PHARM

Question 1

What hormones use the JAK STAT signal transduction pathway?

Answer 1

peptide hormones like GH and prolactin (non-receptor tyrosine kinase, or cytokine receptor pathway)

Question 2

Name the somatostain analogs

Answer 2

somatostatin, octreotide

Question 3

What is the primary MOA, theraputic effect and side effects of octreotide?

Answer 3

MOA inhibit GH
Theraputic effects is to reduce hormone secreting tumors in acromegaly (90% have them)
Side effects-greater than 6 months gallstones, greater than 12 months Vit B12 deficency; also cardiac problems

Question 4

What are the first line agents used in the treatment of hyperprolactinemia? MOA, Theraputic use, Adverse effects and contraindications?

Answer 4

Bromocriptine and cabergoline

MOA D2 agonists

Theraputic use-Both hyperprolactinemia, and acromegaly

Adverse effects-orthostatic hypotension

Contraindicated in pregnancy with small adenomas

Question 5

Name some drug causes of hyperprolactinemia

Answer 5

Antipsychotics, Antidepressants, Antiemetics

Question 6

Can dopamine agonists be used to treat parkinsons disease?

Answer 6

Yes, but rarely used, L-Dopa and others are more likely

Question 7

Name the antithyroid/thioamines/thionamines

Answer 7

Methimazole and propylthiouracil

Question 8

You have a patient come into your clinic c/o weight loss, who has some non-pitting edema in the feet with a sort of orange peel appearance. You suspect that they’re having thyroid issues and testing reveals increased free T4 levels. Additionally they seem agitated and have a fever and increased HR. hx of recent broken bone.

How should you treat them

A. methimazole and SSKI
B. PTU and SSKI
C. thyroidectomy
D. Propranolol, PTU, and SSKI

Answer 8

D. This is a thyroid storm secondary to hyperthyroidism

Drugs of choice: SSKI (overwhelm thyroid, decrease organificaiton), PTU & corticosteroids (decrease peripheral T3), and Propranolol (tachycardia)

Question 9

Patient is pre-op for thyroidectomy secondary to Graves disease. What drug would reduce the blood supply to the thyroid prior to surgery?

A. SSKI
B. propranolol
C. PTU
D. methimazole

Answer 9

SSKI- also decreases production and release of T4, T3

Also take 1 hr after antithyroid medication to make sure thyroid hormone production has decreased

Question 10

Which drug treatment for hypertyroid require liver function pannel prior to administration?

Answer 10

methimazole and PTU

Question 11

Which drug is first line for hyperthyroid treatment?

Answer 11

methimazole- longer acting less side effects than PTU

Question 12

When is methimazole contraindicated in hyperthyroidism?

Answer 12

Pregancy
Allergy to the drug
thyroid storm