Q6 - Endocrine Flashcards
Levothyroxine: Synthroid, levoxyl, unithyroid. Elderly patients ________. ______-based dosing.
Require less - 20-25% less/kg.
Weight (1.6mcg/kg/day)
Counsel patients taking thyroid analogs:
Take on empty stomach
Take same time every day
Same brand
Increased dose in pregnancy (?)
Anti-thyroid meds
radioactive iodine (1st line)
Surgery
3 treatments for hyperthyroid.
You give your patient with hyperthyroid (graves) a pill form of RAI. You expect this medication to have an onset of ______
Delayed up to 2 months.
Pt education with RAI
Use private toilet, sleep alone and avoid intimate contact for up to 8 days
Hydrocortisone used to treat low ________, fludrocortisone treat low_______
Cortisol
Aldosterone
How does fludrocortisone work?
Mimics aldosterone. Exerts activity on distal tubule causing enhanced Na and water transport to maintain H2O and electrolyte balance and maintain BP.
Pegvisomant can falsely elevate GH levels.
Tx of pituitary gland disorder with GH deficiency:
Recombinant GH therapy/Somatropin therapy.
MOA: promotes skeletal, visceral and general body growth, bone, fat and mineral metabolism.
Zomacton - ONLY approved for children.
Humatrope, Norditropin, Nutropin, Genotropin, Omnitrope, Saizen.
When should you administer GH somatotropin therapy?
Before bed to mimic natural surge.
Only approved somatropin therapy for children
Zomacton.
What is used to treat pituitary gland disorder of hyperprolactinemia
D2/DA agonists - cabergoline, bromocriptine, pergolide.
Most severe SE of anti thyroid drug therapy?
Agranulocytosis. Patients present with fever, malaise and sore throat with ANC <1. They can develop sepsis rapidly and die. Unpredictable.
Preferred choice of Dopomine agonist therapy for hyperprolactinemia during pregnancy?
Preferred choice is none
But if must use, then Bromocriptine is the preferred one.
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