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RUSVM Pharmacology > Endocrine Drugs > Flashcards

Endocrine Drugs Flashcards

(111 cards)

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1
Q

Why is Propylthiouracil (PTU) less frequently used in treatment for hyperthyroidsim in cats

A

Higher incidence of serious side effects

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2
Q

What is the best way to dose large patients (>50lbs) for Levothyroxine?

A

mg/m2

________________________

To avoid oversupplementation

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3
Q

General targets of drug therapy for “hyper” endocrine diseases

A

Destroy abnormal tissue/ get rid of the source

Inhibit production of the substance

Enhance elimination of the substance

Inhibit function of the substance

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4
Q

Commonly used long acting insulins

A

Glargine

Prozinc (PZI)

Detemir

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5
Q

Clinical signs of Acute Hypocalcemia

A

Hyperesthesia/ pawing at the face

Tremors progressing to flaccid paralysis, seizures, hyperthermia, bradycardia

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6
Q

Endogenous hormone of glucocorticoids

A

Cortisol

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7
Q

Non genomic effects of glucocorticoids

A

Glucocorticoid receptors in the membrane → Rapid Effects

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8
Q

Short term management of acute hypocalcemia

A

Parenteral Calcium

Oral Calcium

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9
Q

Pharmacokinetics of what type of insulin is generally most predictable

A

Short-Acting

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10
Q

Examples of glucocorticoids with salt ester excipeints

A

Dexamethasone sodium phosphate- Azium, DexSP

Methylprednisolone sodium succinate - Solu-Medrol

Hydrocortisone sodium phosphate - Solu-Delta-Cortef

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11
Q

Treatment of atypical addisons

A

Prednisone

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12
Q

Long term side effects of glucocorticoids

A

Increased susceptibility to infection

Skin changes - hyperpigmentation, thinning, alopecia

Collagen disease, delayed wound healing

Hypertension, thromboembolic disease

Panting

Addisonian signs

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13
Q
A
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14
Q

Oral calcium options for treating Chronic Hypocalcemia

A

Ca Carbonate

Ca Proprionate

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15
Q

Adverse effects of glucocorticoids

A

PU/PD

Catabolic

Antagonize Insulin

Inhibit fertility

“Stress” leukogram

Impair healing

Calcinosis cutis, osteoporosis, thin skin and alopecia

Increase GI acid and decreased mucus

Increase fat absorption/ deposition

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16
Q

Regulation of glucocorticoids

A

Regulated by the hypotalamus/pituitary through the release of CRH and ACTH

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17
Q

Drugs that target the production of ACTH by the pituitary gland

A

Pergolide- Permax

Selegiline- Anipryl

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18
Q

Mechanism of action of mineralcorticoids

A

Regulate Na retention / K excretion by the kidney

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19
Q

T/F: Ca Chloride can be given SQ/IM

A

False

__________________

Ca Chloride is caustic

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20
Q

Primary goal of Diabetes Melitus therapy

A

Address the insulin deficiency

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21
Q

Mechanism of action of oral hypoglycemic agents

A

Stimulate insulin secretion by the pancreatic beta-cells by blocking K channels

Increase tissue sensitivity to insulin

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22
Q

Physiologic effects of glucocorticoids

A

Increase calcium excretion

Reduce Fever

Suppress immune system

Lymphotoxic

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23
Q

Modes of administration for Regular Insulin- Humulin-R

A

IV

IM

SQ

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24
Q

Excipients that may be used for injectible glucocorticoids

A

Salt Esters

Insoluble Esters

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25
Cabimazole is converted to what in the body
Methimazole
26
How does hypoparathyroidism effect calcium
Hypoparathyroidism results in inability of the body to convert vitamin D to calcitriol, thus the GI tract cannot absorb calcium
27
Treatment of typical addisions
Prednisone + either DOCP or Fludrocortisone
28
Most commonly used drug to treat Cushings disease
Trilostain - Vetoryl
29
Commonly used short acting insulin
Regular Insulin - Humulin-R
30
In the cases of "hypo" endocrine diseases we need our therapy to do what
Replace an endogenous substace
31
Likely cause of hypoglycemia
Diet
32
Hypoadrenocortisim is usually caused by
Chronic destructionof the adrenal gland
33
Side effects of drugs targeting "hypo" endocrine diseases are typically related to
Excess of the endogenous substances
34
Examples of glucocorticoids with insoluble ester excipients
Methylprednisolone Acetate - Depo-Medrol Triamcinolone Acetonide - Vetalog
35
Types of corticosteroids
Glucocorticoids Mineralcorticoids
36
Hyperadrenocorticism can be cuased by
Functional adrenal cortical mass Functional pituitary mass
37
Insulin pen is a new product designed for
Vetsulin/Caninsulin
38
Pergolide - Permax
Dopamine agonist Suppress production of ACTH thus reduces cortisol production
39
Endogenous hormone of mineralcorticoids
Aldosterone
40
Lifelong management of hypocalcemia
Replace Vitamin D Calcitriol, DHT, Ergocalciferol
41
Biggest potential side effect of calcitriol
Hypercalcemia
42
Mechanism of action of Iodides and Iodinated Contrast Agents
Inhibit thyroid hormone synthesis Inhibit the release of preformed hormone Inhibit T3 \> T4 conversion in periphery
43
Why would you choose to use Levothyroxine over Liothyronin
Levothyroxine requires less freqent dosing and has lower risk of causing thyrotoxicosis
44
Ketoconazole
Inhibits enzyme in the steroid synthesis pathway Efficacy being questioned Potential for hepatotoxicity - hepatic microsomal enzyme inhibitor
45
Diagnostic tests using glucocorticoids
Low dose dexamethasone suppression test High dose dexamethasone suppression test
46
Most potent, activated form of vitamin D
Calcitriol
47
Salt esters as excipients for glucocorticoids
Make steroid soluble Suitable for IV administration Onset may be faster and duration unchanged
48
DOCP is administered
Parenterally
49
Selegiline - Anipryl
Inhibits MAO-B which results in increased dopamine.
50
Only insulin that can be given IV
Regular Insuin - Humulin-R
51
Insoluble esters as excipients for glucocorticoids
Delayed onset, long duration Opaque - not for IV use
52
Glucocorticoids are used for what effect
Anti-Inflammatory
53
Trilostain - Vetoryl
Inhibits 3beta-hydroxysteroid-dehydrogenase in cortisol pathway Narrow therapeutic index
54
Why is methimazole most commonly used in the treatment of hyperthyroid cats?
Consistently efficacious Side effects are uncommon
55
T/F: Oral medications for Diabetes Melitus treat the cause
False \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_ Cause hypoglycemia
56
Calcium Disorders
Acute Hypocalcemia Chronic Hypocalcemia
57
Thioureylenes used to treat hyperthyroidism in cats
Methimaxole Carbimazole Propylthiouracil PTU
58
Mechanism of Insulin release
Blood glucose rises ​→ energy dependent K channels close → membrane depolarization → insulin release
59
Rapid IV administration of calcium can cause
Arrhythmias
60
Common glucocorticoids
Prednisone Prednisolone Dexamethasone Triamcinolone Methylprednisolone
61
Long acting insulin that forms microprecipitates in physiologic pH which results in very gradual absorption
Glargine
62
Treatment strategy for chronic hypoglycemia
Address the cause if possible and if not alter glucose production or use by the body
63
Genomic effects of glucocorticoids
Nuclear type glucocorticoid receptors in the cytoplasm → move into the nucleus → increase or decrease gene expression
64
Fludrocortisone is administered
orally
65
Common mineralcorticoids
Fludrocortisone DOCP - Desoxycorticosterone pivalate
66
Insulin is produced by
the beta cells and islet of Langerhands in endocrine pancreas
67
General concept when treating acute hypocalcemia
Replace the calcium dificient until the patient can catch up
68
Pharmacological options to treat hyperthyroidism in cats include
Thioureylenes Iodides and Iodinated Contrast Agents
69
T/F: Hypothyroid drugs must be given for the duration of the patients life.
True
70
Goal of therapy for Hypothyroidism in dogs
Replace hormone the body is not producing
71
Short acting insulins are most commonly used for
Hospitalized patients who are not eating
72
Atypical Addisons
Patient lacking only glucocorticoids
73
Drugs that target the production of glucocorticoids in the adrenal gland
Trilostain Ketoconazole
74
Short term side effects of glucocorticoids
Usually not serious unless concurrent factors Lab changes - stress leukogram, decreased thyroid PU/PD, polyphagia Fetal abnormalities/ abortion
75
Mode of administration of Vetsulin/Canisulin
SQ only
76
Exogenous glucose sources used in the treatment of hypoglycemia
Dextrose 50% Solution Glucagon
77
Most common pharmacutical agent used to treat hyperthyroidism in cats
Methimazole
78
Clinical uses of glucocorticoids
Diagnostic testing Physiologic replacement therapy Anti-inflammatory Immunosuppressive
79
Pharmacokinetics of glucocorticoids
Absorbed orally and parenterally Protein bound Some must be hydrolyzed to release the steroid base Metabolites excreted in urine
80
Used to treat Pituitary pars intermedia dysfunction (PPID) in horses
Pergolide - Permax
81
Targets for drug therapy for hyperadrenocorticism
Adrenal gland itself
82
Veterinary approved long acting insulin
Prozinc (PZI) \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_ May have shorter duration than other long acting insulins - especially in cats
83
Lack of response to normal feedback due to what can cause "hyper" endocrine diseases
Hyperplasia Benign neoplasia - adenoma Malignatn neoplasia - carcinoma
84
T/F: Ca Gluconate can be given SQ
True \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_ Should be diluted if given SQ, better to give IV
85
Long acting insulin that has a much higher potency in dogs
Detemir
86
Commonly used intermediate acting insulin
Vetsulin/Canisulin
87
Why are idodies and iodide contrast agents less freqently used in the treatment of hyperthyroid cats
Efficacy is variable and often transient.
88
Categories of Insulin based on duration of action
Short Acting Intermediate Acting Long Acting
89
Used to treat Canine Cognitive Dysfunction and sometimes used in attempt to treat Cushings Disease
Selefiline- Anipryl
90
Glipizide
Oral hypoglycemic drug Only effective in 20-30% of cats May accelerate beta loss
91
General goals of drug therapy in "hypo" endocrine diseases
Drug replacing an endogenous substance Drug replacing something that directly allows the body to regain normal homeostasis
92
Side effects of Methimazole
Mild - GI signs, transient hematologic changes on CBC Severe - Refractory GI signs, Idiosyncratic reactions (facial excoriation, hepatopathy, bone marrow suppression)
93
Treatment strategy for Acute Hypoglycemia
Address the cause and supply exogenous glucose source
94
Goal of therapy for Hyperthyroidism in cats
Stop excessive hormone production
95
Drugs used in the treatement of Hypothyroidism in dogs
Liothyronin (T3) Levothyroxine (T4) Soloxine
96
Hypoadrenocorticism - "Addisons Disease"
Deficient production of glucocorticoids +/- mineralcorticoids
97
Pharmacologic considerations when using glucocorticoids
Potency Duration
98
In the cases of "hyper" endocrine diseases we need our therapy to
Decrease the amount of an endogenous substance that is in excess
99
T/F: Concentrations of human and veterinary insulin products are the same.
False \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_ Human - 100 IU/mL Veterinary - 40 IU/mL
100
Glucocorticoids are produced by the
Zona Fasciculata
101
Typical Addisons
Patient lacking both glucocorticoids and mineralcorticoids
102
Parenteral calcium options for treating acute hypocalcemia
Ca Gluconate Ca Chloride
103
Hyperadrenocorticism - "Cushings Disease"
Excess glucocorticoid production by the adrenals
104
Drugs that can interfere with thyroid test results
Phenobarbital Zonisamide Sulfonamide Glucocorticoids Phenylbutazone Quinidine Others
105
Mineralcorticoids are produced by the
Zona glomerulosa
106
Mechanism of action of Propylthiouracil PTU
Inhibit thyroid hormone synthesis Inhibit conversion of T4 to T3
107
Mechanism of action of Methimaxole and Carbimazole
Inhibit thyroid hormone synthesis
108
Mitotane (Lysodren)
Used in the treatment of hyperadrenocorticism Cytotoxic to cells of the fasciculata Narrow therapeutic index Start with high dose reduce to lower dose
109
Causes of hyperglycemia
Something that does not require therapy Diabetes Mellitus (DM)
110
Periparturient Hypocalcemia
"Milk Fever" "Eclampsia" Acute hypocalcemia Sudden increase in calcium usage for which the patient cannot adapt rapidly enough - generally associated with birth or lactation
111
Oral Hypoglycemic drugs are useful in what type of diabetes
Type II Diabetes \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_ Pancreas is still capable of secreting some insulin

RUSVM Pharmacology (19 decks)

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