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🄼💊MSY2 Pharm (Endocrine/Repro/Thyroid) > Calcium and Anti-Thyroid > Flashcards

Calcium and Anti-Thyroid Flashcards

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1
Q

List the [Vitamin D] drugs (4)

A
  1. Calcitriol
  2. Doxercalciferol
  3. Ergocholecalciferol
  4. Cholecalciferol
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2
Q

[Vitamin D] Indications (5)

A

“Vitamin D allows 2 Huns to Run in Sun Openly”

  1. Supplement
  2. Rickets / Osteomalacia
  3. Osteoporosis Px
  4. hypOparathyroidism
  5. 2º Hyperparathyroidism
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3
Q

[Vitamin D] MOA

A

Vit D Receptor Agonist –> RIPO

(Renal Ca+/P absorption)

(Intestinal Ca+/P absorption)

(PTH expression DEC)

Osteoblast stimulation

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4
Q

[Vitamin D] SE

A

Hypercalcemia

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5
Q

When should [Vitamin D] not be administered?

A

If pt has Hyperphosphatemia as this would–> Malignant Calcification

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6
Q

List the Bisphosphonates drugs (4)

A
  1. Alendronate
  2. Pamidronate
  3. Risendronate
  4. Zoledronate
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7
Q

Bisphosphonates Indications (3)

A
  1. Osteoporosis
  2. Hypercalcemia
  3. [Paget’s Osteitis Deformans]
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8
Q

Bisphosphonates MOA (3)

A

Inhibits Farensyl Pyrophosphate Synthase –>

DEC Protein Farnesylation

Osteoclast Apoptosis

DEC Osteoclast Precursors

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9
Q

Bisphosphonates SE (4)

A
  1. Esophageal irritation
  2. Occular problems
  3. Jaw Osteonecrosis
  4. Renal impairment
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10
Q

Bisphosphonates Contraindications (2)

A
  1. Esophageal Dz
  2. Chronic Kidney Dz
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11
Q

Denosumab Indications (3)

A
  1. Osteoporosis
  2. Hypercalcemia
  3. Giant Cell Tumor of Bone
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12
Q

Denosumab MOA

A

[Anti-RANKL monoclonal Ab]

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13
Q

Denosumab SE (2)

A
  1. Jaw Osteonecrosis
  2. hypOcalcemia
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14
Q

Denosumab Contraindication

A

hypOcalcemia

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15
Q

Teriparitide Indications

A

Osteoporosis

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16
Q

Teriparitide MOA

A

[Intermittent PTH R Agonist] –> which actually Stimulates OsteoBLast –>

Bone growth

INC [Renal 1a-hydroxylase]

INC Renal Ca+ reabsorption

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17
Q

Teriparitide SE (3)

A
  1. Transient Hypercalcemia
  2. Transient Hyperuricemia
  3. Osteosarcoma INC risk
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18
Q

Teriparitide Contraindications (6)

A

Don’t Play YOGA By Teri

  1. Gout
  2. Osteosarcoma (or any active bone malignancy)
  3. Bone Radiation therapy
  4. Alkaline Phosphatase INC unexplained
  5. [Paget’s Osteitis Deformans]
  6. Youth (kids/teens)
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19
Q

Calcitonin Indications (3)

A
  1. Osteoporosis
  2. Hypercalcemia
  3. [Paget’s Osteitis Deformans]
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20
Q

Calcitonin SE (4)

A
  1. Hand Swelling
  2. GI: Abd Cramps & Nausea
  3. INC CA Risk
  4. hypOcalcemia
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21
Q

How long does Calcitonin take to reduce Ca+

A

Rapidly Reduces Ca+ in 4-6 Hours!

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22
Q

Cinacalcet Indications (3)

A
  1. 2° HyperParathyroidism from Renal Failure
  2. 1° HyperParathyroidism
  3. Hypercalcemia
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23
Q

Cinacalcet MOA

A

Calcimimetic that allosterically enhances Ca+ affinity for CaSR in Parathyroid

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24
Q

Cinacalcet SE (2)

A
  1. hypOcalcemia
  2. Seizures
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25
Cinacalcet Contraindication
If Ca+ \< 8.4
26
[Levothyroxine T4] Indication
hypOthyroidism
27
[Levothyroxine T4] MOA
ProHormone thts converted to active T3 --\>[VDR tx factor agonist]
28
[Levothyroxine T4] SE (3)
1. Hyperthyroidism with OD 2. A Fib 3. Bone loss in premenopausal women
29
[Levothyroxine T4] onset
3-5 Days (slow)
30
[Levothyroxine T4] Peak
4 -6 Weeks
31
[Levothyroxine T4] Half life
7 Days
32
[Liothyronine T3] Indication (2)
1. emergent hypOthyroidism (i.e. myxedema coma) 2. Radioiodine therapy prep drug (Thyroid CA pts) - avoids extended period of thyroid hormone withdrawal
33
[Liothyronine T3] MOA
[**Direct** VDR tx factor agonist]
34
[Liothyronine T3] SE
Thyrotoxicosis with OD
35
[Liothyronine T3] onset
2-4 Hours (**fast**)
36
[Liothyronine T3] Peak
Extreme Peaks & Troughs
37
[Liothyronine T3] Half life
19 hours
38
List the [Beta Blocker] drugs used in Hyperthyroidism (2)
1. Propranolol 2. Esmolol
39
[Beta Blocker] Indications in Hyperthyroidism
Ameliorates Adrenergic sx associated with Hyperthyroidism
40
[Beta Blocker] MOA in Hyperthyroidism (2)
* Propranolol **mildly** inhibits peripheral conversion of T4 --\> T3 * Beta Blockers
41
[Beta Blocker] SE (3)
1. CHF Exacerbation 2. INC Airway resistance 3. Peripheral Artery Dz Exacerbation
42
[Beta Blockers] Contraindications (3)
1. Asthma 2. COPD 3. HF
43
If Beta Blockers are contraindicated for Hyperthyroidism, what are the alternative drug choices for it (3)
**DAM**, I can't use my normal Beta Blockers * **D**iltiazem * **M**etoprolol * **A**tenolol
44
List the [Thionamide Thiourylene] drugs (2)
1. Methimazole (MMI) 2. Propylthiouracil (PTU)
45
[Thionamide Thiourylene] Indications
Grave's Dz (Hyperthyroidism)
46
[Thionamide Thiourylene] MOA (3)
1. Inhibits [Thyroid Peroxidase Coupling] 2. Does NOT inhibit release of already formed Thyroid hormone 3. **ONLY PTU** inhibits peripheal Deiodination of T4--\>T3
47
[Thionamide Thiourylene] SE (6)
"A *Grave* reminder she **HASTA** **J**og more!" 1. **S**kin Rash 2. **J**oint Pain 3. **H**epatotoxic (PTU) 4. **A**NCA-positive vasculitis (PTU) 5. **A**granulocytosis (PTU and MMI) 6. **T**eratogenic (MMI)
48
Which [Thionamide Thiourylene] is preferred in **Non**Pregnant pts?
Methimazole (MMI)
49
Which [Thionamide Thiourylene] is preferred in [1st trimester pregnant] pts?
Propylthiouracil (PTU) ## Footnote ***P** for use in **P**regnant pts*
50
IodiDE Indications (3)
1. Thyroid Storm: Severe Hyperthyroidism 2. Thyroidectomy PreOp prep 3. [Radioiodine uptake px after nuclear accident occurs]
51
IodiDE MOA (3)
1. Inhibits Hormone secretion 2. Inhibits Hormone synthesis via [Transient Wolff Chaikoff Effect] 3. DEC Thyroid vascularity
52
How long does IodiDE [Transient Wolff Chaikoff Effect] last
10 days
53
[Radioactive Iodine] Indication (2)
1. Toxic Nodular Goiter 2. Grave's Dz Hyperthyroidism
54
[Radioactive Iodine] MOA
Beta particle Emission causes Follicular cell necrosis
55
[Radioactive Iodine] SE (2)
1. Radiation Thyroiditis 2. Grave's Exopthalmous Exacerbation
56
[Radioactive Iodine] Contraindications (3)
1. Pregnancy 2. Breast Feeding 3. Severe Exopthalmous
57
How long does it take for [Radioactive Iodine] to reach effect
2-3 months!
58
Cholestyramine MOA
Bile Acid Sequestrant that prevents [Thyroid hormone reabsorption]
59
Cholestyramine Indication
Thyroid Storm
60
Amiodarone Elimination half life
100 days ## Footnote **discontinuation will not have instant effect**
61
How does Amiodarone cause Thyroid Dysfunction (4)
1. High iodine content --\> [REFRACTORY Wolff-Chaikoff effect] 2. Inhibits Deiodination of T4--\> T3 3. Blocks binding of T3 to [Thyroid Hormone Receptor] 4. Direct effect on [Thyroid Follicular cell] --\> Destructive Thyroiditis

🄼💊MSY2 Pharm (Endocrine/Repro/Thyroid) (6 decks)

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