc > 100 Abd girth >35 (female), >40 (male) TG > 150 BP > 130/80 (whether taking BP med or not) HDL <50 (female), <40 (male) 2) Metformin |
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Glucagonoma
1) triad 2) treamtment |
1) DM2, diarrhea, Necrolytic Migratory erythema
2) Octreotide |
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Waterhouse Freidrich syndrome
treatment |
methylprednisone
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Primary hyperparathyroid
causes treatment |
causes: adenoma
1) furosemide (loops loose Ca) 2) Calcitonin 3) Bisphosphinates 4) parathyroidectomy |
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Biphosphonates
MOA: uses: S/E: ex: |
MOA: inhibit osteoclasts
uses: primary hyperthyroidism, hypERcalcemia, 2nd line for osteoporosis phx (1st line is raloxafine) S/E: low Ca, low Mg, osteonecrosis, ulcers, drug induced esophagitis (take while sitting upright, with full glass of water, stay sitting up for at least 30 min) ex: -dronate, -dranate, -drenic acid |
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Which bisphosphonates are used for hyPERcalcemia?
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Ibondronate, Zolendrinic acid
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which bisphophonate has decreased incidence of hip fractures and mortality?
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Zolendrinic acid
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Secondary hyperparathyroid
causes: treatment: |
causes: renal failure
treatment: Ca supplements |
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Which 2 forms of hyperthyroid might we use I-131 ablation for?
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1) Graves
-resistant to PTU & methimazole -elderly 2) Plummer's -solitary toxic nodule- Definitely -multinodule- maybe??? |
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Treatment for graves
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1st line: PTU or methimazole
2nd line: I-131 |
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DeQuirvians thyroiditis
clue words: Treatment |
clue words: viral, SUBACUTE granulomatous, painful, lid-lag, transiently hyperthyroid, then hypothyroid
Rx: NSAIDS or corticosteroids for pain hyperphase: propanalol with PTU or methimazole hypOphase: T3 or T4 |
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Silent thyroiditis
clue words: treatment: |
clue words: postpartum, SUBACUTE lymphocytic, painless, transiently hyperthyroid, then hypothyroid
Rx: hyperphase: propanalol with PTU or methimazole hypOphase: T3 or T4 ***Hashimotos is CHRONIC lymphocytic |
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Treatment for thyroid storm
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-propanolol with PTU or methamizole
-glucocorticoids -Iodine (I) to inhibit thyroid hormone release (use Li if pt has Iodine allergy) |
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Treatment for Plummer's disease
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-propanolol with PTU or methimazole
-if solitary nodule--> I-131 -if multinodular-???? |
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Treatment for Hashimotos
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Levothytoxine; aka thyroxine (T4)
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Synthroid
-is one of many market drugs for... -short-coming |
-market drug for T4 (levothyroxine)
-short-coming: Ca and Fe inhibit absorption |
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Reidels struma
-what is it? -clue treatment |
-fibrous thyroiditis
-Clues: firm thyroid, woody CT in neck, die of suffocation -treatment: give T4 if hypothyroid, may need surgery |
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Treatment of pituitary tumor
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transphenoidectomy
EXCEPTIONS 1) prolactinoma: bromocriptine (DA agonist), Cabergoline (DA-2 agonist) 2) GH tumor: octreotide |
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Acromegaly treatment
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1) octreotide (inh GH)
2) pituitary ablation |
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What 2 drugs could lead to "factitious hyperthyroidism"?
Will their T3-T4 levels be elevated? What shows on iodine scan? |
1) Amiodarone
2) IFN alpha T3-T4 elevated, low TSh low uptake on iodine scan |
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What is another name for factitious hyperthyroidism?
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Jod- Basedow effect
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S/E of antithyroid medication (methimazole or PTU)
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Agranulocytosis (must continuously check WBC w differential)
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name all the drugs that inhibit deiodination of T4 (converting T4 to T3)
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1) PTU
2) propanalol 3) dexamethosone |
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I 131 ablation
CI: S/E: |
CI: preggo, severe eye dz
S/E: afib, hand tremor (2/2 dying thyroid cells leaking T3/T4) |
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agranulocytosis
s/s: sign to stop drug causing it: |
s/s: fever, sore throat
sign: WBC < 1,000 |
