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173 Cards in this Set
- Front
- Back
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What are hormones? |
Chemical messengers secreted into the blood that affect target tissues |
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What are the classes of hormones? |
Steroid hormones Protein hormones Amine hormones |
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What substance are steroid hormones synthesize from? |
Cholesterol |
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What sites are steroid hormones synthesized? |
Adrenal glands Gonads Placenta |
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What type of hormones are bound by carrier proteins for transport? |
Steroid hormones |
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What are the clinically significant steroid hormones? |
Cortisol Aldosterone Testosterone Estrogen Progesterone |
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Which hormones are lipid soluble? |
Steroid hormones |
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What are the sites of protein hormone synthesis? |
Anterior pituitary gland Placenta Pancreas Parathyroid gland |
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What type of hormones are stored in the cell until needed for use? |
Protein hormones |
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What are the clinically significant protein hormones? |
FSH LH HCG Insulin Glucagon PTH Growth hormone Prolactin |
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What are the sites of anime hormone synthesis? |
Thyroid Adrenal glands |
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What substance are amine hormones synthesized from? |
Amino acids |
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What are the clinically significant amine hormones? |
Epinephrine Norepinephrine Thyroxine Triiodothyronine |
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What is the function of the hypothalamus? |
Maintain homeostasis |
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What is considered the master gland? |
Anterior pituitary gland |
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What is the function of the anterior pituitary gland? |
Secretes hormones that regulate other glands |
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What is the action of tropic hormones? |
Acts on specific endocrine gland |
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What is the action of direct effector hormones? |
Acts directly on peripheral tissues |
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What are the tropic hormones? |
TSH LH FSH ACTH |
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What are the direct effector hormones? |
Growth hormone Prolactin |
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What time of day will cortisol levels be the highest? |
Morning |
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What time of day will cortisol levels be at its lowest? |
Late afternoon Early evening |
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Increased levels of growth hormone will result as what during childhood? |
Gigantism |
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Increased levels of growth hormone will result as what during adulthood? |
Acromegaly |
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What are the clinical manifestations of increased growth hormone? |
Enlarged extremities Impaired glucose tolerance Hypertension |
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Decreased levels of growth hormone will result as what during childhood? |
Dwarfism |
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Hyperprolactinemia causes? |
Hypogonadism |
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What hormones are produced by the hypothalmus? |
CRH GHRH GnRH TRH Antidiuretic hormone Somatostatin Oxytocin |
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What hormones are produced by the anterior pituitary gland? |
TSH LH FSH ACTH GH Prolactin |
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What is the purpose of therapeutic drug monitoring? |
Ensure dosage in therapeutic range Identify drug outside range |
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What is the specimen of choice for TDM? |
Serum Plasma Whole blood |
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What is the therapeutic range? |
The range that produces maximal therapeutic benefit |
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What are the routes of drug administration? |
Oral Intravenous Intramuscular Subcutaneous Transcutaneous Inhaled Suppository |
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What is the most common route of drug administration? |
Oral |
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What is the least invasive route of drug administration? |
Oral |
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Which route of drug administration injects directly into the circulatory system? |
Intravenous |
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What route of drug administration is injected directly into the muscle tissue? |
Intramuscular |
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What route of drug administration is injected right under the skin? |
Subcutaneous |
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Where are most drugs absorbed in the body? |
GI tract |
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What happens after drugs are absorbed in the GI tract? |
Go through the liver before entering circulation |
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How are drugs transported in the circulation? |
Bound to plasma proteins |
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Acidic drugs bind to what substance? |
Albumin |
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Alkaline drugs bind to what substance? |
Alpha-1-acid glycoprotein |
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What are free drugs? |
Unbound drugs that interact with a target site and produce a response |
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What does TDM assays measure? |
Total drug = protein bound + free |
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How are drugs eliminated from the body? |
Hepatic metabolic processes Renal filtration |
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What happens to drugs in the liver? |
Converted into metabolites Conjugated to make water soluble |
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What is the peak drug level? |
Highest concentration in blood |
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What is the trough drug level? |
Lowest concentration in blood |
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What is the goal of TDM? |
Keep trough level from inefficiency Keep peak level from toxicity |
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Approximately how many doses are required to achieve steady state? |
7 doses |
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What is steady state? |
Amount of drug entering body is equal to amount of drug being eliminated |
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What is steady state? |
Amount of drug entering body is equal to amount of drug being eliminated |
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When is the trough drug level blood drawn? |
Right before next dose is administered |
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When is the peak drug level blood drawn? |
1hr after oral drug administration 30 min after IV administration |
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What are the cardioactive drugs? |
Digoxin Lidocaine Quinidine Procainamide |
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What is digoxin used to treat? |
Congestive heart failure |
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What is the mechanism of action for digoxin? |
Inhibits sodium-potassium pump |
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What is the function of lidocaine? |
Antiarrhythmic drug |
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What is the metabolite of lidocaine? |
MEGX |
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What is quinidine used to treat? |
Cardiac arrhythmias |
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What is procainamide used to treat? |
Cardiac arrhythmias |
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What is the metabolite of procainamide? |
N-Aceytl procainamide |
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What are the antibiotic drugs? |
Aminoglycosides Vancomycin |
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What are aminoglycosides used to treat? |
Gram negative bacterial infections |
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What toxic effects does aminoglycosides have? |
Nephrotoxicity Ototoxicity |
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What is vancomycin used to treat? |
Gram positive cocci and bacilli infections |
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What is the mechanism of action for aminoglycosides? |
Inhibit protein synthesis of organism |
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What is the mechanism of action for quinidine? |
Inhibits sodium and potassium channels |
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What is the mechanism of action for procainamide? |
Blocks sodium channels |
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What is the method of action for vancomycin? |
Inhibits cell wall synthesis |
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What toxic effects does vancomycin have? |
Nephrotoxicity Ototoxicity Red man syndrome |
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What is red man syndrome? |
Erythemic flushing of the extremities |
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What are the antiepileptic drugs? |
Phenobarbital Phenytoin Valproic acid Carbamazepine |
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What is phenobarbital used to treat? |
Used to control seizures |
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What is primidone? |
Inactive form of phenobarbital |
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What is phenytoin used to treat? |
Control seizures |
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What is valproic acid used to treat? |
Control seizures |
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What is carbamazepine used to treat? |
Control seizures |
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What are the psychoactive drugs? |
Lithium Tricyclic antidepressants |
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What is lithium used to treat? |
Manic depression Bipolar disorder |
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How is lithium administered? |
Orally as lithium carbonate |
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What drugs are included in the tricyclic antidepressants? |
Amitriptyline Imipramine Doxepin |
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What are tricyclic antidepressants used to treat? |
Depression Insomnia |
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What is the metabolite of amitriptyline? |
Nortriptyline |
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What is the metabolite of imipramine? |
Desipramine |
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What are the bronchodilator drugs? |
Theophylline |
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What is theophylline used to treat? |
Asthma COPD |
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What are the immunosuppressive drugs? |
Cyclosporine Sirolimus Tacrolimus |
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What is the function of immunosuppressive drugs? |
Suppress transplant rejection Graft versus host disease |
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What is the specimen of choice for testing immunosuppressive drugs? |
Whole blood |
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What are the antineoplastic drugs? |
Methotrexate |
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What are antineoplastic drugs used to treat? |
Cytotoxic anti-tumor therapy |
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What is the mechanism of action for antineoplastic drugs? |
Inhibits DNA or RNA synthesis of developing tumors |
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What are the techniques used to measure TDM? |
Immunoassays Gas chromatography Liquid chromatography Mass spectrometry HPLC |
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What is the function of the parathyroid gland? |
Regulates calcium and phosphate |
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What is the most common cause of primary hypothyroidism? |
Hashimoto's disease |
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What lab values will be observed in hypothyroidism? |
TSH: Increased Free T4: Decreased Cholesterol: Increased LDH: Increased |
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What are the symptoms of hypothyroidism? |
Goiter Fatigue Weight gain Cold intolerance |
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What is hypothyroidism? |
Underproduction of thyroid hormones |
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What is the most common cause of primary thyrotoxicosis? |
Grave's disease |
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What lab values will be observed in hyperthyroidism? |
TSH: Decreased Free T4: Increased |
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What are the symptoms of hyperthyroidism? |
Weight loss Heat intolerance Exopthalmos |
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What is exophthalmos? |
Bulging eyes |
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What is thyrotoxicosis? |
Overproduction of thyroid hormone Hyperthyroidism |
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What is the most useful test for diagnosing and monitoring thyroid diseases? |
TSH Free T4 |
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Thyroid hormones are composed of what compound? |
Iodine |
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Iodine deficiency can cause? |
Thyroid dysfunction |
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What is the principle carrier of thyroid hormones? |
Thyroxine-binding globulin |
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What are the biologically active thyroid hormones? |
Free T3 Free T4 |
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What are the two cell types of the thyroid gland? |
Follicular cells Parafollicular cells |
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What is the function of follicular thyroid cells? |
Secrete thyroid hormones |
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What is the function of parafollicular thyroid cells? |
Secrete calcitonin Calcium regulation |
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What are the thyroid hormones? |
T3 T4 Calcitonin |
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What hormones are produced by the placenta? |
Progesterone Human chorionic gonadotropin Human placental lactogen |
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What is hyperandrogenemia? |
Excess androgens |
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What causes hirsutism? |
Hyperandrogenemia |
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What is hypoandrogenemia? |
Decrease androgens |
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What is the primary male sex hormone? |
Testosterone |
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Where is testosterone produced? |
Leydig cells of the testes |
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What is the function of testosterone? |
Develops of reproductive system Develops secondary male traits |
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What hormone stimulates testosterone production? |
Luteinizing hormone |
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What hormone stimulates spermatogenesis? |
Follicle stimulating hormone |
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What effect does hypoprogesteronemia have? |
Infertility Abortion of fetus |
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What effect does hyperprogesteronemia have? |
Prevents menstrual cycle |
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What is the function of HCG? |
Triggers corpus luteum to release progesterone and estrogen |
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What hormone is detected during pregnancy? |
bHCG |
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What is the function of human placental lactogen? |
Estrogen/progesterone synthesis Mammary gland development |
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What is the function of progesterone? |
Promotes uterine growth Maintains uterine lining |
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What happens during the first half of the menstrual cycle? |
FSH promotes growth of ovarian follicles |
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When does estrogen peak in the menstrual cycle? |
Mid-cycle |
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When does LH surge on the menstrual cycle? |
Mid-cycle |
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What is the result of the LH surge of the menstrual cycle? |
Triggers ovulation |
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Where is progesterone produced? |
Ovarian follicles |
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What is the function of estrogen? |
Develops reproductive system Develops secondary sex traits |
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What is the principle estrogen secreted by the ovaries? |
Estradiol |
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What hormone stimulates the production of estrogen? |
Follicle stimulating hormone |
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What hormone stimulates progesterone production? |
Luteinizing hormone |
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What structure produces vasopressin and oxytocin? |
Supraoptic and paraventricular nuclei of the hypothalamus |
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What is the function of the posterior pituitary gland? |
Storage of hormones produced by the hypothalamus |
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What hormones are stored in the posterior pituitary gland? |
Vasopressin Oxytocin |
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What is the function of vasopressin? |
Stimulates reabsorption of water |
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What causes syndrome of inappropriate ADH? |
Increased levels of ADH |
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What causes diabetes insipidus? |
Decreased ADH levels |
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What symptom will be present in both diabetes insipidus and SIADH? |
Excessive thirst |
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What is the function of oxytocin? |
Stimulates contractions in labor Ejection of breast milk in feeding |
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What is the function of prolactin? |
Stimulates lactation |
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What is the function of aldosterone? |
Regulates sodium balance |
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What causes Conn syndrome? |
Hyperaldosteronism Increase aldosterone |
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What causes Addison's disease? |
Hypoaldosteronism Decreased aldosterone Decreased cortisol |
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What are the characteristics of diabetes insipidus? |
High urinary output Decreased ADH Hypernatremia Dehydration Loss of fluids |
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What are the characteristics of SIADH? |
Low urinary output Increased ADH Hyponatremia Over hydrated Fluid retention |
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What type of hormones are produced by the adrenal cortex? |
Steroid hormones |
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What type of hormones are produced by the adrenal medulla? |
Amine hormones |
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What causes Cushing syndrome? |
Increased cortisol |
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What hormones are secreted by the adrenal cortex? |
Aldosterone Cortisol Androgens |
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What are the lab findings in Addison's disease? |
Increased ACTH Low cortisol Decreased sodium Deceased chloride Increased potassium Pigmented skin |
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What are the symptoms of Cushing's syndrome? |
Hyperglycemia Moon face Buffalo hump |
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Catecholamines are synthesized from? |
Tyrosine |
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What are the hormones secreted from the adrenal medulla? |
Epinephrine Norepinephrine Dopamine |
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What are the end stage metabolite of epinephrine and norepinephrine? |
Vanillylmandelic acid |
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What is the metabolite of dopamine? |
Homovanillic acid |
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What hormones are increased in pheochromocytoma? |
Epinephrine Norepinephrine |
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What type of sample is used to detect catecholamines? |
24 hr urine collection |
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What hormones are increase in neuroblastoma? |
Epinephrine Norepinephrine Dopamine |
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Where is gastrin produced? |
Stomach |
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What is the function of gastrin? |
Stimulates secretion of gastric fluid and pancreatic enzymes |
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What is the metabolite of serotonin? |
5-hydroindole acetic acid 5-HIAA |
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What sample is collected for 5-HIAA? |
24hr urine |
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What is the function of serotonin? |
Smooth muscle stimulant and vasoconstriction |
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What is serotonin produced from? |
Tryptophan |
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What structure secretes serotonin? |
Enterochromaffin cells in GI tract |
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What structure secretes catecholamines? |
Chromaffin cells of adrenal medulla |
