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96 Cards in this Set
- Front
- Back
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What are some benefits of estrogen therapy?
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-osteoporosis prevention
-Alzheimer's disease prevention -symptomatic relief of menopause |
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What are some S/E of estrogen therapy?
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-thrombosis
-endometrial and breast cancer -patch: skin reactions -avoid in patients w/ hx of breast cancer or thromboembolism |
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What can be used in combo with estrogen to make a complete therapy?
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progestin
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Name some progesterone therapy products?
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-medroxyprogesterone (Provera)
-megestrol (Megace) |
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Name some combo estrogen and progestin products.
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-Prempro
-Premphase -CombiPatch |
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What are some side effects of CombiPatch?
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may increase risk of thrombosis
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What is the deal with Premphase?
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2 weeks on and 2 weeks of and can cause menstruation to start again.
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What are some other options for for hot flashes that don't involve estrogen therapy?
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-SSRIs (Paxil, Prozac, etc)
-Venlafaxine (Effexor) -Clonidine (Catapress) |
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What can too much estrogen in OCPs cause?
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-nausea
-bloating -breast tenderness -HTN -HA |
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What can too little estrogen in OCPs cause?
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-break-thru bleeding
-increased spotting -hypomenorrhea |
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What can too much progestin cause in OCPs?
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-breast tenderness
-HA -fatigue -mood changes |
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What can too little progestin cause in OCPs?
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-late break through bleeding
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What are some side effects of DepoProvera?
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-can't use for longer than 2 years because of osteoporosis
-weight gain -irregular menstruation - |
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What is a side effect with the Ortho Evra patch?
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increased risk of DVT
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How does Plan B work/ how do you take it?
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-1 pill w/in in 72 hrs and the second pill 12 hours later
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What is premenstrual syndrome/dysmenorrhea?
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painful menstrual cramps that are likely due to prostaglandin imbalance
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What are the treatment options for premenstrual syndrome/dysmenorrhea?
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-NSAIDs are first line
-OCP for those who want to use them -nitro patches -CCB -Mg -electrical nerve stimulation |
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What does a class A drug for obstestrics mean?
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safe
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What does a class B drug for obstestrics mean?
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likely safe
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What does a class C drug for obstestrics mean?
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unknown, benefit of therapy must outweigh risk to fetus
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What does a class D drug for obstestrics mean?
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known risk to fetus, use only if in dire need
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What does a class X drug for obstestrics mean?
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known tetatogenic agen, contraindicated in pregnancy
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Why do pregnant women need folate?
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prevent neural tube defects
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What drugs can you use for acute HTN in a pregnant person?
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-Mg Sulfate (IV)
-hydralazine (IV, PO) -methyldopa (IV, PO) |
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What is a benefit of using Mg Sulfate for acute HTN in pregnant women?
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works quickly and you can titrate quickly. Usually a bolus follwed by a continious infusion
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Are ACE inhibitors safe in pregnancy?
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No
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Are beta blockers safe in pregnancy?
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mostly, except for atenolol because it can cause growth retardation
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Are CCBs safe in pregnancy?
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Yes, especially verapamil
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Are thiazide diuretics ok?
Loop diuretics? |
-NO must avoid
-may be okay |
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Are methyldopa and hyralazine okay in pregnancy?
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YES
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Tell me about misoprostol (Cytotec)
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-prostaglandin analog that causes dilation of the cervix and uterine contractions
-PO or vaginally -can't turn off once you start |
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Tell me about oxytocin (Pitocin)
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-used for induction of labor
-cont. IV fusion -has to be titrated to wrk -doesn't work in all women |
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Tell me about dinoprostone (Cervidil, Prpidil)?
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-prostaglandin that dilates the cervix
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Is tylenol okay in pregnancy?
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yes
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Is Tylenol w/ codeine okay?
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yes
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Is acetaminophen/hydrocodone okay in pregnancy?
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yes
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Are NSAIDS or COX-2 inhibitors okay in pregnancy?
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only on occasion
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When must you avoid ASA? (what trimester?)
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avoid in 3rd trimester
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What is the DOC for diabetic pregnant women?
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insulin
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What diabetic drug is contraindicated in pregnancy?
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sulfonylureas
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Can you use Metformin, acarbose, or glitazones in pregnancy?
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not known
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What depression drugs must you avoid in pregnancy?
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-TCAs
-MAOIs |
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Are SSRIs okay in pregnancy?
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probably, but avoid Paxil
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Are cephalosporins okay in pregnancy?
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yes, for the most part, but you MUST avoid Rocephin.
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Why must you avoid Rocephin in the last few weeks before delivery in pregnancy?
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b/c bilirubin is highly protein bound, ans so it Rocephin and it will push bilirubin off of albumin and cause bilirubin will go into the brain
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Tell me about sulfas in pregnancy.
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must avoid last few weeks prior to delivery because of bilirubin binding
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Is Macrodantik safe in pregnancy?
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yes
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Are PCNs okay in pregnancy?
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Yes
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Are aminoglycosides okay in pregnancy?
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yes, for the most part
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Are fluoroquinolones safe in pregnancy?
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NO
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Are tetracyxline okay in pregnancy?
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NO
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Are inhaled steroids okay in pregnancy?
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Yes
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Is cromolyn/Intal okay in pregnancy?
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YES
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Are inhaled B-2 agonists okay in pregnancy?
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YES
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Are ipratropium/Atrovent okay in pregnancy?
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YES
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Are oral steroids okay in pregnancy?
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YES
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How do you treat N/V and other GI issues in pregnancy?
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-fluids
-small, frequent meals -Compazine, Phenergan, Reglan |
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Are PPIs okay in pregnancy??
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don't know, but DON't use
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Tell me about the treatment of Allergies, Cough, and cold in pregnancy/
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-topic or local therapy is best
-can use decongestants -antihistamines are okay for the most part -avoid Nyquil |
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Tell me about Vaccines, Biologicals, Etc in pregnancy.
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-no live viruses
-hepatitis is okay -immunoglobulins are okay -RhoGam is okay |
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When are androgens given?
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-for men who don't produce enough testosterone (andropause)
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What are some forms of testosterone that can be given?
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-Fluoxymesterone/Halotestin
-testosterone/Androderm |
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Name an anabolic steroid.
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methyltestosterone/ Android
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How does finasteride/Proscar work?
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inhibits production of 5-alpha testoserone
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Flutamide/Eulexin
-class -how it works |
-Hormone Antagonist
-testosterone receptor antagonist used for prostate cancer to slow down tubor growth |
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Bicalutamide/Casodex
-class -how it works |
-testosterone receptor antagonist used for prostate cancer to slow down tubor growth
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tamoxifen/Nalvadex
-class -how it works |
-estrogen receptor antagonist
-used on occasion for breast cancer, but other tisssues it acts as an estrogen |
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What are some risk associated with tamoxifen?
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-increase risk of uterine cancer
-increase risk of thrombosis -causes hot flashes |
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How do bisphosphonates work?
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inhibit osteoclast-mediated bone resorption (non hormonal)
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Name 2 bisphosphonates.
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-alendronate/Fosamax
-risedronate/Actonel |
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How do calcitonin drugs work to prevent osteoporosis?
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inhibit oseoclast-mediated bone resorption
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Who are calcitonins good for?
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-spinal fractures
-thoughs who don't respond to bisphosphonates |
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How is the calcitonin Miacalcin/Calcimar given?
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injection
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How is the calcitonin Miacalcin Nasal given?
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nasal spray
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What are some forms of calcium carbonate?
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-Oscal
-Tums |
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Tell me about the use of calcium citrate/Citrical?
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-use when pts is on acid supressing therapy but will have to take more of than if taking tums
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Tell me about calcium phosphate/Posture
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Lyle thinks it is dumb because it is stone and doesn't disolve
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How does raloxifene/Evista wokr?
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-may stimulate osteoblasts and inhibit oseoclasts
-estrogen antagonist in some tissues and agonist in other tissues |
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What are some S/E with raloxifene/Evista?
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-can cause hot flashes
-DOESN"T increase risk of cancer or thrombosis |
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What is the only osteoporosis med that increases bone mass?
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Teriparatide/Forteo
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How does Teriparatide/Forteo work?
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-parathyroid hormone fragment that stimulates osteoblast activity
-increases Gi absorption of Ca -increases renal reabsorption of Ca |
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What is levothyroxine/Synthroid used for?
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-hypothroidism
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If you are young, what is the dose of levothyroxine/synthroid you can give?
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100-150 mcg per day
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If you are elderly or frail, what is the dose of levothyroxine/synthroid you can give?
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start w/ 25-50 mcg per day and titrate to effect or toxicity
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What are some S/E of levothyroxine/synthroid?
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-hyperthyroidism
-nervousness -weakness -heat intolerance -sweating -weight loss -thin skin -exophthalmos -loose stool |
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T4 TSH Dose
normal normal 1? low high 2? normal normal/low 3? high any 4? |
1-same
2-increase 3-same 4-decrease |
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Name some thyroid antagonist.
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-methimazole (Tapazole)
-propylthioruacil (PTU) |
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Methimazole/Tapazole
-class -how it works |
-thyroid antagonist
-inhibits iodination of thyroxin precursors |
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propylthiouracil/PTU
-class -how it works |
-thyroid antagonist
-blocks conversion of T4 to T3 peripherally |
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What are some side effects of thyroid antagonist?
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-tachycardia
-rash -agronulocytosis -hypothroidism -delay 4-8 weeks in onset of effects (7 +/- day half-life of T4) |
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Tell me about radiactive iodine (I-131)
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-only goes to thyroid
-step for non-surgical patient -can develop hypothyroidism from it |
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Tell me about plain iodine (negative feedback)
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-supresses pituitary b/c of negative feedback loop
-doesn't always work |
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What are some causes of diabetes insipidus?
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-drugs (Li, democlocycline)
-head trauma -renal insensitivity |
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What drug can you use to treat CDI?
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desmopressin
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What are some causes of SIADH?
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-carbamazepine (Tegretol)
-SSRI antidepressants -diuretics -some cancers (lung) |
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What drug can treat SIADH?
How does it work? |
-demeclocycline/Ceclomycin
-antagonist ADH @ receptor |
