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endocrine pharm > endocrine pharm > Flashcards

endocrine pharm Flashcards

1
Q

Addisons diseease

A

replace cortisol with hydrocortisone and replace aldosterone with fludrocortisone

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2
Q

Addisonian crisis

A

Give hydrocortisone STAT

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3
Q

Conn’s syndrome

A

unilateral adrenalecomy

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4
Q

Conn’s syndrome 2nd line tx

A

spironolactone

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5
Q

hypoaldosterone tx

A

replace Na, 10mEq/kg/day or give fludrocortisone

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6
Q

congenital adrenal hyperplasia

A

replace cortisol with hydrocortisone or dexamethasone and replace aldosterone with fludrocortisone

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7
Q

Pheochromocytoma

A

90% curable with Sx.

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8
Q

Topical tx for diabetic neuropathy

A

Capsaicin cream, Salonpas

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9
Q

Gabapentinin

A

an anticonvulsant that is used in diabetic neuropathy

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10
Q

Pregabalin

A

aka Lyrica. An anticonvulsant used in diabetic nerve pain

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11
Q

Duloxetine

A

SNRI, useful in diabetic neuropathy

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12
Q

Amitryptiline

A

a TCA, is useful in diabetic neuropathy and is often combined with Gabapentine

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13
Q

Metoclopramide

A

used for diabetic gastropareisis, it is a pro kinetic to get the gut moving

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14
Q

DKA tx

A

will admit these pts, give IV insulin, K and fluids

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15
Q

Standard tx in DM its that is not targeting their glucose….

A

must control their HTN with an ACEi (Lisinopril) or an ARB (Losartan)

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16
Q

DM pts that develop hypoalbuminura

A

put them on a BB, like carvedilol

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17
Q

First line therapy in DM II

A

Metformin

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18
Q

second line DMII therapy that reduces AIC 1-2% and can be added

A

Glimeperide, glyburide, Glipizide

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19
Q

Glimeperide, glyburide, Glipizide

A

can add to Metformin therapy, but can cause hypoglycemia and cannot use if sulfa allergy

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20
Q

second line DMII therapy that reduces AIC 0.6-1% and can be added

A

-Gliptins, Januvia, Tradjenta

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21
Q

-gliptins

A

URI side effects

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22
Q

second line DMII therapy that reduces AIC 0.5-0.7% and can be added

A

-Gliflozins

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23
Q

-Gliflozins

A

weight loss, genital candidiasis

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24
Q

-glinide

A

Prandin and Starlix, decrease post-prandial glucose, but can cause hypoglycemia and weight gain

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25
Q

-glitazone

A

Gain weight, but can increase HDL (get it in the zone)

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26
Q

Miglitol

A

for DM: can lose weight, and no hypoglycemia risk

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27
Q

Acarbose

A

For DM: same as miglitol, can lose weight and there is no hypoglycemia risk

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28
Q

-glutide

A

injectable DM drug, can decrease AIC 1-1.1% but is contraindicated in IBD pts

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29
Q

Amylin and Symlin

A

are injectable DM drugs that can be used in DM 1 and 2 to reduce post-prandial glucose

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30
Q

basal insulin

A

Lantus and levemir

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31
Q

insulin that has 10-15 minute onset

A

Homolog or Novalog

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32
Q

insulin that has a 30-60 minute onset

A

regular insulin

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33
Q

insulin that has a 1-3 hour onset

A

NPH, will peak in 5-8 hrs

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34
Q

Humulin

A

used more in DM-1. super high concentrated insulin.

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35
Q

first line tx in Graves disease

A

Methimazole, carbimazole

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36
Q

Tx Graves disease in pregnant pt

A

PTU

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37
Q

Drug that can add to Graves disease therapy

A

BB (propranolol) can be added to PTU or methimazole to reduce adrenergic symptoms.

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38
Q

dietary modifications for tx of Graves disease

A

decrease iodized salt intake

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39
Q

2nd line therapy for Grave’s disease

A

radioactive iodine

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40
Q

2nd line therapy for kids with Graves disease

A

99-technetum. regular iodine is not safe.

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41
Q

3rd line therapy for Graves disease

A

thyroidectomy. done more in kids and pregnancy that do not tolerate PTU or if cardio issues not controllable

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42
Q

it is safe to use radioactive iodine in graves disease with opthalmopathy

A

NO. it will make it worse

43
Q

acute thyroiditis tx

A

antibiotics, according to FNA culture results

44
Q

silent thyroiditis tx

A

stop Lithium use. Do NOT give steroids

45
Q

Subacture thyroiditis tx

A

large dose Aspirin or NSAIDS. Can give glucorticoids if needed

46
Q

elongated Subacute thyroiditis tx

A

may need to add levothyroxine if they have dipped into the second phase of hypothyroid symptoms

47
Q

Hashimotos thyroititis “hashitoxicosis” tx

A

can give BB, propranolol, for hyperthyroid symptoms

48
Q

Redials thyroiditis tx

A

surgery to relieve fibrotic tissue that is causing compression symptoms

49
Q

Jod-Basedow tx

A

(drug induced thyroiditis) d/c amiodarone, give methimazole and K

50
Q

Type 2 amiodarone induced thyroiditis

A

give prednisone taper and d/c amiodarone

51
Q

Plumbers disease tx

A

thyroidectomy

52
Q

thyrotoxicosis tx

A

“thyroid storm”. these its are admitted. Slow cooling, will be put on propranolol (BB), methimazole or PTU and glucocorticoids. This is the only emergency with thyroid excess

53
Q

Sick Euthyroid Syndrome tx

A

mostly just watch and wait. should resolve in 4-6 weeks. tx with levothyroxine is controversial

54
Q

iatrogenic hypothyroidism tx

A

low dose levothyroxine

55
Q

hypothyroid first line therapy

A

Levothyroxine (synthroid, levoxyl, levothroid, etc).

56
Q

Levothyroxine is safe in pregnancy

A

TRUE

57
Q

2nd line therapy in hypothyroidism

A

Liothyronine. Is not used as mono therapy.

58
Q

Myxedema coma tx

A

slow warming, IV levothyroxine, hydrocortisone to prevent adrenal crisis and CONTROL VENTILATION

59
Q

immediate Hypoparathyroidism tx

A

First thing to do is give IV Calcium, 1-2 g. This hurts!

60
Q

chronic hypoparathyroidism tx

A

calcitriol and calcium supplementation (tums) is first line

61
Q

chronic hypoparathyroidism second line tx

A

ergocalciferol and calcium supplementation

62
Q

Acute hyperparathyroidism tx

A

IV fluids to dilute excess Ca

63
Q

primary hyperparathyroidism tx

A

partial parathyroidectomy

64
Q

Secondary hyperparathyroidism tx

A

renal transplant?

65
Q

tertiary hyperparathyroidism tx

A

total parathyroidectomy with autotransplantation

66
Q

Page’s disease of the bone tx

A

Fosamax (bisphosphanates), Calcium and Vitamin D

67
Q

Kallmann’s Syndrome Tx

A

stimulate the pituitary with pulsatile GnRH, or sex hormone replacement

68
Q

Prolactinoma tx

A

Cabergoline or Bromocriptine (Dopamine agonists)

69
Q

Pituitary adenoma tx

A

sphenoidal approach pituitary resection

70
Q

Acromegaly first line tx

A

surgical removal of pituitary ademona

71
Q

Acromegaly second line tx

A

Octreotide of lanreotide somatostatin

72
Q

GHD short stature tx

A

recombinant GH

73
Q

GH deficiency in adults tx

A

low dose recombinant GH to increase quality of life

74
Q

Cushing disease tx

A

Transsphenoidal pituitary resection

75
Q

cushings disease second line tx

A

surgery attempt #2

76
Q

cushings disease third line therapy

A

Ketocondazole and/or metyrapone

77
Q

Cushing syndrome tx

A

tx the underlying cause. may need to to bilateral or unilateral adrenalectomy

78
Q

Nelson’s syndrome tx

A

pituitary removal

79
Q

SIADH first tx step

A

restrict fluid intake

80
Q

SIADH second tx steps

A

diuresis, but be careful because too much hypertonic solution can lead to cerebral hemorrhage

81
Q

Neurogenic DI tx

A

rehydrate cells with hypotonic IV (be careful, cerebral edema) and give ADH replacement, desmopressin

82
Q

Nephrogenic DI tx

A

Rehydrate their cells with hypotonic IV solution (be careful of cerebral edema) and diurese them with thiazide diuretic, HCTZ

83
Q

Rhabdo tx

A

Hydration and switch Statin therapy

84
Q

Papillary carcinoma >1.5 cm tx

A

total thyroidectomy

85
Q

Follicular adenoma tx

A

total thyroidectomy

86
Q

medullary carcinoma tx

A

thyroidectomy + lymphadenectomy

87
Q

PTU

A

works in the periphery and is good in pregnancy

88
Q

life threatening side effect of antithyroid medications

A

PTU and methimazole can cause agranulocytosis

89
Q

metyrapone

A

fast acting tx for cushing, decreases Cortisol and increases ACTH

90
Q

hyperaldosteronism first line tx (that is not Conn’s)

A

Spironolcactone

91
Q

Hyperaldosteroneism second line tx

A

Eprenelone

92
Q

Lipitor

A

statin that will decreased LDL by 55%. watch for LFTs

93
Q

Lipitor is safe in pregnancy

A

FALSE

94
Q

Pravastatin and Pitavastatin

A

statin that is good if cannot take a cytochrome using statin

95
Q

Niacin

A

will increase HDL

96
Q

Flushing

A

common side effect of Niacin use, along with liver damage. Can give baby ASA

97
Q

Drug of choice for homozygous familial hyperlipidemia

A

Niacin

98
Q

Tracer, Trilipix

A

fenofibrate that will decrease TG

99
Q

Welchol

A

will decrease LDL and increase LDL slightly, no affect on TG. is not absorbed, so is drug of choice if your pt has hyperlipidemia and liver disease.

100
Q

Ezetemibe

A

well tolerated drug that decreases cholesterol absorption in the gut. Often combined with statin to decrease LDL >55%

101
Q

Lovasa

A

omega 3 fatty acid drug to decrease TG. watching for increased LDL and allergy

102
Q

high intensity statin

A

Atorvastatin 40 and 80; Rosuvastatin 20 and 40

103
Q

it is ok to take red rice yeast with Lovastatin

A

False. This can cause OD and renal failure.

endocrine pharm (1 decks)

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