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Pharm Exam 3 > CH 44: Endocrine drugs > Flashcards

CH 44: Endocrine drugs Flashcards

1
Q

hypersecretion of corticosteroids:
treatment:

A

Cushing’s syndrome
ketoconazole (Nizoral) and mitotane (Lysodren)

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2
Q

hyposecretion of corticosteroids:
treatment:

A

Addison’s disease
hydrocortisone, prednisone

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3
Q

hyposecretion of progesterone:
treatment:

A

dysfunctional uterine bleeding
medroxyprogesterone (provera) and norethindrone

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4
Q

hyposecretion of insulin:
treatment:

A

DM
insulin and oral antidiabetic drugs

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5
Q

hyposecretion of parathryoid hormone treatment:

A

human parathyroid hormone (Natpara), vitamin D, and calcium supplements

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6
Q

DI drug treatment

A

desmopressin (DDAVP, Noctiva, Stimate) and vasopressin

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7
Q

SIADH drug treatment

A

conivaptan (Vaprisol) and tolvaptan (Samsca)

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8
Q

treatment for hyposecretion of GH

A

somatropin (Genotropin, others)

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9
Q

hypersecretion of GH

A

acromegaly

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10
Q

acromegaly drug treatment

A

octreotide (Sandostatin)

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11
Q

Grave’s disease drug treatment

A

propylthiouracil (PTU) and I-131

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12
Q

therapeutic effects of Somatropin (GH)

A

Treat growth hormone deficiency
Evaluate pituitary function

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13
Q

adverse effects of Somatropin (GH)

A

Pain at the injection site
hyperglycemia
arthralgia
myalgia
abdominal pain
otitis media
headache
bronchitis
hypothyroidism
hypertension (HTN)
flulike symptoms

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14
Q

Safety and monitoring for somatropin (GH)

A

Annual bone assessment for children- epiphyses
Glucose
AST, ALT
thyroid function
Teach about s/s of hyperglycemia,
Need to follow up with lab tests

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15
Q

therapeutic effects of bromocriptine (GH antagonist)

A

acromegaly

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16
Q

adverse effects of bromocriptine (GH antagonist)

A

Pain at the injection site,
hyperglycemia,
arthralgia,
myalgia,
abdominal pain,
otitis media,
headache,
bronchitis,
hypothyroidism,
hypertension (HTN),
flulike symptoms

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17
Q

safety and monitoring of bromocriptine (GH antagonist)

A

Assess for cardiovascular disease
Monitor for pregnancy
Monitor blood pressure

18
Q

therapeutic effects of vasopressin & desmopressin (ADH)

A

Regulation of fluid balance – reabsorption of water in the kidneys
Treatment of DI
nocturia

19
Q

adverse effects of vasopressin & desmopressin (ADH)

A

Headache,
nasal congestion or irritation,
nausea
Water intoxication,
coma,
thromboembolic disorder,
hyponatremia

20
Q

safety and monitoring of vasopressin & desmopressin (ADH)

A

Monitor weight
Input and Output
Electrolytes
Dehydration
Water intoxication – drowsiness listless SOB headache
Hyponatremia
Caution with NSAIDs

21
Q

thyroid hormone increases___

A

basal metabolic rate (metabolism)

22
Q

life threatening hyperthyroidism

A

thyroid storm

23
Q

thyroid storm clinical manifestations

A

high fever
tachycardia
HF
MI
delirium
coma

24
Q

therapeutic effects of levothyroxine T4 (thyroid)

A

increases T4 levels

25
Q

adverse effects of levothyroxine T4 (thyroid)

A

Weight loss,
headache,
tremors,
nervousness,
heat intolerance,
insomnia,
menstrual irregularities
Dysrhythmias,
HTN,
palpitations

26
Q

safety and monitoring of levothyroxine T4 (thyroid)

A

TSH levels
T3 and T4 uptake
Palpitations,
anxiety,
heat intolerance
Soy can inhibit absorption!!!
Take at same time
Take 4 hour from multivitamins, aluminum hydroxide etc

27
Q

therapeutic effects of methimazole (anti-thyroid)

A

decreased levels of T4

28
Q

adverse effects of methimazole (anti-thyroid)

A

Nausea,
rash,
pruritus,
weight gain,
headache,
fever,
numbness in fingers,
leukopenia,
diarrhea,
hypothyroidism
Agranulocytosis,
bradycardia,
hepatotoxicity (methimazole)

29
Q

safety and monitoring for methimazole (anti-thyroid)

A

AST, ALT, ALP!!!
TSH level
VS
Weight
Signs of hypothyroidism
No pregnancy
Can increase PT
Avoid foods with extra iodine
Need to follow up with labs!!!
Report flulike symptoms

30
Q

3 classes of steroid hormones

A

glucocorticoids
mineralocorticoids
gonadocorticoids

31
Q

gonadocorticoids =

A

androgens = puberty

32
Q

mineralocorticoids =

A

aldosterone = regulation of plasma volume with sodium reabsorption and potassium excretion = RAAS

33
Q

= excessive ADH = HTN and hypokalemia

A

tumors

34
Q

glucocorticoids =

A

30 = cortisol, cortisone, etc = effect nearly every cell

35
Q

functions of glucocorticoids

A

oIncrease the level of blood glucose (hyperglycemic effect) by inhibiting insulin secretion and promoting gluconeogenesis, the synthesis of carbohydrates from lipid and protein sources
oIncrease the breakdown of proteins and lipids and promote their utilization as energy sources
oSuppress the inflammatory and immune responses (see Chapters 33 and 34)
oIncrease the sensitivity of vascular smooth muscle to norepinephrine and angiotensin II
oIncrease the breakdown of bony matrix, resulting in bone demineralization
oPromote bronchodilation by making bronchial smooth muscle more responsive to sympathetic nervous system activation.

36
Q

adverse effects of longterm corticosteroid therapy

A

Behavioral changes
Eye changes
Immune response
Metabolic changes
Myopathy
Osteoporosis
Peptic ulcers

37
Q

uses for hydrocortisone (corticosteroid)

A
  • Allergies
  • Asthma
  • Cancer
  • Edema
  • GI disease
  • Joint disorders
  • Skin disorders
  • Shock
38
Q

therapeutic effects of hydrocortisone (corticsteroid)

A

Increase adrenocortical levels
Decrease inflammation

39
Q

adverse effects of hydrocortisone (corticosteroid)

A

Mood swings,
weight gain,
acne,
facial flushing,
nausea,
insomnia,
sodium and fluid retention,
impaired wound healing,
menstrual abnormalities
Peptic ulcer,
hypocalcemia,
osteoporosis with possible bone fractures,
loss of muscle mass,
decreased growth in children,
possible masking of infections

40
Q

safety and monitoring for hydrocortisone (corticosteroid)

A

See table 44.5
Vital signs – bp, pulse, tachycardia
Electrolytes and glucose, lipid levels, ALT, AST, BUN Creatinine
GI bleed
Osteoporosis
Vision – cateracts
Signs and symptoms of Cushing’s
Signs and symptoms of infection
Take with food – oral
LOTS of interactions
Take early in the morning
Eat foods with potassium
Do not stop abruptly – need to taper

Pharm Exam 3 (5 decks)

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