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Digital PharmD

Informatics in Pharmacy

Endocrine Disorders

Thyroid Disorders: Hyperthyroid

August 12, 2018 By Dr. G, PharmD

Graves Disorder, pituitary adenomas, toxic goiter, drug-induced (excess thyroid hormone, amiodarone)elevated free T4, suppressed TSH Can use radioactive iodine update study to diagnose. Uptake is elevated if thyroid is excessively secreting T4 or T3: Graves disease, TSH-secreting adenoma, toxic adenoma, multinodular goiter Clinical presentation: weight loss, lid lag, heat intolerance, goiter, fine hair, tachycardia, nervousness, menstrual disturbances, sweating, […]

Thyroid Disorders: Hypothyroid

August 12, 2018 By Dr. G, PharmD

Hypothyroid Disorders: Hashimoto’s disease: Most common. Iodine deficiency most common cause worldwide.  Can also be due to pituitary insufficiency or drug-induced (amiodarone, lithium). Diagnose with low free T4, elevated TSH, thyroid antibodies Symptoms: cold intolerance, dry skin, fatigue, weight gain, bradycardia, slow reflexes, coarse skin and hair, periorbital swelling, goiter, menstrual irregularities Levothyroxine is the drug of […]

Adrenal Disorders

August 12, 2018 By Dr. G, PharmD

Acromegaly – bromocriptine or octreotideHyperprolactinemia – surgical resection, cabergoline or bromocriptine Cushings Disease- Diagnosed by a dexamethasone suppression test or 24-hour urinary cortisone test. Symptoms: central obesity, peripheral fat, myopathies, osteoporosis, back pain, diabetes, hirsutism, hypertension Treatment: Surgical resection if possible Pasireotide: 0.6-0.9 mg BID subQ (adverse effects: hypoglycemia, hypocortisolism, diarrhea, nausea, gallstones, headache, bradycardia) Ketoconazole: Hinders cortisol […]

Obesity

August 12, 2018 By Dr. G, PharmD

BMI Defined: 18.5-24.9 – Normal 25.0-2939 – Overweight 30-34.9 – Class I Obesity 35-39.9 – Class II Obesity 40 or greater – Class III Obesity Treatment: Orlistat – AE: Hepattoaxity and kidney stones Lorcaserin: AE: headaches, dizziness, nausea and vomiting, dry mouth, memory or attention problems, hypoglycemia.  DC if 5% weight not lost in 12 […]

Diabetes

August 12, 2018 By Dr. G, PharmD

This is a very simply rundown of diabetes.  The diabetes information on the ambulatory care board exam is more complex.  Knowing the basics of how to diagnose diabetes, goals, how to change insulin and which drugs not to use in which patients is probably enough for the BCPS. Pre-Diabetes Fasting Plasma Glucose: 100-125 mg/dl 2-hour […]

Ketoacidosis

August 12, 2018 By Dr. G, PharmD

Ketoacidosis is more common in type 1 diabetes than in type 2.  The goal treatment is to stop ketosis, not to normalize glucose. Common symptoms: polyuria, polydipsia, vomiting, dehydration, weakness, altered mental status, coma, abdominal pain, Kussmaul respirations, tachycardia, hyponatremia, hyperkalemia Treatment: Fluid replacement: start with 0.45-0.9% NS, change to 5% dextrose or dextrose containing saline […]

Diabetes Insipidus

August 12, 2018 By Dr. G, PharmD

Decreased anti-diuretic hormone (ADH) production or lack of ADH effect.Symptoms: polydipsia, polyuria, lethargy, and confusionTreatment: desmopressin, chlorpropamide, carbamazepine for central DI, thiazide, low sodium diet and indomethacin in nephrogenic DI.

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acid base acidosis acute coronary syndrome alkalosis analgesics anaphylaxis aortic dissection arrhythmia Beta-Blockers biostatistics blood pressure cardiac markers CHA2DS2-VasC cocaine COVID-19 diabetes diabetes inspidius Guidelines heart failure Heparin hypersensitivity hypertension hypovolemic shock intubation ionotropes journal club lipids LMWH medication safety morphine conversions myocardial infarction needs work NOAC NSTEMI obstructive shock pharmacoeconomics pheochromocytoma pressors reference materials right mi sedation septic shock shock STEMI Updated 2020