Pharm 3 Thyroid Drugs

Front 1

T4 vs T3

Back 1

1. T4 more abudant 2. T3 more biologically active 3. T3 metabolized more quickly than T4

Front 2

thyrotropin actions

Back 2

stim Iodide uptake, syn and sec thyroglobulin, endocytosis and proteolysis of thyroglobulin, sec t3 and t4, inc blood flow, inc transcr of thyroperoxidase and thyroglobulin genes

Front 3

types of hypothyroidism

Back 3

Endemic, myxedema (adults), cretinism (fetal)

Front 4

types of hyperthyroidism

Back 4

Toxic nodular goitre, grave's, carcinoma, thyrotoxicosis

Front 5

clinical presentation of cretinism

Back 5

Mental retardation, growth retardation, sluggishness

Front 6

myxedema clinical presentation

Back 6

Lethargy, pale puffy skin, cold intolerance, bradycardia, weight gain, mental impairment

Front 7

Rx for hypothyroidism

Back 7

T4 (oral, for chronic replacement) T3 (no chronic, for myxedemic coma)

Front 8

ENDEMIC GOITRE

Back 8

low I and compensatory thyroid hypertrophy, prev by giving them I, treat w/ thyroxine and I supplement

Front 9

symptoms of Thyrotoxicosis

Back 9

Nervousness, tremor, heat intolerance, tachy, weightloss, decr cholesterol, increase food intake

Front 10

Thyroid storm (extreme toxicosis)

Back 10

Fever, tachy, a fib, agitation, delerium, coma, vomiting, diarrhea

Front 11

causes of hyperthyroidism

Back 11

thyroid hormone ingestion, diffuse toxic goiter, hyperfunctioning adenoma, toxic multinodular goiter, painless thyroiditis, subacute thyroiditis, thyroid stimulating hormone - secreting adenoma, HCG-secreting tumors

Front 12

TREATMENT OF HYPERTHYROIDISM

Back 12

Anti-thyroid drugs, irradiation, surgery

Front 13

THIOUREYLENES (propylthiouracil and methimazole)

Back 13

inhib thyroperoxidase and conversion of t4 to t3 (long term treatment, in conjunction w/ irradiation, prior to surgical treatment)

Front 14

PTU vs MMI

Back 14

PTU may act more rapidly by inhibiting peripheral deiodination, MMI crosses placenta and milk, PTU shorter half life

Front 15

IODINE MOA

Back 15

Inhibits release of thyroxine from thyroglobulin, inhib organifiction, dec gland size and vascularity, antagonize thioureylenes and radioiodine, rapid onset and escape phenomenon, not for long term

Front 16

IODINE clinical uses

Back 16

Preoperative preparation for thyroidectomy, use after radio therapy, protection after radio exposure, treatment of endemic goitre

Front 17

radioiodide

Back 17

diagnosis (small amount) and ablation therapy cause hypothyroid

Front 18

SYMPATHOLYTICS

Back 18

beta blocker, adrenergic neuron blocker, contraindicated for DM and airway obstruction

Front 19

things that inhibit osteoclasts

Back 19

estrogen calcitonin bisphosphonates

Front 20

things that activate osteoclasts

Back 20

interleukin -1 , TNF, PTH

Front 21

pulsatile vs continuous PTH

Back 21

Intermittent – stimulates bone growth
continious - bone resorption

Front 22

Therapeutic indication for PTH

Back 22

Osteoporosis

Front 23

Physiological actions of calcitriol:

Back 23

Increases intestinal CA2+ and phosphate absorption

Front 24

CLINICAL uses of Vit D (ergocalciferol and calcitriol)

Back 24

rickets,osteomalacia,Vit D deficiency due to malabsorb and liver disease, hypocalcemia (low pth) osteodystrophy, osteoporosis

Front 25

CALCITONIN

Back 25

inhib osteoclast, dec renal abs of Ca and PO4, treat hypercalcemia and osteroporosis, side effects: Nausea vomiting, facial flushing, escape phenomenon

Front 26

estrogen

Back 26

stim apop of osteoclast

Front 27

actions of bisphophonates

Back 27

"1. induce apoptosis of osteoclasts by binding to hydroxyappetite(simple) 2. Loss of bone-resorptive activity by inhibiting FPP synthase and prevent prenylation of small GTPase signaling (osteoclast apop)

Front 28

clinical uses of bisphophonates

Back 28

ostoporsis, paget's, hypercalcemia, bone metastases

Front 29

side effects of bisphophonates

Back 29

osteonecrosis of the jaw

Front 30

hypercalcemia Symptoms

Back 30

reduced renal function and nephrocalcinosis

Front 31

therapy for osteoperosis

Back 31

calcitonin, teriparatide, sodium floride and bisphosphonate w/ Ca supplement, hormone therapy, raloxifene. calcitriol

Front 32

Pathophysiology and symptoms of osteomalacia and rickets

Back 32

lack of mineralization

Front 33

treatment of osteomalacia

Back 33

Simple vitamin D deficiency (Rickets) is treated with ergocalciferol(intestinal) and calcitrial (renal failure) nutritional

Front 34

paget's disease

Back 34

increase bone resorption compensated by accelerated bone formation (skull tibia humorus, pain deformity and bone fractures)

Front 35

effects of t3 and t4

Back 35

inc BMR (heat O2 consumption), heart and gut affected, inc resp to lipolytic hormones, in abs glucose, heart and liver glycogen depletion, makes B adrenergic receptors more sensitive and numerous, potential GH, CNS DEVEL, inc conversion of t4 to t3

Front 36

side effects of T3 and T4

Back 36

nervousness, insomnia, Cardio prob

Front 37

cautions to look for w/ thyroxine therapy

Back 37

cardio probs, adrenal cortex insufficiency, DM, Sympathomimetics, coumarin and related anticoagulants

Front 38

side effects of thioureylenes

Back 38

agranulocytosis, skin rash, goitre, hepatitis, nephritis, fever

Front 39

side effects of iodine

Back 39

toxicosis, hypothyroid, mouth and throat sores, acne, diarrhea, cough

Front 40

treatment of Grave's

Back 40

thioureylenes, thyrectomy, radioiodine

Front 41

treatment of thyroid storm

Back 41

sympatholytic, iodide (high dose), thioureylene

Front 42

actions of PTH

Back 42

bone resorption, Ca uptake and PO4 secretion by kidneys, and conversion of Vit D to active, intestinal absorption of Ca

Front 43

side effects of PTH

Back 43

nausea, headache, dizziness, cramps, hypercalcemia, gout

Front 44

side effects of vit D

Back 44

hypercalcemia

Front 45

teriparatide

Back 45

PTH analog, promotes new bone formation

Front 46

treatment of paget's

Back 46

calcitonin and etidronate (bisphosphonate)

Front 47

what is
renal osteodystropy

Back 47

kidneys don't make active Vit D treat w/ calcitriol bisphos and Ca (NOT ERGOCALCIFEROL)

Front 48

symptoms of osteoporosis

Back 48

reduced bone mass, fractures