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Endocrine Pharm I
Dr. Call; Endocrine Pharmacology I
| Question | Answer |
|---|---|
| Describe Endocrine | Hormone is released from gland and travels through blood to reach the target organs. |
| Describe Paracrine | Hormone is released from cell and effects neighboring cells |
| Describe Autocrine | Hormone is released from and affects the VERY SAME cell. |
| What hormones are produced from the posterior lobe of the pituitary? | Vasopressin, Oxytocin |
| What horomones are produced from the anterior lobe of the pituitary? | Prolactin, TSH, LH, FSH, GH, & ACTH |
| What hormone steroids interact with Nuclear hormone receptors? | Glucocorticoids, mineralcorticoids, androgens, progesterone, and estrogen. And Thyroid Hormones (They are proteins that are the exception to the rule. They are protein hormones that are lipophillic and have nuclear affects |
| What are inhibitors of thyroid hormone synthesis? | -Propylthiouracil -Iodide -Radioactive Iodine |
| Are thyroid hormones lypophillic? | Yes |
| Explain how thyroid hormones (T3 & T4) are released? | TRH (thyrotropin-releasing hormones) released from the hypothalamus. TSH (thyroid stimulating hormone) is released from the Pituitary. The peripheral gland the releases T3 & T4. (iodide is needed) |
| How does thyroid hormone synthesis occur in the thyroid? | Iodide is actively transported into the thyroid cell. It diffuses across the cells to the apical membrane, where it is oxidized and attached to tyrosine residues of THYROGLOBULIN. |
| What tyroid hormone is most prevelant? | T4 |
| Which thyroid is more effective? | T3 is 3- 5x more effective |
| What are the effects of the thyroid hormones? | -Directly regulate metabolism. -Modulate effect of other metabolic hormones (catecholamines, insulin, corticol, glucagon) -Increaes cardiac rate -increase metabolic rate in response to cold and stress. Necessary for growth and mautration of CNS. |
| What can develop in small children who lack thyroid hormone? | Cretinism - which is a mental retardation due to not enough thyroid hormone in the fetus. |
| What are some sign and symptoms of hypothyroidism? | -Slow metabolic rate, weight gain, hypothermia. -Slow Speech, poor memory. -Sensitivity to cold. -Lethargic,fatigue, depression. -BRADYCARDIA (HIGH TSH b/c of FAILURE OF THE THYROID GLAND) |
| What is used in the treatment of hypothyroidism> | Levothyroxine, |
| How is the growth of a goiter stimulated? | HIGH TSH LEVELS. A goiter is the growth of a thyroid gland due to excessive TSH (pituitary) stimulation. TSH levels are high b/c of low/no thyroid hormone. (eg no dietary iodide) |
| If a patient has no iodide in the diet what may happen? | Goiter - Abnormal hypertrophy of the thyroid gland |
| What is Levothyroxine? | Sodium Salt of T4. It produces normal levels of both T3 and T4. Doses are titrated to the individual. Doses should be sufficient to keep TSH levels in the normal range. |
| What is the drug Levothyroxine used for? | -Hypothyroidism -Can also be used to prevent goiters. |
| If a patient has liver disease and hypothyroidism what would you give to them? | You would need to give them a mix of T4 & T3. |
| What are the side effects of Levothyroxine? | Side effects are symptoms of Hyperthyroidism: Fast Metabolism, Cardiac;arrhythmias,tachycardia, Weak Muscles, Hot, Sweating, Tremor, Insomnia, Anxiety, Osychosis, Diarrhea, Nausea, & Vomiting. |
| What are the sign and symptoms of hyperthyroidism? | Fast Metabolism, Cardiac;arrhythmias,tachycardia, Weak Muscles, Hot, Sweating, Tremor, Insomnia, Anxiety, Osychosis, Diarrhea, Nausea, & Vomiting. |
| What are some CNS signs ans symptoms of hyperthyroidism? | Insomna, Anxiety, Psychosis |
| What are some GI signs and symptoms of hyperthyroidism? | Diarrhea, Nausea, Vomiting |
| What are some causes of hyperthyroidism? | Graves Disease & Toxic Nodular Goiter. |
| What is Toxic Nodular goiter? | Cause of hyperthyroidism; toxic nodular goiter is the development of an adenoma of the thyroid that produces too much thyroid hormone. |
| What is Graves Disease? | Cause of hyperthyroidism; Antibodies to TSH receptor (constantly activates the receptor), Stimulate gland to produe too much T3/T4. |
| What is a common symptom of graves' disease? | Exophthalmus (eyes popping out) |
| What are some treatments of hyperthyroidism? | Remove Gland, Destroy Gland (Radioactive Iodine), Decrease T3 & T4: Propylthiouracil, Iodide. |
| What drugs are used to decrease T3 & T4 synthesis and release? | Propylthiouracil & Iodide. |
| What does radioactive Iodine do? | Destroys the thyroid gland. Can cause THYROID STORM. Used in elderly patients and those w/ heart diseae. |
| What drug blocks the conversion of T4 to T3? | Propylthiouracil |
| PTU may cause a goiter what will help prevent this? | Add T4 to reduce TSH. |
| What drug is the first line of treatment for Graves' Disease? | Propylthiouracil. |
| What is a thyroid storm and what drug is used to prevent it? | A thyroid storm happens when you use radioactive Iodine to destroy the gland and you release a "storm" of stored up T3 & T4 (can be dangerous and cause arrhythmias). Treat with Propylthiouracil and Iodide. |
| What are some side effects of propylthiouracil? | Goiter (may need to add T4 to reduce TSH levels), keep dose low in pregnancy (prevent cretinism and goiter in fetus) |
| What hyperthyroidism drug is faster acting? | Iodide (rapidly decreases synthesis and release of T4 & T3) -Short Term Effects. |
| Which hyperthyroid drug reduces the vascularity abd thyroid content of gland? | Iodide. |
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allievisner2
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