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Endocrine
Agents Used for Endocrine disorders
| Term | Definition |
|---|---|
| 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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