Endocrinology
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69 terms
Terms | Definitions |
|---|---|
 Fludrocortisone | Most commonly used mineralocorticoid replacement drug Used with cortisone/hydrocortisone ADRs: Sodium and water retention, edema, CHF, arrhythmia, hypokalemia, muscle weakness, HTN |
| Medrol dose pack | Methylprednisolone 48 mg tapered to 4 mg over 6 days |
| Prednisone | Sterapred 5 to 60 mg qd |
| Fluticasone (oral) | Florinef 0.2 mg po 3x/week |
| Fluticasone (inhaled) | Flonase 2 sprays/nostril QD 50 mcg spray |
| Fluticasone/salmeterol | Advair 2 puffs BID 45/21, 115/21, 230/21 |
| Mometasone | Nasonex 2 sprays/nostril QD 50 mcg spray |
| Budesonide/formoterol | Symbicort 2 puffs BID 80/4.5, 160/4.5 |
| Vasopressin | Pitressin Exogenous ADH Increase BP, vasoconstriction 8-arginine (animal sources) ADH and oxy at 20:1 ratio SQ or IM for shock |
| Desmopressin | DDAVP Intranasal BID for DI DOA 10-20 hours Nocturnal disuresis: QD before bed |
| Oxytocin | Pitocin Induction and speeding up of labor Post partum bleeding Abortion IV, dose dependent ADRs: contractions, tetany, rupture with subsequent distress, injury and death of newborn, NV, vasoconstriction and HTN |
| Magnesium sulfate | slows contractions may slow HR and RR IV |
| Terbutaline | Beta 2 agonist DOC inhibits contractions May increase HR and cause arrhythmia |
| Ritodrine | Beta 2 agonist FDA approved May increase HR and cause arrhythmia |
| Nifedipine | CCB Common off-label use |
| Levothyroxine sodium | Synthroid, levoxyl Oral, qd before breakfast IV in myxedema coma Liver and urine Nodules, carcinoma ADRs: weight loss, diarrhea, fever, angina, increased HR and BP, irregular menses, sweating, tremors, HA, nervousness, insomnia, psychosis Caution with heart disease LT use may be associated with osteoporosis May need increased doses of DM drugs May need higher dose with estrogen drugs Do not d/c abruptly Report heart symptoms Pregnancy A |
| Lugol's solution | 5 or 10% potassium iodide Oral ST if sensitive pre-op to decrease vascularity rash, HA, sore gums, hypersalivation, pruritis |
| Radioactive iodine | Beta rays to destroy Gamma rays to image pre-op Avoid during pregnancy and lactation |
| Thioamides | PTU and methimazole Inhibit the union of iodine and tyrosine Pre-op or in thyrotoxic crisis ADR: rash, fever, myalgia, jaundice, nausea, agranulocytosis, goiter Cross placenta and in milk PTU may compromise coagulation |
| Teriparatide | Forteo Osteoporosis, osteogenesis imperfecta, etc. Intermediate exposure to PTH activates blasts more than clasts Once daily injections More than two years -- osteosarcoma |
| EDTA | Chelates calcium in emergency |
| Tx for hypercalcemia | EDTA, diuretics (thiazide or furosemide), calcitonin |
| Calcitonin | SQ, IM or nasal for osteoporosis, etc. Allergic potential, resistance NVD, inflamm, rhinitis, HA, insomnia, anxiety |
| Bisphosphonates | Osteoporosis, etc. DOC Inhibit reabsorption of bone Poorly absorbed Increased density in three months Nitrogen (prevent protein synth in clast) and non-nitrogen (compete with ATP in clasts) Use with calcium and vitamin D Full glass water, before meals, stay upright ADR: flatulence, gastritis, HA, dry mouth, MS pain |
| Estrogen | Used with calcium to increase bone mineralization up to 10 years post menopause Increased risk of breast and endo cancer |
| Raloxifene | Evista SERM Anti-effect on uterus and breasts SO prevention of cancer in high risk patients 60 mg po QD regardless of meals |
| Alendronate | Fosamax Post men osteoporosis 70 mg po Q week |
| Ibandronate | Boniva 150 mg Q month OR 3 mg IV q 3 month |
| Risedronate | Actonel Post meno osteopor 5 mg po QD or 35 mg Q month or 75 mg on 2 consec days Q month |
| Forteo | 20 mcg SQ qd 28 dose device severe osteoporosis |
| Estrogen | Contraception, HRT ADRs: nausea, breast tenderness, thromboembolic events, MI, endometrial cancer |
| SERMs | Bind estrogen receptors to exert estrogenic or anti-estrogenic effects |
| Tamoxifen | competes with estrogen for binding sites in breast tissue to fight breast cancer in post menopausal, sensitive women ADRs: hot flashes, nausea, vaginal bleeding, hyperplasia of the endometrium, endometrial cancer CPY450 |
| Raloxifene | Evista Blocks estrogen receptors in breast tissue and decreases bone turnover without an effect on endometrial tissue; decreeases LDL Prophylaxis of breast CA, prvention and treatment of postmenopausal osteoporosis ADRs: hot flashes, leg cramps, DVT, PE |
| Clomiphene | Clomid partial estrogen agaonist interferes with negative feedback of estrogens on the hypothalamus to promote continued gnrh release anovulatory cycles ADRs: HA, N, vasomotor flushing, visual disturbances, ovarian enlargement, multiple births |
| Antiestrogen | Letrozole (Femara) Aromatase inhibitor for the tx of hormonally responsive breast cancer post-op Also reduce and prevent gynecomastia by athletes |
| Progesterone | Hormone replacement Contraception Dysmenorrhea Endometriosis Infertility ADR: HA, depression, weight gain, decreased libido, increased LDL, decreased HDL, acne, hirsutism |
| Antiprogestin | Mifepristone Abortion Misoprostol to induce uterine contraction Bleeding, incomplete abortion |
| MoA for contraceptives | PRevent ovulation Impair gametogenesis Interfere with gestation ADRs: breast fullness, depression, fluid retention, HA, NV, CV thromboembolic events, HTN, MI Increased risk of breast cancer but decreased risk of endometrial and ovarian cancer Abnormal glucose tolerance, weight gain Contraindicated in CV disease, dependent neoplasms, liver disease or pregnancy |
| Combination oral contraceptives | Monophasic or triphasic Extended cycle Continuous contraception Transdermal patch (ethinylestradiol and norelgestrone) Vaginal ring (ethinyl estradiol, etonogestrel) |
| Mini pill | Norethindrone Less effective breast feeding, intolerant to estrogen |
| Injectable progestin | Medroxyprogesterone acetate IM Q 3 months Weight gain, amenorrhea Fertility may be delayed |
| Progestin implants | Etonogestrel Three years Very effective, reversible IRregular bleeding, HA |
| IUD | Levonorgestrel LT for five years! |
| Post coital | 72 hours within and repeated at 12 after first Levonorgestrel Ulipristal acetate (Ella) up to five days after |
| Danazol | Mild androgen with some antiestrogenic activity to inhibit the release of FSH and LH ADRs: weight gain, acne, decreased bresats size, deep voice, increased libido, hirsutism |
| Fluoxymesterone, oxandrolone | synthetic androgens for oral admin with hepatic adrs |
| Androgen ADRs | Women: deep voice, acne, hirsutism, masculin, male pattern baldness, excess muscle, menstrual irregs Men: increased muscle, priapism, impotence, decreased sperm, gynecomastia, acne, prostatic hypertrophy |
| Ketoconazole | inhibits enzymes involved in steroid synthesis |
| Finasteride, dutasteride | treatment of prostatic hypertrophy |
| flutamide, bicalutamide, nilutamide | bind androgen receptors treatment of prostatic cancer |
| AndroGel | 50 mg to shoulder or arm QD |
| Premarin | 0.3 to 1.25 mg po QD (estrogen) |
| Femara | Letrozole 2.5 mg po QD |
| Prempro | estrogen and progestin combo 0.625 mg with 2.5 mg or 5 mg po QD |
| Premarin vaginal cream | 0.5 mg to 2 mg applied vaginally QD x 21 days with 7 days off or twice per week for 21 day cycle with 7 days off |
| Evista | 60 mg po QD |
| Yaz, ortho tricyclen lo | estrogen/progestin OCP 1 tab po qd |
| Nuvaring | estrogien/progestin contraceptive insert and leave in place for three weeks, remove and repeat after one week without |
| Janumet | Metformin plus Sitagliptin 500/50 or 1000/50 PO BID |
| Avandia | Rosiglitazone 4 mg PO QD to start |
| Humalog | 75/25 pen |
| Glucophage | Metformin 500 mg BID po to start |
| Other humalogs | Humalog Kwikpen Humulin N |
| Micronase | Glyburide 2.5 mg QD with breakfast to start |
| Actos | Piglitazone Basal coverage 15 or 20 mg po QD |
| Januvia | Sitagliptin Basal coverage 100 mg po QD |
| Lantus | Glargine Basal coverage 0.2 mg per kg SQ QD |
| Byetta | Exenatide Meal coverage, type 2 5 mcg SQ BID one hour before meals, six hours apart |
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