Exam 2: Endocrine Pharmacology Flashcards Preview

Pharmacology II > Exam 2: Endocrine Pharmacology > Flashcards

Flashcards in Exam 2: Endocrine Pharmacology Deck (45):
1

Name the 3 thyroid diseases

1. Lack of iodine in diet
- excessive secretion of TSH, resulting in thyroid hypertrophy (Goiter)
2. Primary hypo/hyperthyroidism = disease of thyroid gland
3. Secondary hypo/hyperthyroidism = disease of pituitary or hypothalamus gland

2

What is the precursor to making synthetic thyroid hormones T4 and T3?

L-tyrosine

3

Which chemical is required for synthesis of thyroid hormones?

Iodine
- without iodine, build-up of TH precursor, resulting in goiter
- americans obtain iodine from iodized salt

4

2 synthetic thyroid preparations are made by industry:

1. Sodium levothyroxine (T4 = Synthroid, Levoxyl)
2. Sodium liothyronine (T3 = Cytomel)

5

What is the preferred drug for most cases of hypothyroidism?

Sodium levothyroxine (Synthroid, Levoxyl)

6

Use for Sodium levothyroxine (T4 = Synthroid)

replacement or supplement therapy in hypothyroidism

7

Mechanism of action for Sodium levothyroxine

- Affects DNA transcription and stimulates protein synthesis
- Promotes gluconeogenesis
- Mobilizes glycogen stores
- **Increases basal metabolic rate

8

Important adverse effects of Sodium levothyroxine

Overdose...
1. Palpitations, tachycardia
2. Nervousness, sweating
3. Increased appetite
4. Weight loss

9

Name the drugs used to treat Hyperthyroidism

1. Propylthiouracil
2. Iodides
3. methimazole (Tapazole)
4. Radioactive Iodide I 131

10

Use of Propylthiouracil (PTU)

treatment of hyperthyroidism in preparation for surgery or radioactive iodine therapy

11

Mechanism of Propylthiouracil (PTU)

Blocks iodination reaction in thyroid gland; blocks synthesis of T4 and T3

12

Side effects of PTU

skin rash
nausea
agranulocytosis

13

What are Iodides

saturated solution of potassium iodide

14

Mechanism of action of Iodides

Not clear...
Probably reduces secretion of thyroid hormone

15

Use of Iodides

Used in conjunction with propylthiouracil to prepare patients for surgery

16

Use of Methimazole (Tapazole)

Hyperthyroidism
Return patient to a normal metabolic state prior to thyroidectomy

17

Mechanism of action of methimazole (Tapazole)

Blocks iodination reaction in thyroid gland
Blocks iodine's ability to combine with tyrosine to form T3 and T4

18

Which of the hypertensive drugs is considered undesirable

methimazole (Tapazole)
- expensive, inconvenient, adverse effects

19

Oral side effects of methimazole (Tapazole)

Taste alteration
Salivary gland swelling

20

How does Radioactive iodide I 131 work?

Patient swallows iodine tagged with radioactive nucleotide = drug binds to iodine receptors and slowly irradiates and destroys thyroid gland (

21

Dental considerations of patients with hypothyroidism

1. Easier from management perspective
2. Cold, tired/fatigued
3. MORE sensitive to CNS depressants
- lower dose

22

Dental considerations of patients with hyperthyroidism

1. Nervous; may have increased blood pressure
2. May be sensitive to epinephrine
- if active disease, ABSOLUTE contraindication to epinephrine
3. Palpitations and tachycardia
4. May perceive more pain
5. Less sensitive to CNS depressants

23

Type I diabetes results from what?

autoimmune destruction of the pancreatic beta cells.

24

What is the only effective drug in treating Type 1 diabetes?

Insulin

25

Structure of Insulin

2 chains connected via disulfide bridges

26

T or F, Insulin preparations currently used are from animal sources

False, no longer used. Current insulin is available as human-type insulin

27

How is insulin administered?

All insulins are injected subcutaneously (SC)

28

Insulin is classified in what 3 ways?

1. Onset
2. Peak
3. Durations of action

29

Name the short-acting insulin preparations

Insulin Regular (HumuLIN R)

30

Name the rapid-acting insulin preparations

Insulin Aspart (NovoLOG)
Insulin Glulisine (Apidra, Apidra Solostar)
Insulin Lispro (HumaLOG)

31

Name the intermediate acting insulin preparations

Insulin NPH (HumuLIN, NovoLIN N)

32

Name the intermediate to long-acting insulin preparations

Insulin Detemir (Levemir)

33

Name the long-acting insulin preparations

Insulin Glargine (Lantus, Lantus Solostar)

34

Use of Lantus Solostar (insulin glargine)

Treatment of type 1 diabetes and type 2 diabetes to improve glycemic control.

35

Oral complications of Lantus Solostar

Numbness of mouth

36

General idea behind drugs that work to fix Type 2 diabetes

Target cells become insensitive to insulin. So, more insulin is needed to elicit response in resistant cells.

37

Name the goals of oral drug therapy for management of Type 2 Diabetes

1. Increase insulin secretion in glucose-dependent manner
2. Suppress hepatic gluconeogenesis
3. Improve insulin sensitivity

38

Risk of Oral Drug Therapy for Type 2 diabetes

hypoglycemia

39

Name the Primary drugs for Type 2 diabetes

1. sulfonylureas (traditional oral hypoglycemias)
2. Biguanides (Metformin)
3. Alpha-glucosidase inhibitors
4. Thiazolidinediones (TZDs)
5. Incretins - GLP-1 agonists, DD-4 inhibitors

40

Name the 1st generation Sulfonylureas

1. tolbutamide (Orinase)
(others not in bold...)

41

Name the 2nd generation Sulfonylureas

1. glipizide (Glucotrol)
(one more but not in bold)

42

What is the major distinction between 1st and 2nd generations of Sulfonylureas

Potency
-2nd generation are more potent but not more effective

43

3 warnings with Sulfonylureas

1. Increased cardiovascular mortality
2. Sulfonamide allergy
3. Caution with use if severe hepatic disease

44

Describe a very serious drug interaction with Sulfonylureas

Aspirin
- simultaneous administration may enhance the hypoglycemic response to the sulfonylurea

45

What is the result of a drug interaction between aspirin and sulfonylurea?

hypoglycemia