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Questions and Answers
What is the primary effect of Raloxifene in postmenopausal women?
What is the primary effect of Raloxifene in postmenopausal women?
What is the administration route for Denosumab?
What is the administration route for Denosumab?
Which form of calcitonin is known to be more potent?
Which form of calcitonin is known to be more potent?
What distinguishes Strontium ranelate in osteoporosis treatment?
What distinguishes Strontium ranelate in osteoporosis treatment?
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What is the primary use of Sodium fluoride in relation to dental health?
What is the primary use of Sodium fluoride in relation to dental health?
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Which of the following β-Adrenoceptor antagonists is commonly used to manage hyperthyroidism-related cardiovascular stimulation?
Which of the following β-Adrenoceptor antagonists is commonly used to manage hyperthyroidism-related cardiovascular stimulation?
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What is the primary immediate effect of iodide salts in treating thyroid crisis?
What is the primary immediate effect of iodide salts in treating thyroid crisis?
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What is the half-life of Radioactive Iodine (I-131) after administration?
What is the half-life of Radioactive Iodine (I-131) after administration?
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What is a key contraindication for the use of Radioactive Iodine?
What is a key contraindication for the use of Radioactive Iodine?
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Which bone disorder is characterized by a gradual reduction in bone mass and increased fracture risk from minimal trauma?
Which bone disorder is characterized by a gradual reduction in bone mass and increased fracture risk from minimal trauma?
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What notable effect does the prolonged use of iodide salts have on thyroid function?
What notable effect does the prolonged use of iodide salts have on thyroid function?
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What causes the abnormal mineralization of new bone matrix in osteomalacia?
What causes the abnormal mineralization of new bone matrix in osteomalacia?
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What is the maximum effect duration after administration of Radioactive Iodine to treat thyroid conditions?
What is the maximum effect duration after administration of Radioactive Iodine to treat thyroid conditions?
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What is the drug of choice for thyroid hormone replacement in patients with hypothyroidism?
What is the drug of choice for thyroid hormone replacement in patients with hypothyroidism?
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What is a common adverse effect of excess thyroid hormone?
What is a common adverse effect of excess thyroid hormone?
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Which medication is considered the drug of choice during pregnancy and lactation for treating hyperthyroidism?
Which medication is considered the drug of choice during pregnancy and lactation for treating hyperthyroidism?
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Which of the following treatments can be used for hyperthyroidism?
Which of the following treatments can be used for hyperthyroidism?
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What is the half-life of Levothyroxine (T4)?
What is the half-life of Levothyroxine (T4)?
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Which condition can result from the use of thioamide drugs in patients?
Which condition can result from the use of thioamide drugs in patients?
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What condition in children is primarily caused by vitamin D deficiency?
What condition in children is primarily caused by vitamin D deficiency?
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What is the primary action of antidote drugs like Carbimazole and Methimazole?
What is the primary action of antidote drugs like Carbimazole and Methimazole?
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Which pharmacologic agents are known to inhibit bone resorption by osteoclasts?
Which pharmacologic agents are known to inhibit bone resorption by osteoclasts?
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In elderly patients with hypothyroidism, why is a low initial dose of thyroid hormone recommended?
In elderly patients with hypothyroidism, why is a low initial dose of thyroid hormone recommended?
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What is the effect of teriparatide in bone treatment?
What is the effect of teriparatide in bone treatment?
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Which of the following is NOT a common reason for osteomalacia in adults?
Which of the following is NOT a common reason for osteomalacia in adults?
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What is the primary use of bisphosphonates?
What is the primary use of bisphosphonates?
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What is the role of estrogen in bone health?
What is the role of estrogen in bone health?
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What is the best method to manage hypercalcemia associated with cancer?
What is the best method to manage hypercalcemia associated with cancer?
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Which bisphosphonate was the first approved for osteoporosis treatment?
Which bisphosphonate was the first approved for osteoporosis treatment?
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Study Notes
Thyroid Hormone Preparations
- Levothyroxine (T4) and liothyronine (T3) are synthetic thyroid hormone preparations.
- Levothyroxine is the drug of choice for thyroid hormone replacement in patients with hypothyroidism.
- Both T4 and T3 are well absorbed orally.
- Levothyroxine has a half-life of one week, while liothyronine has a half-life of two days.
- Elderly patients or those with ischemic heart disease should receive low initial doses of levothyroxine with slow increases to prevent angina or myocardial infarction.
- Excess thyroid hormone can lead to the clinical features of thyrotoxicosis.
Antithyroid Agents
- Antithyroid agents used to treat hyperthyroidism include thioamide drugs, β-adrenoceptor antagonists, iodide salts, and radioactive iodine (RAI).
- Thioamide drugs, such as carbimazole, methimazole, and propylthiouracil (PTU), inhibit thyroid hormone synthesis.
- Propylthiouracil is the preferred drug during pregnancy and lactation.
- Thioamide drugs are given orally and can cross the placenta and are secreted in breast milk.
- Common adverse effects of thioamide drugs include hypothyroidism, goiter enlargement, and agranulocytosis.
- β-adrenoceptor antagonists, such as propranolol, are used to reduce cardiovascular stimulation associated with hyperthyroidism and in thyroid storm.
- Iodide salts, like potassium iodide tablets and Lugol solution, have an immediate reducing effect on thyroid hormone release and are used in thyroid crisis.
- Radioactive iodine (I-131) is a colorless, tasteless solution of sodium iodide that is rapidly absorbed from the gut and concentrated by the thyroid gland.
- I-131 emits β-particles that destroy thyroid tissue.
- RAI is the definitive treatment for relapsed Graves' disease, toxic multinodular goiter, and toxic solitary nodule.
- RAI is contraindicated in pregnancy and lactation.
- The effect of RAI on the thyroid takes several weeks to develop, with the maximum effect occurring after two months.
Drugs Affecting Calcium and Bone
- Osteoporosis is the most common bone disorder, characterized by reduced bone mass leading to fractures.
- Osteomalacia is characterized by abnormal mineralization of new bone matrix, often caused by vitamin D deficiency.
- Adequate calcium and vitamin D intake are essential for bone formation in children and to prevent osteoporosis in adults.
- Calcium-rich foods, primarily dairy products, and supplements can help meet these requirements.
Pharmacologic Agents affecting Bone
- Bisphosphonates (etidronate, alendronate, pamidronate, risedronate, tiludronate, ibandronate, zoledronic acid) inhibit bone resorption by osteoclasts.
- Alendronate is the first bisphosphonate approved for osteoporosis treatment.
- Bisphosphonates are used for several disorders, including Paget disease, hypercalcemia, and osteolytic bone lesions from cancer.
- Estrogen and raloxifene reduce bone loss by inhibiting osteoclast formation and activation.
- Denosumab inactivates gene transcription required for osteoclast viability and function, offering a unique approach to osteoporosis treatment.
- Calcitonin, available as salmon calcitonin or recombinant human calcitonin, inhibits osteoclast activity and decreases bone turnover.
- Teriparatide is a recombinant form of human PTH that stimulates bone formation by osteoblasts.
- Strontium ranelate inhibits bone resorption and increases bone formation.
- Fluoride is used to prevent tooth decay, replacing hydroxyl groups in calcium phosphate salts with fluoride to form fluorapatite, which is more resistant to erosion.
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Description
This quiz covers the essential concepts related to thyroid hormone preparations, specifically levothyroxine and liothyronine, along with antithyroid agents used to manage hyperthyroidism. Test your knowledge on their mechanisms, uses, and important considerations in different patient populations.
