Term
| Which thyroid replacement medication has the highest risk of cardiotoxicity? |
|
Definition
|
|
Term
| What drug classes are used to tx hyperthyroidism? |
|
Definition
Thioamides
Iodides
Radioactive iodine |
|
|
Term
| What are examples of thioamides and which is the DOC? |
|
Definition
*Methimazole
Propylthiouracil |
|
|
Term
|
Definition
| Inhibit thyroid peroxidase enzyme |
|
|
Term
| Black box warning of propylthiouracil? |
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Definition
|
|
Term
| Why is propylthiouracil preferred in the 1st trimester of pregnancy? |
|
Definition
| Mostly protein-bound- has difficulty crossing the placenta |
|
|
Term
| What is the pregnancy category of the thioamides? |
|
Definition
|
|
Term
|
Definition
| Inhibit organification & hormone release by inhibition of thyroglobulin proteolysis |
|
|
Term
| MOA of radioactive iodine? |
|
Definition
| Destruction of thyroid parenchyma |
|
|
Term
| How does propranolol help treat thyrotoxicosis? |
|
Definition
| Can prevent peripheral conversion from T4-T3 |
|
|
Term
| MC cause of hypothyroidism? |
|
Definition
|
|
Term
|
Definition
| Disease state of end stage untreated hypothyroidism- stupor, weakness, hypothermia, possibly death |
|
|
Term
| Pathophys of Graves' disease? |
|
Definition
| Immunologic disorder in which our T cells stimulate our B cells to synthesize antibodies against our thyroid antigens |
|
|
Term
| What drug may used to manage thyrotoxicosis in pts in whom B-blockers are contraindicated (e.g. asthma)? |
|
Definition
|
|
Term
|
Definition
B-blockers for cardiovascular symptoms
Propylthiouracil to inhibit hormone synthesis |
|
|
Term
|
Definition
Recombinant GH
Acts thru GH receptors to increase IGF-1 |
|
|
Term
|
Definition
|
|
Term
| What drugs are in the class of GH agonists? |
|
Definition
Somatropin- recombinant GH
Mecasermin- synthetic IGF-1 |
|
|
Term
|
Definition
| Synthetic somatostatin analog |
|
|
Term
|
Definition
|
|
Term
| Symptoms of ovarian hyperstimulation syndrome? |
|
Definition
| ovarian enlargement, ascites, hypovolemia, and possibly shock |
|
|
Term
| What is the indication for HCG? |
|
Definition
| Activate Luteinizing Hormone receptors |
|
|
Term
|
Definition
| Recombinant or urine-derived |
|
|
Term
| What medications are recombinant FSH analogs? |
|
Definition
| Follitropins (alpha, beta, or urine derived) |
|
|
Term
|
Definition
| Urine-derived FSH and LH (from postmenopausal women) |
|
|
Term
|
Definition
| Downregulates GnRH receptors, inhibiting gonadotropin release |
|
|
Term
| What drugs are used to suppress endogenous gonadotropin release in women undergoing ovarian stimulation? |
|
Definition
| Leuprolide and Ganirelix- downregulate GnRH receptors |
|
|
Term
| What drug class can help suppress hyperprolactinemia? |
|
Definition
| Dopamine D2 agonists- bromocriptine |
|
|
Term
| What drugs are ADH receptor antagonists? |
|
Definition
|
|
Term
| Which ADH receptor antagonist is selective for V2 receptors? |
|
Definition
|
|
Term
| Normal recommended adult daily intake of iodide? |
|
Definition
|
|
Term
| Recommended intake of iodide during pregnancy/lactation? |
|
Definition
|
|
Term
| How much iodide does the thyroid take up daily for hormone synthesis? |
|
Definition
|
|
Term
| What transporter takes iodide up into the thyroid gland and what chemicals inhibit this transporter? |
|
Definition
Na-I cotransporter
Thiocyanate, perchlorate |
|
|
Term
| What is the function of the peroxidase enzyme? |
|
Definition
| Oxidizes iodide into active iodine |
|
|
Term
| What can inhibit the oxidation of iodide into active iodine? |
|
Definition
|
|
Term
| What function does proteolysis serve in the thyroid? |
|
Definition
| Cleaves T3, T4, MIT and DIT from thyroglobulin |
|
|
Term
| What protein reversibly binds to T3 and T4 in the blood? |
|
Definition
| TBG- thyroxine binding globulin |
|
|
Term
| How much of T4 is in its free form? |
|
Definition
|
|
Term
| How much of T3 is in its free form? |
|
Definition
|
|
Term
| What meds can inhibit peripheral conversion of T4 to T3? |
|
Definition
| radiocontrast media, beta blockers, corticosteroids, and amiodarone |
|
|
Term
| What effect does pregnancy, estrogen, and OCPs have on thyroid levels? |
|
Definition
| Increase TBG sites --> increased total and bound thyroid hormones, but free levels remain unchanged |
|
|
Term
| What effect do rifampin, carbamazepine, and phenobarbital have on thyroid metabolism? |
|
Definition
| Increase it --> may require dose increase |
|
|
Term
| Which has greater cardiotoxicity risk: synthroid or liothyronine? |
|
Definition
|
|
Term
| What antithyroid med has a black box warning for severe hepatitis? |
|
Definition
|
|
Term
| Why is propylthiouracil preferred in the first trimester of pregnancy? |
|
Definition
| More protein bound --> less crosses the placenta |
|
|
Term
| How long do we treat w/ propylthiouracil before remission of hyperthyroidism? |
|
Definition
|
|
Term
| Tx of choice for myxedema coma? |
|
Definition
| Loading dose of IV levothyroxine: 300–400 mcg initially, followed by 50–100 mcg daily |
|
|
Term
| Diplopia and pretibial dermopathy should make you think of what disorder? |
|
Definition
|
|
Term
| Cardiovascular management of thyroid storm? |
|
Definition
Propranolol/esmolol
If B-blockers contraindicated, diltiazem |
|
|
Term
| What is the drug of choice for hyperthyroidism? |
|
Definition
|
|
Term
| What recombinant hormone is associated w/ slipped capital femoral epiphysis (SCFE) in children? |
|
Definition
|
|
Term
| Adverse fx of mecasermin? |
|
Definition
| Hypoglycemia, Intracranial hypertension, Increased liver enzymes |
|
|
Term
| Adverse fx of somatropin in children? |
|
Definition
• Pseudotumor cerebri
• Slipped capital femoral
epiphysis
• Progression of scoliosis
• Edema
• Hyperglycemia |
|
|
Term
| Adverse fx of somatropin in adults? |
|
Definition
Peripheral edema
• Myalgia
• Arthralgia |
|
|
Term
| Adverse fx of octreotide? |
|
Definition
| gastrointestinal disturbances, gallstones, bradycardia, and cardiac conduction abnormalities. |
|
|
Term
| Adverse fx of pegvisomant? |
|
Definition
|
|
Term
| What is ovarian hyperstimulation syndrome? |
|
Definition
| Includes ovarian enlargement, ascites, hypovolemia, and possibly shock |
|
|
Term
| Steps of ovulation induction? |
|
Definition
1) inhibit endogenous gonadotropin secretion by administering GnRH agonist/antagonist
2) Stimulate follicle development via FSH analog
3) Stimulate oocyte maturation via LH analog |
|
|
Term
|
Definition
| ovarian hyperstimulation syndrome, multiple pregnancies in women, gynecomastia in men, headache, depression, and edema. |
|
|
Term
| Which is more likely to cause ovarian hyperstimulation syndrome: leuprolide or ganirelix? |
|
Definition
|
|
Term
| Which has more specific V2 action: vasopressin or desmopressin? |
|
Definition
|
|
Term
| Adverse fx of vasopressin? |
|
Definition
Increased intestinal activity
• Nausea
• Cramps
• Ischemia |
|
|
Term
| Which ADH antagonist is hepatotoxic: conivaptan or tolvaptan? |
|
Definition
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