Pharm II Exam 2 – Endocrine Hints
2
PHARM II EXAM 2 – ENDOCRINE HINTS Cause growth retardation in PEDS Hypothyroidis m Emergency hypothyroid condition Myxedema Coma Drug of choice for Hypothyroid Levothyroxine (start dose at 50mcg) Periorbital puffiness Hypothyroidis m Causes of Myxedema Coma Cold exposure, infection, analgesics, sedatives, respiratory, other severe illness Excessive doses of Thyroid h. Heart Failure / Angina MI / ↓ BMD TX: IV thyroid hormone, steroid, mech ventilation Drugs that ↑ T4 clearance (CYP 450 inducers) Thyroid h. replacement 1. Carbamezapine 2. Rifampin 3. Phenytoin “CRP” Thionamide MEDS Propylthiouracil (PTU) Methimazole (Tapazole) Drug that blocks conversion of T4T3 Amiodarone Inhibits T4T3 Preferred in pregnancy PTU Scanty / irregular menses ↑ BMs / fine hair SX’s of Hyperthyroidism Major SE of Thionamides Agranulocytosis (w/n 3 months of start) Inhibits peroxidase (Iodide Iodine) Thionamides Iodism: (SE of Iodide, used to block thyroid h. release) 1. Metallic taste 2. Burning mouth 3. Sore gingiva 4. Gynecomastia adjunctive therapy with surgery to acutely inhibit thyroid hormone release Iodide ↓ size & vascularity of gland Contraindicatio ns of BB’s Decompensated or severe CHF, cardiomyopathy, asthma Develop necrosis & fibrosis of interstitial tissue Radioactive Iodide (Sodium Iodide 131) If thyroidectomy is planned, steps PTU or Methimazole given prior to surgery BB’s used adjunctively for Symptoms: Palpitations, anxiety, tremor, & heat intolerance Hyperthyroid Thyroid storm
-
Upload
nhung-nguyen -
Category
Documents
-
view
7 -
download
3
description
pharmacology
Transcript of Pharm II Exam 2 – Endocrine Hints
PHARM II EXAM 2 ENDOCRINE HINTSCause growth retardation in PEDSHypothyroidismEmergency hypothyroid conditionMyxedema Coma
Drug of choice for HypothyroidLevothyroxine(start dose at 50mcg)Periorbital puffinessHypothyroidism
Causes of Myxedema ComaCold exposure, infection, analgesics, sedatives, respiratory, other severe illnessExcessive doses of Thyroid h. Heart Failure / AnginaMI / BMD
TX: IV thyroid hormone, steroid, mech ventilationDrugs that T4 clearance (CYP 450 inducers)Thyroid h. replacement1. Carbamezapine2. Rifampin3. Phenytoin CRP
Thionamide MEDSPropylthiouracil (PTU)Methimazole (Tapazole)Drug that blocks conversion of T4T3Amiodarone
Inhibits T4T3Preferred in pregnancyPTUScanty / irregular menses BMs / fine hairSXs of Hyperthyroidism
Major SE of ThionamidesAgranulocytosis(w/n 3 months of start)Inhibits peroxidase (Iodide Iodine)Thionamides
Iodism:(SE of Iodide, used to block thyroid h. release)1. Metallic taste2. Burning mouth3. Sore gingiva4. Gynecomastiaadjunctive therapy with surgery to acutely inhibit thyroid hormone releaseIodide
size & vascularity of gland
Contraindications of BBsDecompensated or severe CHF, cardiomyopathy, asthmaDevelop necrosis & fibrosis of interstitial tissueRadioactive Iodide(Sodium Iodide 131)
If thyroidectomy is planned, steps PTU or Methimazole given prior to surgeryBBs used adjunctively for Symptoms: Palpitations, anxiety, tremor, & heat intolerance
Hyperthyroid medical emergencyThyroid storm
TX: BBs (dont prevent), IV fluids, PTU, Iodides (after PTU)Leuprolide (Lupron)
Continuous dosing: Suppress growth of endometriosis / prostate CAGnRH Med to secrete FSH / LH
Pulsatile dosing: Cause ovulation in pts w/ central amenorrhea
IV (continuous drip) to prevent GI bleeding from esophageal varicesOctreotide (Sandostatin)Somatostatin analog
Reduce portal pressure in portal HTNGiven to postpartum bleeding (IV drip)Oxytocin (Pitocin)(may cause HTN)
Used for Central DIand TX of enuresisVasopressin (DDAVP)ADHNasal spray formulation for bed wettingVasopressin (DDAVP)
Smooth/ moist skin, unusually fine hairHyperthyroidismDry skin, course hair, slowed/hoarse speechHypothyroidism
Yellow = underlined portions of the lectureFine tremor (of protruded tongue, outstretched hands)Hyperthyroidism
