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Agents Used for Endocrine disorders

Which Thyroid hormone is more active Triiodothyronine (T3)
Grave's Disease most common form of hyperthyroidism
Myxedema term used for hypothyroidism in adults
Cretinism term used for hypothyroidism in infants
Clinical presentation of hypothyroidism pale, puffy face, cold, dry skin, brittle hair or loss of hair, dec HR and Temp, lethargy, fatigue, cold intolerance, impaired mentality
Levothyroxine (Synthroid) used to treat hypothyroidism, synthetic form of T4 converted to T3
Synthroid adverse effects tachycardia, angina, tremors, intensify effects of WARFARIN
Liothyronine synthetic form of T3, used to tx hypothyroidism, often combined with synthroid
Plummer's Disease toxic nodular goiter, same as grave's disease but no exopthalmos
Clinical presentation of hyperthyroidism (Graves) exophthalmos (protrusion of eyeballs), inc. HR, flushed warm skin, always hot, tremors, nervousness, anxiety, insomnia, increased appetite, weight loss, diarrhea
Thyrotoxic Crisis (Thyrotoxic storm) when pts experience significant stress, not triggered by rise in thyroid hormones, causes hyperthermia, severe tachycardia, restlessness, agitation, tremor, unconsciousness, coma, hypotension, heart failue
Methimazole (Taazole)...thionamide drug prototype for tx of hyperthyroidism, blocks synthesis of thyroid hormone by inhibiting peroxidase which prevents formation of iodine and pervens coplin of MIT and DIT
Propylthiouracil (PTU) 2nd line of tx for hyperthryroidism, similar to methimazole, causes liver dmage, shorter half-life, safer in pregnancy, blocks conversion of T4 to T3
Methimazole 1st line tx for hyperthyroidism, no LIVER damage, longer 1/2 life, not safe in 1st trimester or lactation, does not block conversion of T4 to T3
Radioactive Iodine used to destroy thyroid tissue, to produce chemical remission without causing complete destruction of the gland
MOA of Radioactive Iodine emits beta particles to destroy thyroid tissue, takes several months to be effective
Adverse Effects of Radioactive Iodine delayed hypothyroidism, contraindicated in pregnancy and lactation
Non-Radioactive Iodine (Lugol's solution) decreases circulating T4 and T3, used for thyroidectomy and thyrotoxic crisis. Side effect: Iodism
Anterior Pituitary Hormones Growth hormone (GH), Corticotropin (ACTH), Thyrotropin (TSH), FSH, Lutenizing hormone (LH), prolactin
Posterior Pituitary Hormones Oxytocin, antidiuretic hormone (Vasopressin)
Growth Hormone (GH) promotes growth, promotes protein synthesis, carbohydrate metabolism, used for: ped and adult growth hormone deficiency, non-GH related short stature, Prader-Willi Syndrome (PWS),
Adverse effects of GH hypergylcemia, neutralizing antibodies, carpal tunnel syndrome, fatality in Prader-Willi syndrome, interacts with glucocorticoids
Somatropin growth hormone preparation
Mecasermin (Increlex) synthetic of natural insulin-like gowth factor-1, used in GH deficiency that is not responsive to GH tx
Adverse Effect of Mecasermin hypoglycemia, hypertrophy of tonsils, intracranial hypertension, vomiting, arthalgia, OM, elevated aminotransferases and lipids, overgrowth of fat, facial bones, and kidneys
Octreotide and Lanreotide analogs that suppress GH release, given by injection
Pegvisomant blocks GH receptors, used for acromegaly
Prolactin produced by anterior pituitary, stimulates milk production
Effects of hypersecretion of Prolactin Females: amenorrhea, galactorrhea, infertility Males: reduced libido and potency, galactorrhea Possible delayed puberty
Thyrotropin synthetic form of TSH used for diagnosis of thyroid CA
Corticotropin/Cosyntropin synthetic form of adrenocorticotropic hormone (ACTH), used for dx of adrenocortical dysfunction
Gonadotropins FSH and LH-regulate gonadal function, used to treat infertility
FSH females: stimulates follicular growth and development in ovaries males: stimulate sperm production
LH females: promote ovulation and formation of corpus luteum males: stimulates testosterone synthesis by Leydig cells
Menotropins (Menopur, Repronex) 50/50 of LH/FSH
Urofollitropin (Bravelle) FSH
Follitropin alpha (Gonal-f) & Follitropin beta (Follistin AQ) human FSH preparation
Oxytocin produced by the hypothalamus, stored in post pituitary, promotes uterine cntx and stimulates milk production
Antidiuretic Hormone (ADH)-Vasopressin promotes renal conservation of water, increase premeabilit of collecting ducts, produced in hypothalamus
Therapeutic uses of ADH diabetes insipidus, cardiac arrest, post-op abd distention, prep for abd radiography, nocturnal enuresis, hemophila A, Von Willebrands disease
Adverse effect of ADH water intoxication, excessive vasoconstriction
Conivaptan (Vaprisol) & Tolvaptan ADH antagonist, used for hyponatremia. monitor SODIUM levels d/t risk for hypernatremia
Leuprolide GnRH analog, suppress LH and FSH release, used to tx endometriosis, uterine fibroids, central precocious puberty, and prostate CA
Nafarelin GnRH analog, used to tx endometriosis, but does not improve fertility, suppress LH and FSH release
Bromocriptine dopamine agonist, inhibits prolactin secretion, can correct amenorrha, galactorrhea, and infertility
Cabergoline dopamine agonist, inhibits prolactin secretion, used in infertility as reducing prolactin leads to return of ovulation
Demopressin ADH preparation, used for diabetes insipidus, nocturnal enuresis, and hemophilia
Addison's Disease (chronic adrenal insufficiency) adrenocortical insufficiency, obesity, fat redistribution to face, stomach and upper back, hyperglycemia, glycosuria, HTN, fluid & electrolyte imbalances
Cushing's Disease adrenal hormone excess, causes weakness, hypotension, emaciation, hypoglycemia, hyperkalemia, hyponatremia, increase pigmentation of skin and mucous membranes
Hydrocortisone synthetic steroid identical to cortisol. used to tx adrenal insufficiency (Addison's), allergic rxn to INFLAMMATION, and CA
Cortisone, Prenisone, and Dexamethasone preferred drugs for tx of chronic adrenal insufficiency (Addison's)
Dexamethasone used to dx Cushing's (dex suppresion test)
Cortisone prodrug that converts to hydrocortisone
Fludrocortisone potent mineralcorticoid, used to tx Addison's, primary hypoaldosteronism, and congenital adrenal hyperplasia.
Adverse Effects of Fludrocortisone HTN, edema, cardiac enlargement, hypokalemia
Adreoncorticotropic Hormone (ACTH) used for diagnostic testing
Cosyntropin synthetic analog of ACTH, when used cortisol levels rise above 20 = normal, if does not rise then adrenal insufficiency is present
Ketoconazole off label use for prostate CA, works by inhibiting testicular, adrenal, and prostatic production of androgens
Side effects of long-term use of high-dose corticosteriods Redistribution of fat, Glucose intolerance, Moon face or buffalo hump
Adrenal crisis acute adrenal insufficiency, s/s hypotension, dehydration, weakness, lethargy, and GI symptoms
How to tx adrenal crisis rapid fluid replacement, sodium, glucose, and glucocorticoids,
Created by: julzbanks



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