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Nanju > Ch 50 Pituitary, Thyroid, Parathyroid > Flashcards

Ch 50 Pituitary, Thyroid, Parathyroid Flashcards

0
Q

What disease results from hyperthyroidism

A

Graves’ disease

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1
Q

If a persons PSH level is increased what type of disorder do you have

A

You have a thyroid problem

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2
Q

What are manifestations of hypothyroidism

A 
Decreased BP
decreased HR
Decreased metabolism, resulting in wt. gain
Lethargy
Heat intolerance 
..........levers thing slows down
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3
Q

What are manifestations of hyperthyroidism

A 
Increased BP
increased HR
wt. loss
Bulging eyes
Cold intolerance
Thinking slows down
Insomnia
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4
Q

What are signs and symptoms of thyrotoxicosis ( thyroid crisis)

A 
Tachycardia
Fever
Dysrhythmias 
HF
flushed skin
....can lead to coma
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5
Q

What is true of hyperthyroidism

A

When you have hyperthyroidism some or all of the gland may have to be removed…supplemental hormones will be given for the duration of life

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6
Q

What is anterior pituitary gland dysfunction

A

Includes growth hormone deficiency and excess

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7
Q

What is posterior pituitary glad dysfunction

A

Major disorders are diabetes insipidus and syndrome of inappropriate ANTIDIURETIC hormone ( SIADH)

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8
Q

What is thyroid gland dysfunction

A

Hyper functioning or hypo functioning gland, misfunctions that may either be caused by a congenital defect or by a problem that occurs later in life

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9
Q

Parathyroid gland dysfunction

A

Hormone is a major regulator of serum calcium and phosphate
A decrease in serum calcium concentration is the dominant regulator of PTH, with a response rate of just a few seconds
A decrease in phosphate causes an indirect effect on PTH by combining with calcium and decreasing serum calcium concentrations

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10
Q

What are growth hormones prototype drug

A

Somatropin

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11
Q

What is true of GH deficiency

A

Growth hormone deficiency, leading to short stature, was initially treated with growth hormone injections extracted from the pituitary gland of cadavers.
Presently synthetic human GH ( rhGH), produced from recombinant DNA is available
rhGH is very expensive

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12
Q

What is Somatropin used for

A

It is used as long term replacement of inadequate endogenous GH secretion

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13
Q

How is Somatropin administered

A

SC, IM

Excreted in liver and kidneys

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14
Q

What is the pharmacodynamics of Somatropin

A

It stimulates cell growth and cellular mitosis, facilitates cellular uptake of amino acids for protein synthesis, and promotes use of fatty acids for energy

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15
Q

What are contraindications of Somatropin

A

Growth hormone in children with closed epiphyses

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16
Q

What are adverse effects of Somatropin

A 
Headache 
HTN
joint and back pain
Peripheral edema
Muscle aches
Rhinitis
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17
Q

What are drug interactions of Somatropin

A

Anabolic steroids

Androgens, estrogens, or thyroid hormones may accelerate epiphyseal maturation

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18
Q

What can hypothyroidism develop from

A

Hypothyroidism may develop during Somatropin therapy

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19
Q

For patients who require chronic cycling peritoneal dialysis, when should they receive there doses of Somatropin

A

In the morning after there dialysis is completed

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20
Q

What may Somatropin therapy induce

A

It may induce insulin resistance

Be alert for the development of hip or knee pain and inform provider

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21
Q

What is an ongoing assessment of a person with Somatropin therapy

A

Evaluate thyroid function at regular intervals because hypothyroidism compromises rGH drug effects

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22
Q

Patients taking Somatropin should have what lab values monitored on a routine basis due to adverse effects of drug therapy

A

TSH
GLUCOSE LEVEL
Because Somatropin can cause hypothyroidism and glucose intolerance.

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23
Q

What two hormones does the posterior pituitary gland store

A

Vassopressin and oxytocin
They are produced in the hypothalamus. They are synthetic analogues of the naturally occurring posterior pituitary gland hormone.
Prototype: desmopressin

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24
Q

What does the posterior pituitary gland hormone desmopressin do

A

It manages central DI and nocturnal enuresis and maintains homeostasis in hemophilia A.

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25
Q

How is desmopressin administered

A

Intranasally
Orally
Parenterally IV or SC

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26
Q

What are adverse effects of desmopressin

A 
Abdominal pain 
Transient headache
Nasal congestion
Nausea
Rhinitis
Facial flushing
27
Q

What are drug interactions of desmopressin

A

Carbamazepine, chlorpromazine, and NSAIDS

28
Q

How can maximize the therapeutic effects of desmopressin

A

Establish baseline values for wt., BP, electrolytes and urine specific gravity
Protect ADH solutions from agitation and temperature extremes

29
Q

What can alter the therapeutic response of desmopressin

A

Alcohol

30
Q

What are the Pharmacotherapeutics of levothyroxine, Synthroid

A

These drugs are used as a replacement therapy in hypothyroidism
It acts a replacement for natural thyroid hormone in hypothyroidism

31
Q

What should a person be cautious of when taking Synthroid or levothyroxine

A

Be cautious of ppl on anticoagulants and ppl with diarrhea, it can exacerbate it.
Hold if HR is tachycardic because this med increases HR
GIVE 30 min before meals or 2 hr after, because food decreases absorption

32
Q

If a person is tachycardic and has hyperthyroidism what med will you expect to give

A

Beta blockers

33
Q

What can long term hormone treatment result in

A

Osteoporosis

34
Q

What is Somatropin

A

A growth hormone

35
Q

What is desmopressin

A

A posterior pituitary hormone regulator

36
Q

What are anti thyroid compounds

A

They treat hyperthyroidism

37
Q

What is the prototype anti thyroid hormone

A

Methimazole (MMI)
Propythiouracil
Iodine radioactive sodium iodine ( I-131)

38
Q

What is needed for synthesis of thyroid hormones

A

Low doses of iodine is needed for thyroid hormone synthesis

39
Q

What is MMI methimazole

A

Palliative treatments of hyperthyroidism/ inhibits the synthesis of thyroid hormone.
Administered orally, excreted in the kidneys, metabolized in the liver

40
Q

What are adverse effects of methimazole

A

Hives, itching, fever, arthralgia, joint swelling, vertigo, drowsiness,nausea, vomiting, altered taste sensation.

41
Q

What are drug interactions of methimazole

A

Beta blockers
Theophylline
Warfarin

42
Q

What is Lugol

A

Presurgical solution of iodine prior to surgery

43
Q

How can one minimize adverse effects of MMI therapy

A

Arrange for periodic blood tests to monitor hematologic and thyroid functions
Monitor bone marrow function

44
Q

How many parathyroid glands do we have

A

4 parathyroid glands

45
Q

What is the regulation of calcium do strictly to

A

The regulatio. Of calcium is due strictly to parathyroid glands

46
Q

Paget’s disease

A

Softening of bones

Overactive bone formation

47
Q

What are antihypercalcemic drugs

A

Antihypercalcemic drugs do not directly affect the parathyroid gland or PTH but rather inhibit bone reabsorption of calcium
Theses drugs are frequently used in Paget’s disease
Individuals with symptomatic disease experience bone pain and deformity, fractures, spinal cord compression, or cranial and spinal cord entrapment.

48
Q

What is the prototype antihypercalcemic drug

A 
Calcitonin
Alendronate 
Etidronate
Pamidronate
Risedronate
Tiludronate
49
Q

Any time you see the suffix -nate, what does it mean

A

Parathyroid supplement

50
Q

What is calcitonin used for

A

Treatment of symptomatic Paget’s disease

51
Q

What are contraindications of calcitonin

A

Allergies to salmon

52
Q

What are adverse effects of calcitonin

A

GI disturbances
Skin rash
Flushing of the face and hands
Nasal irritation or rhinitis if using nasal spray alternate nostrils

53
Q

What are drug interactions of calcitonin

A

Calcium supplements
Antacids
Vitamin D
Theophylline

54
Q

For Paget’s disease, how should calcitonin be administered

A

INJECTION

55
Q

What does hypocalcemia lead to

A

Muscle tetany (severe Charlie horse)

56
Q

What is an ongoing assessment of the administration of calcitonin

A

Calcitonin can cause the serum calcium level to drop, resulting in tetany and cardiac arrhythmias

57
Q

If calcitonin salmon is given with calcium supplements, antacids, or vitamin D, What will happen

A

There is risk of HYPERCALCEMIA and therapeutic effect is decreased

58
Q

What are antihypercalcemic drugs

A

Calcitonin (1,25- dihydroxyvitwmin D3, rocaltrol [ capsules, solution])
Calcijex ( parenteral)

59
Q

Tell me what you know about vitamin D

A

Vitamin D Compounds regulate absorption of calcium and phosphate
Vitamin D is considered a hormone, although it is not a natural human hormone.
Vitamin D Metabolites control intestinal absorption of dietary calcium, tubular reabsorption of calcium from the kidney, and mobilization of calcium from the skeleton in conjunction with PTH
vitamin D is also involved in MG metabolism
Vitamin D works together with PTH and calcitonin to regulate calcium homeostasis .

60
Q

What is calcitrol used for

A

Management of hypocalcemia

It is a fat soluble vitamin derived fro natural sources ( fish, liver oils) or from conversion of provitamins

61
Q

What are contraindications of calcitriol

A

Given carefully to patients at risk for hypercalcemia or hypercalcuria

62
Q

What are adverse effects of calcitriol

A

Weakness headache nausea vomiting

Dry mouth constipation bone pain

63
Q

What are drug interactions of calcitriol

A

Thiazide diuretics

64
Q

What should chronic dialysis patients avoid while on calcitriol therapy

A

Avoid magnesium containing antacids

Nanju (15 decks)

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