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Pharmacology > 46. Endocrine > Flashcards

46. Endocrine Flashcards

1
Q

What regulates the endocrine system?

A

negative feedback loops

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2
Q

5 hormones released from the anterior pituitary

A
  • growth hormone (GH)
  • thyroid stimulating hormone (TSH)
  • adrenocorticotropic hormone (ACTH)
  • follicle stimulating hormone (FSH)
  • luteinizing hormone (LH)
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3
Q

2 drugs made in the hypothalamus and stored in and released from the posterior pituitary

A
  • antidiuretic hormone (ADH)

- oxytocin

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4
Q

growth hormone deficiency replacement drug

A

Somatropin

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5
Q

contraindications of somatropin

A
  • corticosteroids (inhibits effects)

- malignancy (can cause growth)

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6
Q

side effects of somatropin

A
  • arthralgias
  • myalgias
  • edema
  • weakness
  • glucose fluctuations (monitor)
  • hypothyroidism (monitor)
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7
Q

adverse reactions to somatropin

A
  • seizures
  • intracranial hypertension
  • secondary malignancy
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8
Q

most common cause and tx of acromegaly (GH excess in adults) or gigantism (GH excess in children)

A
  • cause: pituitary tumor

- tx: radiation or medication (if radiation not effective)

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9
Q

somatostatin analogue that reduces GH effect

A

Lantreotide

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10
Q

How are growth hormone medications (somatropin and lantreotide) given?

A

by injection

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11
Q

What is the function of somatostatin that is released from the hypothalamus?

A

inhibits secretion of GH

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12
Q

side effects of Lantreotide

A
  • N/V/D
  • constipation
  • ABD pain
  • weight loss
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13
Q

excess ADH that causes fluid retention

A

syndrome of inappropriate antidiuretic hormone (SIADH)

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14
Q

sxs of SIADH

A
  • fluid overload
  • edema
  • hyponatremia
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15
Q

tx of SIADH

A
  • fluid restriction
  • hypertonic saline (pulls fluids back into vessels)
  • drug therapy
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16
Q

deficiency of ADH that causes large amounts of water to be excreted by kidneys

A

diabetes insipidus (DI)

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17
Q

sxs of DI

A
  • severe fluid volume deficit (dehydration)

- electrolyte imbalances (hypernatremia)

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18
Q

tx of DI

A

Desmopressin acetate

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19
Q

most common cause of SIADH

A

small cell carcinoma of the lungs

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20
Q

ADH replacement medication

A

Desmopressin

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21
Q

contraindications of Desmopressin

A
  • renal disease

- hyponatremia or hx of hyponatremia

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22
Q

side effects/adverse effects of desmopressin

A
  • hyponatremia (monitor electrolytes)
  • headache
  • dyspepsia
  • N/V
  • seizures (due to electrolyte problems)
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23
Q

sxs of hyperthyroidism

A
  • heat intolerance
  • fine straight hair
  • bulging eyes
  • tachycardia
  • increased BP
  • diarrhea
  • weight loss
  • amenorrhea
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24
Q

sxs of hypothyroidism

A
  • cold intolerance
  • receding hairline
  • extreme fatigue
  • anorexia/lethargy
  • constipation
  • bradycardia
  • weight gain
25
Q

severe hypothyroidism (can be life threatening) with facial swelling, memory loss, lethargy, slow speech, and emotional changes

A

myxedema

26
Q

congenital hypothyroidism that results in delayed physical and mental growth

A

cretinism

27
Q

medication indicated for primary hypothyroidism with or without goiter

A

Levothyroxine

28
Q

MOA of Levothyroxine

A
  • increases metabolic rate, O2 consumption, utilization and mobilization of glycogen stores
  • promotes gluconeogenesis and body growth
  • stimulates protein synthesis
29
Q

contraindications for Levothyroxine

A
  • thyrotoxicosis

- MI

30
Q

side effects of Levothyroxine

A
  • N/V/D
  • anorexia
  • cramps/tremors
  • nervousness
  • irritability
  • weight loss
  • diaphoresis
31
Q

adverse reactions to Levothyroxine

A
  • tachycardia
  • hypertension
  • osteoporosis
  • thyroid crisis
  • cardiovascular collapse
32
Q

When is Levothyroxine supposed to be taken?

A

first thing in the morning on an empty stomach (food could interfere w/ absorption)

33
Q

T/F: it is okay to switch brands of Levothyroxine

A

False; there is some variability in dosage between brands so stick with the same to get the same dose

34
Q

2 mechanisms that raise serum Ca levels

A
  • increased PTH secretion from parathyroid glands

- activation of vitamin D to increase intestinal reabsorption of Ca

35
Q

how does PTH increase serum Ca

A
  • decrease renal excretion of Ca
  • increased intestinal absorption of Ca via vitamin D activation
  • releaser of Ca from bone
36
Q

excess secretion of PTH that causes increased serum Ca levels -> pulls Ca from bone and risk for osteoporosis

A

hyperparathyroidism

37
Q

deficiency in PTH secretion which causes hypocalcemia; usually caused by damage to parathyroid gland (surgery or radiation)

A

hypoparathyroidism

38
Q

vitamin D analogue medication used to treat parathyroid disorders and manage hypocalcemia in chronic renal failure

A

Calcitriol

39
Q

MOA of Calcitriol

A
  • enhances Ca deposits into bones by active form of vitamin D’s metabolite (calcitriol)
  • increases reabsorption of Ca by kidneys and intestinal absorption
  • decreases serum phosphate, bone resorption, and PTH levels
40
Q

side effects of Calcitriol

A

early signs of hypercalcemia

  • fatigue/weakness
  • somnolence/drowsiness
  • headache
  • N/V/D
  • cramps
  • dizzy/vertigo
  • metallic taste
  • constipation
  • xerostomia
41
Q

adverse effects of Calcitriol

A

late signs of hypercalcemia

  • anorexia
  • photophobia
  • dehydration
  • cardiac arrhythmias
  • HTN
  • sensory disturbances
  • hypercalcemia/hypercalciuria
  • hyperphosphatemia
42
Q

What is the class and indication of Alendronate

A
  • class: bisphosphonate

- indication: osteopenia/osteoporosis

43
Q

MOA of Alendronate

A

inhibits bone resorption via action on osteoclasts

44
Q

Side effects of Alendronate

A
  • bone pain
  • acid reflux
  • upset stomach
45
Q

Adverse effects of Alendronate

A
  • avascular necrosis of the jaw
  • spiral fractures of the femur
  • duodenal ulcers
46
Q

Nursing notes for Alendronate

A
  • must take on an empty stomach w/ water and remain upright for 30 minutes after taking (lower ulceration risk)
  • limited to 5 years of use
  • report jaw or thigh pain and notify provider before dental work
47
Q

symptoms of Addison’s disease (adrenocortical insufficiency)

A
  • bronze pigmented skin
  • hypoglycemia
  • postural hypotension
  • weight loss
  • weakness
  • changes in hair distribution
48
Q

symptoms of Cushing’s disease (adrenocortical excess)

A
  • hyperglycemia
  • moon face
  • buffalo hump
  • purple striae
  • bruises and petechiae
  • Na and fluid retention (edema)
  • gynecomastia in males
  • osteoporosis
  • increased risk of infection
49
Q

Class and indication for Prednisone

A
  • class: glucocorticoid

- indication: adrenocortical insufficiency or Addison’s disease

50
Q

MOA of Prednisone

A
  • suppresses inflammation, immune responses (humoral), and adrenal function
  • has mild mineralocorticoid activity
51
Q

contraindications for Prednisone

A
  • untreated serious infections
  • hypersensitivity
  • varicella
52
Q

side effects of Prednisone

A
  • fluid/Na retention
  • nausea and diarrhea
  • ABD distention
  • increased appetite
  • immunosupression
  • hyperglycemia
  • purple striae, moon face, and weight gain
53
Q

Adverse reactions to Prednisone

A
  • angioedema
  • cardiac arrhythmia
  • osteoporosis/fractures (long-term therapy)
  • cardiac arrest
  • cardiomyopathy
  • GI ulceration
54
Q

Nursing notes for Prednisone

A
  • don’t like to keep pts on long term
  • should be tapered to prevent adrenal crisis
  • don’t start when someone has infection
  • monotor glucose levels
  • make sure UTD on vaccines before starting
55
Q

class for Fludrocortisone

A

mineralcorticoid

56
Q

MOA of Fludrocortisone

A
  • promotes Na retention and K and hydrogen excretion

- maintains fluid balance

57
Q

adverse reactions of Fludrocortisone

A
  • hypokalemia
  • fluid imbalance
  • fluid overload
  • hypertension
58
Q

Nursing notes for Fludrocortisone

A
  • monitor I&O
  • monitor serum Na and K
  • monitor BP
59
Q

T/F: Fludrocortisone will always be given with Prednisone

A

True; never given on its own

Pharmacology (22 decks)

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