CPharm L10: Endocrine Disorders

CPharm L10: Endocrine Disorders

CPharm L10: Endocrine Disorders

What is the preferred medical treatment for canine Cushing's disease?

Trilostane

What is the MOA of trilostane?

Reversibly inhibits cortisol synthesis

What drug treats Cushing's by destroying adrenal cortical tissue?

Mitotane (Lysodren)

What is the preferred treatment for a resectable adrenal tumor causing Cushing's?

Adrenalectomy

What is the major complication of trilostane & mitotane?

Hypoadrenocorticism (Addison's disease)

What should you do if a dog on trilostane develops vomiting, diarrhea or weakness?

Hold medication & contact veterinarian

What should be monitored during trilostane treatment?

Clinical signs, electrolytes & cortisol

What is the treatment for primary Addison's disease?

DOCP + prednisone/prednisolone

What is an oral alternative to DOCP?

Fludrocortisone

What is the emergency treatment for an Addisonian crisis?

IV fluids + glucocorticoids

What drug protects the heart during severe hyperkalemia?

Calcium gluconate

What drug blocks aldosterone in primary hyperaldosteronism?

Spironolactone

What drug is used for alpha blockade before pheochromocytoma surgery?

Phenoxybenzamine

What is the treatment for canine hypothyroidism?

Levothyroxine

When should T4 be rechecked after starting levothyroxine?

Approximately 4 weeks

What is the preferred definitive treatment for feline hyperthyroidism?

Radioactive iodine (I-131)

What drug medically treats feline hyperthyroidism?

Methimazole

What is the MOA of methimazole?

Inhibits thyroid hormone synthesis

What are the serious adverse effects of methimazole?

Facial pruritus, hepatotoxicity & cytopenias

What complication can occur after treating feline hyperthyroidism?

Underlying renal disease becomes apparent

What insulins are commonly first-choice for canine diabetes mellitus?

Porcine lente (Vetsulin) or NPH

What insulins are commonly first-choice for feline diabetes mellitus?

Glargine U-100 or PZI (ProZinc)

What is the major complication of insulin treatment?

Hypoglycemia

What oral drugs can treat selected newly diagnosed diabetic cats?

Bexagliflozin (Bexacat) or velagliflozin (Senvelgo)

What is the MOA of SGLT2 inhibitors?

Increase urinary glucose excretion

What life-threatening complication is associated with SGLT2 inhibitors?

Euglycemic diabetic ketoacidosis

What insulin is commonly used in diabetic ketoacidosis?

Regular insulin

What drug suppresses insulin secretion in canine insulinoma?

Diazoxide

What drug treats central diabetes insipidus?

Desmopressin

What drug treats acute symptomatic hypocalcemia?

IV calcium gluconate

What is the difference between trilostane & mitotane?

Trilostane inhibits cortisol synthesis while mitotane destroys adrenal tissue

What is the difference between primary & secondary Addison's disease?

PRIMARY = requires glucocorticoid & often mineralocorticoid replacement

SECONDARY = usually requires glucocorticoids only

What is the major difference between DOCP & fludrocortisone?

DOCP is injectable mineralocorticoid only while fludrocortisone is oral with some glucocorticoid activity

Why is beta blockade given only after alpha blockade in pheochromocytoma?

To prevent severe hypertension from unopposed alpha stimulation

What should be monitored during methimazole treatment?

T4, CBC, chemistry & renal function

What should be checked before increasing insulin in a poorly controlled diabetic patient?

Injection technique, diet, glucose curve & insulin resistance

Which cats are candidates for SGLT2 inhibitors?

Newly diagnosed stable diabetic cats that are eating and have not received insulin

What is the preferred definitive treatment for canine insulinoma?

Surgical removal

What is the treatment for chronic hypoparathyroidism?

Calcitriol + oral calcium

What is the treatment for renal secondary hyperparathyroidism?

Renal diet + phosphate binders if needed