Pharmacology Unit 4 - Endocrine Pt. 2 Flashcards
(150 cards)
more than ____________ of glucocorticoid therapy can cause adrenal suppression
2 weeks
stress dose steroids with minor stress give _______x the dose for ____________ hours
2; 23-48
stress dose steroids with severe stress (accidental trauma, major surgery), give up to ________x the normal dose for _____________ hours
10; 48-72
if a patient receives stress dose steroids, it takes ____________ months for HPA function to return to normal and an additional ____________ months for cortisol levels to return to normal
2-12; 6-9
corticosteroids increase pepsin and gastrin which puts patients at risk for _______________
peptic ulcers
how do you treat chronic adrenocortical insufficiency (addisons disease)
hydrocortisone and fludrocortisone
how do you treat acute adrenocortical insufficiency (addisons)
- high dose glucocorticoid therapy IV (100 mg Q8h until stable)
- correct fluid and electrolytes
- taper glucocorticoid (hydrocortisone) therapy and initiate mineralcorticoid (fludrocortisone) when stable
describe the synthesis of thyroid hormone
- symporter pulls iodide from the gut and diet into thyroid gland
- in the follicular cell iodide is converted to iodine via thyroidal peroxidase (organification)
- thyroglobulin is cleaved into T3/T4
how is iodide converted into iodine in the thyroid gland?
via thyroidal peroxidase (organification)
which thyroid hormone is the most potent
which thyroid hormone is the most potent
T3
T3 is ___________ x more potent/active than T4
2-3
for T4 to be utilized it has to be _______________ by ______________ enzymes to T3
deiodinated; 5’ deiodinase (D1,D2,D3)
what is the primary pathway for the metabolism of thyroxine (T4)
deiodination
what drugs block the metabolism of T4 by blocking the three 5’deiodinase enzymes ?
- amiodarone
- contrast dye
- beta blockers
- corticosteroids
_____________ and _______________ are physiologic conditions that block the three 5’ deiodinase enzymes responsible for the metabolism of T4 to t3
severe illness; starvation
out of T3 and T4, which is most released from the thyroid gland
T4
ratio of release T4:T3
5:1
_________% of circulating T3 is d/t the metabolism of T4, and ___________% is from the direct thyroid secretion
80; 20
__________ is the inactive form of thyroid hormone, and _______ is the active form
T4; T3
large doses of iodine inhibit ___________________, which leads to a(n) ___________ in thyroid hormone levels
organification; reduction
_______________ influences the synthesis of T3 and T4
iodide levels
what conditions have a stimulatory effect on the hypothalamus to release TRH
- cold (hypotherm)
- acute psychosis
- circadian and pulsatile rhythm
what inhibits the release of TRH from the hypothalamus
- increased T3/T4
- severe stress
what inhibits the release of TSH from the AP
- somatostatin
- dopamine
- corticosteroids
- increased T3/T4