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D1 Spring > Pharmacology - Pituitary, Thyroid, Parathyroid Drugs (Exam 5) > Flashcards

Pharmacology - Pituitary, Thyroid, Parathyroid Drugs (Exam 5) Flashcards

1
Q

What are the major endocrine glands?

A

Pituitary
Thyroid
Parathyroid

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2
Q

What does thyrotropin do?

A

Stimulates thyroid to release thyroid hormone

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3
Q

What is thyrotropin also called?

A

Thyroid-stimulating hormone (TSH)

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4
Q

Which hormone is upstream of TSH?

A

Thyrotropin-releasing hormone (TRH)

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5
Q

Which mechanism regulates hormone levels?

A

Negative feedback

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6
Q

Which gland is called the “master gland” since it regulates other endocrine glands?

A

Pituitary

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7
Q

What does the pituitary gland secrete?

A

Peptide hormones

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8
Q

What effect does the pituitary gland have?

A

Tropic

(tells other glands to secrete their hormones)

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9
Q

What happens if you don’t have any gonadotropins (LH, FSH)?

A

Entire reproductive system fails

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10
Q

What happens if you don’t have growth hormone and thyrotropin?

A

Normal growth/development is not possible (dwarfism)

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11
Q

Hypopituitariasm

A

Pituitary hormone deficiency

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12
Q

What causes dwarfism?

A

Decreased growth hormone

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13
Q

What causes hypothyroidism?

A

Increased thyroid-stimulating hormone (TSH)

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14
Q

What causes decreased metabolism?

A

Decreased thyroid hormone

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15
Q

What causes Addison Disease?

A

Decreased corticosteroids

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16
Q

What causes loss of secondary sex characteristics?

A

Decreased LH & FSH

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17
Q

What causes diabetes insipidus?

A

Decreased ADH

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18
Q

What are the symptoms of hypopituitarism (pituitary hormone deficiency)?

A

Hypopigmentation
Thinning/softening of skin
Decreased libido
Retarded dental development

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19
Q

What are 5 things associated with hypersecretion of pituitary hormones?

A

Sexual precocity
Acromegaly
Gigantism
Goiter
Cushing Disease

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20
Q

What are goiters caused by?

A

Overactive thyroid

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21
Q

What is Cushing Disease caused by?

A

Increased corticosteroids

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22
Q

Which hormones are involved in the anterior pituitary (adenohypophysis)?

A

Growth hormone (GH, aka somatotropin)
Luteinizing hormone (LH)
Follicle-stimulating hormone (FSH)
Thyroid-stimulating hormone (TSH)
Adrenocorticotropic hormone (ACTH)
Prolactin
B-lipotropin

“FLAT PeG B”

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23
Q

Anomalies associated with growth hormone (GH)

A

Deficiency: dwarfism
Hypersecretion: gigantism

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24
Q

Anomalies associated with LH & FSH

A

Deficiency: loss of secondary sex characteristics
Hypersecretion: sexual precocity

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25
Q

Anomalies associated with TSH

A

Deficiency: hyperthyroidism
Hypersecretion: hypothyroidism

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26
Q

Anomalies associated with ACTH

A

Deficiency: Addison Disease
Hypersecretion: Cushing Disease

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27
Q

Anomalies associated with prolactin

A

Deficiency: failure to lactate
Hypersecretion: galactorrhea & infertility

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28
Q

What are natural and synthetic hormones of pituitary used as?

A

Pituitary hormone drugs

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29
Q

What can pituitary hormone drugs do?

A

Mimic or block actions

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30
Q

Which hormones are gonadotropins?

A

LH & FSH

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31
Q

What does FSH do?

A

Stimulate follicle growth

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32
Q

What does LH do?

A

Induce ovulation

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33
Q

What can LH & FSH be used to treat?

A

Infertility

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34
Q

What combo of hormones is a patient with infertility given? What is the outcome?

A

Gonadotropins (LH & FSH) + hCG -> superovulation (in vitro fertilization)

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35
Q

Which pituitary hormone drug is a recombinant growth hormone?

A

Somatotropin

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36
Q

What is somatotropin/GH used to treat?

A

Dwarfism
Wasting syndrome or anorexia cachexia syndrome (ex: in AIDS)

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37
Q

What is another name for growth hormone inhibiting hormone (GHIH)?

A

Somatostatin

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38
Q

Which pituitary hormone drug is an analogue of somatostatin?

A

Octreotide

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39
Q

What does Octreotide inhibit?

A

Inhibits release/production of GH
Inhibits release of serotonin & vasoactive substances

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40
Q

What does octreotide treat?

A

Acromegaly

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41
Q

Which pituitary hormone drug is a dopamine receptor agonist?

A

Bromocriptine

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42
Q

Bromocriptine is _______ soluble and penetrates the _______

A

lipid; BBB

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43
Q

What does Bromocriptine inhibit?

A

Prolactin release

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44
Q

What is Bromocriptine used to treat? (2)

A

Female infertility resulting from hyperprolactinemia (too much prolactin)

Parkinson’s Disease

45
Q

Which pituitary hormone drug is an antidiuretic hormone (ADH)?

A

Vasopressin

46
Q

What does vasopressin cause?

A

Increased water retention

47
Q

What is vasopressin used to treat?

A

ADH deficiency - diabetes insipidus (excessive thirst)

48
Q

What is the suffix of the synthetic analogs of vasopressin?

A

“-pressin”

49
Q

What does oxytocin induce and control?

A

Induce labor (contracts uterine muscle)
Induce postpartum lactation
Control postpartum hemorrhage

50
Q

What is the root of oxytocin drugs?

A

“tocin”

(ex: pitocin, suntocinon)

51
Q

What is the most common endocrine disorder?

A

Diabetes mellitus (type II)

52
Q

What is the 2nd most common endocrine disorder?

A

Thyroid dysfunction

53
Q

Low TSH causes what?

A

High thyroid hormone (due to negative feedback)

54
Q

High TSH causes what?

A

Low thyroid homrone

55
Q

Which disease?

Low TSH
High T4 thyroid hormone

A

Hyperthyroidism

56
Q

Which disease?

High TSH
Low T4 thyroid hormone

A

Hypothyroidism (primary)

57
Q

What are the 3 thyroid hormones?

A

T3
T4
Calcitonin

58
Q

What is involved in T3 and T4 thyroid hormones?

A

Iodine

59
Q

What do thyroid hormones regulate?

A

Energy metabolism
Growth/development

60
Q

What does calcitonin regulate?

A

Calcium metabolism

61
Q

What do thyroid hormones act on?

A

Every tissue/organ

62
Q

What do increased levels of T3 and T4 thyroid hormones do in the heart?

A

Increase B1 receptor activity

63
Q

What does an increase in B1 receptor activity due to increased T3 and T4 thyroid hormones cause?

A

Increased HR, contractility, and sensitivity to catecholamines

64
Q

What are the general effects of increased T3 and T4 thyroid hormones?

A

Increased energy metabolism
Increased growth/development

65
Q

What are the general effects of decreased T3 and T4 thyroid hormones?

A

Decreased energy metabolism
Decreased growth/development

66
Q

T/F hypothyroidism is common, and it is more common in women than men

A

True

67
Q

T/F hypothyroidism increases dramatically in women after 40

A

True

68
Q

__________ hypothyroidism is common, especially among older women. This contributes to hyperlipidemia, cardiac dysfunction, osteoporosis, and carpal tunnel

A

Subclinical

(asymptomatic)

69
Q

What disease?

Fatigue
Depression/mood swings
Hair loss/thin eyebrows
Bradycardia
Hypotension
Intolerance to cold
Difficulty handling stress

Decreased metabolism (weight gain)
Decreased development

Increased sensitivity to CNS depressants

A

Hypothyroidism

70
Q

What disease?

Nervousness
Anxiety
Emotional liability
Tachycardia
Tremors
Osteoporosis of alveolar bone

Increased metabolism (weight loss)
Increased development

Decreased sensitivity to CNS depressants

Increased sensitivity to pain and epi

A

Hyperthyroidism

71
Q

What 2 things cause hypothyroidism? Which one is most common in the US?

A

Iodine deficiency
Hashimoto’s Disease (#1 cause in US)

72
Q

Chronic inflammation of the thyroid affecting middle aged women

A

Hashimoto’s Disease

73
Q

How does hypothyroidism appear in children?

A

Cretinism

(mental defects, stunted growth)

74
Q

How does hypothyroidism appear in adults?

A

Myxedema

75
Q

What can happen when a pregnant women has hypothyroidism?

A

Child has large teeth

76
Q

What disease?

Delayed tooth eruption
Malocclusion
Increased gingivitis/perio
Gingiva is inflamed or pale and enlarged
Poorly shaped teeth; large teeth
Caries

A

Hypothyroidism

77
Q

What disease?

Accelerated tooth eruption
Early loss of deciduous teeth/early eruption of permanent teeth
Loss of alveolar process
Diffuse demineralization of jaw
Maxillary or mandibular or alveolar osteoporosis
Rapidly progressing perio destruction

A

Hyperthyroidism

78
Q

What drugs are used for treating hypothyroidism?

A
  1. Levothyroxine sodium (Synthroid) - T4
  2. Liothyronine sodium - T3
79
Q

What is the 1/2 life of Levothyroxine sodium (Synthroid)? How long does it take to reach steady state?

A

1/2 life = 7 days
Steady state = 1 month

80
Q

What is the 1/2 life of Liothyronine sodium? What does this cause?

A

Shorter than Levothyroxine sodium (Synthroid)

Greater risk for cardiotoxicity

81
Q

What are the associated diseases of hyperthyroidism?

A

Graves’ Disease (diffuse toxic goiter)
Plummer’s Disease (toxic nodular goiter)
Thyrotoxicosis

82
Q

What disease presents with a diffusely enlarged, highly vascular thyroid gland that is common is young adults who have antibodies against thyrotropin (TSH) receptor?

A

Graves’ Disease

83
Q

What is the #1 cause of hyperthyroidism in the US?

A

Graves’ Disease

84
Q

What disease presents with nodules that secrete excessive hormones, while the rest of the tissue is atrophied, primarily in older patients?

A

Plummer’s Disease

85
Q

What disease presents with excessive heat production, increased SNS, increased neuromuscular activity, increased sensitivity to pain, ophthalmopathy (swelling), exophthalmos (protruding eyes), and anxiety?

A

Thyrotoxicosis

86
Q

What are 2 ways to treat hyperthyroidism?

A
  1. Radioactive iodine
  2. Thyroidectomy
87
Q

What is the risk of thyroidectomy to treat hyperthyroidism?

A

Excessive release of thyroid hormones
Acute thyrotoxicosis (life threatening)

88
Q

What must patients take before treating hyperthyroidism to prevent excessive release of thyroid hormones and acute thyrotoxicosis?

A

Propylthiouracil
Methimazole
Propranolol

89
Q

What do Propylthiouracil and Methimazole inhibit?

A

Synthesis of thyroid hormones

90
Q

What happens after the thyroid is destroyed or removed when treating hyperthyroidism?

A

Pt develops hypothyroidism and is put on synthetic thyroid hormones

91
Q

What are 3 anti-thyroid agents and their effects?

A
  1. Iodine (decrease thyroid hormone synthesis)
  2. Propanolol (decrease HR/contractility)
  3. Diltiazem (decrease HR/contractility)
92
Q

What 3 hormones are involved with Ca2+ homeostasis?

A
  1. Parathyroid hormone (PTH)
  2. Calcitonin (from thyroid)
  3. Vitamin D
93
Q

What does parathyroid hormone (PTH) stimulate?

A

Ca2+ absorption & bone resorption

94
Q

What organs does PTH act on? What are the effects on these organs when Ca2+ levels are LOW?

A

Kidneys (prevents Ca2+ loss)
Bones (resorption)
Intestines (absorb more Ca2+)

95
Q

What does PTH stimulate?

A

Bone turnover (resorption/formation)

96
Q

What is the parathyroid hormone drug?

A

Teriparatide

97
Q

What does Teriparatide cause when dose is constant?

A

Bone resorption

98
Q

What does Teriparatide treat when doses are low and intermittent?

A

Osteoporosis

99
Q

Increase in extracellular Ca2+ causes an _________ in calcitonin release

A

increase

100
Q

What does increased calcitonin cause?

A

Decreases osteoclast activity/bone resorption
Increases urinary Ca2+ secretion

(to decrease plasma Ca2+ levels)

101
Q

What is the calcitonin hormone drug?

A

Salmon calcitionin

102
Q

What does salmon calcitonin treat?

A

Paget’s Disease
Osteoporosis

103
Q

What disease presents with excessive, disorganized bone remodeling, weak/misshapen bones, and bone fracture?

A

Paget’s Disease

104
Q

What are the vitamin D drugs?

A

Cholecalciferol (vitamin D3)
Ergocalciferol (vitamin D2)

105
Q

What is formed in the skin from 7-dehydrocholesterol by action of UV radiation?

A

Cholecalciferol (vitamin D3)

106
Q

What is the root in vitamin D drugs?

A

“calci”

107
Q

What increases phosphate?

A

Vitamin D

108
Q

What decreases phosphate?

A

PTH

109
Q

Where is 85% of phosphate in the body?

A

Bone & teeth

D1 Spring (47 decks)

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