pharm 5 set 2

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pharm 5 set 2
2013-11-19 14:54:51

pharm 5 Endocrine lecture
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  1. T3 liothyronine &
    T4 levothyroxine
    • stimulate the use of energy
    • - oxygen consumption and heat production
    • Stimulate the heat
    • - oxy demand and cardiac output
    • Promote growth and development
    • - brain, C/PNS, skeletal muscle
  2. Hypothyroidism in adults and children?

    what does it do to the body?
    • A= Myxedema
    • C= Cretinism

    • Decreased metab. rate
    • pale puffy face, cold skin, brittle hair, weight gain, dec. HR, fatique, lethargy
  3. Levothyroxine / T4 Synthroid

    • Converted into T3 (active form) in the body
    • Accelerates the degrad of Vit K
    • Interacts w/ many drugs and food
    • BRAND NAME is best
  4. Liothyronine / T3-Cytomel

    • Short 1/2 life
    • Twice daily use
    • used as an additive to Synthroid regiment when needed
  5. Grave's and Plummer's
    • hypothyroid
    • Increase in all metab rates

    Exopthalmos --> only in Graves
  6. What is used to treat Exopthalmos?
    oral glucocorticoids - stop immune process
  7. Thyrotoxic crisis
    • Hyperthyroidism
    • Thyroid storm
    • Excessive levels causing seizures, coma, death

    • will really increase metab rate
    • Load up with Potassium Iodine or Iodide Salts on theory that too much will shut the thyroid down
  8. Propylthiouracil / PropylThyrocil

    Methimazole / Tapazole

    • blocks T3/4 production
    • Tx for 6-12 months, then stop
    • Used in conjunction with Beta Blockers --> block thyroid symptoms
    • agranulocytosis
  9. Iodine

    low vs high levels
    required for T3 and T4 production

    • low= decrease production
    •  = Thyroid gland increases in size - Goiter

    • high= causes decreased iodine uptake
    •  = suppression of synthesis and production of hormones
  10. Iodine 131

    • radioactive isotope taken up byt he thyroid
    • Not toxic to other tissues

    can become Hypothyroid
  11. What does the Hypothalamus stimulate and inhibit?
    Anterior Pituitary
  12. How does the Hypothalamus stimulate the anterior pituitary?

    How does it inhibit it?
    stim= secretes Growth Hormone Release Hormone

    inhib= secretes Somatostatin
  13. what stimulate the release of GH?

    inhibits it?
    stim= Hypoglycemia, fasting, starvation, stress

    inhib= inc. glucose levels, free fatty acids, obesity, cortisol
  14. what does GH do?
    • control growth
    • -protein and carb metab
    • - increase bld glucose
  15. childhood dwarfism
    • proportionally small stature
    • only Tx is GH
  16. Somatropin / Humatrope
    • GH replacement
    • diabeticgenic - causes significant Hyperglycemia

    • reconstitute in a vial
    • -no shaking
    • -IM injection
    • -given 6 days, none on 7th of week
  17. Gigantism
    puberty excess of GH

    Surgical removal of pituitary
  18. Acromegaly
    • adult excess of GH
    • need radiation
  19. Octreotide / Sandostatin
    • used for acromegaly
    • analog of somatostatin (GH inhib)

    also used for Intractable Diarrhea
  20. Pegvisomant / Somavert
    used for acromegaly

    GH receptor antagonist
  21. long term effects of anabolic steroids
    • kidney disease
    • liver disease
    • cancer
  22. DDAVP / Desmopressin
    Anti-diuretic Hormone

    • Used for Diabetes Insepidus
    • Reabsorbs H2O in kidney tubules

    nasal administration
  23. Arginine Vasopressin
    • antidiuretic hormone
    • causes smooth ms contraction (vasoconstrict)

    uses= gi bleed, support circulation shock or arrest, similar to Epi in emergency situation

    SE= tissue ischemia or necrosis, inc. cardiac workload
  24. Parathyroid Hormone
    • needed for Calcium reasorption from bone
    • Activates Vit. D
    • Decreases Ca++ excretion
  25. Vit D

    increases GI absorption, promotes reabsorp from bone, & dec. excretion

    Must be activated via sunlight, bile, or renal action
  26. Calcitonin
    • used in ca++ control
    • decreases plasma levels
    • inhibits reasorp from bone
    • inc. ca++ excretion

    • Some foods (spinach) decrease Ca++ absorp
    • Glucocorticoids  increase Ca++ excretetion and decrease GI absrop
  27. Hypocalcemia
    • increases neuromuscular exitability
    • -spasms, tetany, convulsions

    caused from deficiency of PTH, Vit. D, or calcium
  28. Tx for Hypercalcemia
    • IV saline, promote urination --> for life threatening situation
    • Give calcitonin --> dec. mobilization from bone
    • Eat bran --> dec. intestinal absorption
    • can use diuretics --> increase Ca+ excretion
  29. Edetate Disodium / EDTA
    • Chelating agent that binds ca+ in the blood
    • used for sever hypercalcemia

    • binding increases excretion
    • rapid reduction of serum ca+
    • -can result in profound hypocalcemia
    • used as anti-coag in blood drawing tubes
  30. Alendronate / Fosamax
    Bisphosphonate used for osteaporosis

    absorbed by osteoclasts, decreasing their activity

    • Taken on empty stomach, swallow whole, full glass h2o, and sit up for 30 minutes after
    • -avoid esophagitis
  31. Tamoxifen / Novadex

    Reloxifene / Evista
    SERMS and osteoporosis 

    • estrogen effects some tissue
    • - preserves bone density, lowers cholesterol, pro-coagulant

    • Anti-estrogran effects in others
    • - prevents cancer in breast and endometrium
  32. osteoporosis in men
    men can take Fosamax