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TH receptors
Pituitary THYROID PREPARATIONS
Liver
Kidney Adverse Effect: Hyperthyroidism
Heart
Intestine In children:
Restlessness
Jcelimpin 1c 9/10/2011
With contribution of Elbert Mendez
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Jcelimpin 1c 9/10/2011
With contribution of Elbert Mendez
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Jcelimpin 1c 9/10/2011
With contribution of Elbert Mendez
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o Thyroid storm
1-2 mg slow IV Thyrotoxicosis
40-50 mg PO q6 hrs In 3-6 weeks improvement with thioamides
2-4 months after initiation of therapy FT4 and
Calcium Channel Blocker (asthma) total T3 normalizes
- diltiazem Once euthyroid: follow-up every 4-6 months
Jcelimpin 1c 9/10/2011
With contribution of Elbert Mendez
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Jcelimpin 1c 9/10/2011
With contribution of Elbert Mendez
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GLUCOCORTICOID MOA
- Onset of action: 4-6 hours Estrogen-agonist = bone
- Duration of action: 6-10 hrs Estrogen antagonist = endometrium and
breast
MOA on the bone Action
o Antagonize vitamin D excretion Increases bone mineral density
o Stimulate renal calcium excretion Reduction in the risk of vertebral fracture
o Block bone formation (collagen synthesis) with osteoporosis
o Inhibit secretion and effectiveness of cytokine
that stimulate osteoclastic bone resorption Adverse Effects venous thromboembolis (caucasian)
o Increase PTH-stimulated bone resorption Clinical use: to prevent post menopausal osteoporosis and
fracture
Clinical uses for disorers associated with the bone
o Reverse hypercalcemia secondary to: Biphophanates
Multiple myoma P-O-P structure of pyrophosphate
Lymphomas
Sarcoidosis MOA
Vitamin D intoxication Inhibit recruitment and apoptosis of osteoclast
Dose Stimulate osteoclast activity (indirectly)
o Prednisone 30-60 mg PO daily
Apoptosis of osteoclast:
Adverse effects on the bone Amino biphosphanate
o Osteoporosis in adults Alendronate, riserdronal
o Stunt skeletal development in children
Other effects:
Inhibit 1,25 (OH)2 D3 prodn
ESTROGEN - protective to bone Inhibit intestinal Ca++ transport
- Given orally
MOA - Absorption is impaired by food
o Block PTH action reduce bone - Cause GI irritation
resorption
Jcelimpin 1c 9/10/2011
With contribution of Elbert Mendez
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Thiazides Hypocalcemia
MOA: Ca++
Increase effectiveness of PTH in stimulating Vit D
reabsorption of Ca++ in renal tubules
Enhance Ca++ reabsorption by increasing Na Hyperphosphatemia
reabsorption Sevelamer (PO4 binding gel)
Effects: Hypophosphatemia
Decrease secretion of the ff. in urine: Emergency tx
- Calcium Treat underlying cause
- Oxalate
Inhibit excretion of: Hyperparathyroidism cinaclet
- Magnesium
- Zinc Osteoporosis
Clinical use: reduce hypercalciuria Ca++ and Vit D
Contraindication: hyperparathyroidism Biphosphanate
Calcitonin
Flouride Raloxifen
MOA: stabilize hydroxyapatite crystal of bones and teeth Teriparatide
Clinical use:
- Effective prophylaxis of dental caries Pagets Disease
- Topical preparartion *to reduce pain and prgressive deformity
- Calcitonin
Adverse effects: - Biphosphanate
Nausea and vomiting - Plicamycin
GIT blood loss Vit D chronic kidney disease
Athralgia and athritis
Note! For any mistakes, please make necessary correction. Thanks!
Jcelimpin 1c 9/10/2011
With contribution of Elbert Mendez
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Jcelimpin 1c 9/10/2011
With contribution of Elbert Mendez