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343 Pharm Exam 4 > Chapter 49: Pituitary, Thyroid, Parathyroid And Adrenal Disorders > Flashcards

Chapter 49: Pituitary, Thyroid, Parathyroid And Adrenal Disorders Flashcards

1
Q

With any endocrine condition, you have a hormone does what?

A

Too much or too little
( symptoms of too much of this hormone or less )

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2
Q

How do we treat that hormone that’s too much or less?

A

Get the glands to produce less or more of it

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3
Q

Side effects of any endocrine disorders are like
Hypo ?
Or hyper?

A

Same as hyper gland

We’ll see hypo problems

So if we treat hypothyroidism
We look at side effects of hyperthyroidism

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4
Q

What is the growth hormone function?

A

Stimulates growth in tissue and bone

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5
Q

If you have too little growth hormone it means what?

A

You’re too short

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6
Q

You can’t just go to the doctor and ask the doctor for a growth hormone for your child. Instead what reason would be the only reason we give a child a growth hormone?

A

If they aren’t producing any to begin with

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7
Q

What is the drug for growth hormone deficiency?

A

Somatropin

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8
Q

What are side effects of somatropin? (3)

A

Anti diabetics work better now !!
So putting risk of hypoglycemia

Seizures
Intracranial pressure (edema)
Leukemia

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9
Q

When do you not give the growth hormone??
Like what are the 2 contraindications?

A

Acutely ill patients
Closed growth plates

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10
Q

Why does the growth hormone not work when a patient doesn’t have growth plates no more??

A

Because the bones are fully formed. As big as it is

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11
Q

What’s another name for growth hormone excess?

A

Acromagaly
( overgrowth of bone in the face, hands, feet’s )

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12
Q

What are the 4 drugs for growth hormone excess?

A

Pegvisomant
Lanreotide
Octreotide
Bromocriptine

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13
Q

What are the 5 side effects of growth hormone excess?

A

Chest pain
Hypertension
Cardio toxicity
Brady cardiac
Dysrthymias

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14
Q

No onto antidiuretic hormone

A
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15
Q

What is the function of antidiuretic hormone?

A

Helps stop diuresis

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16
Q

If you have too much ADH? What does it do!?
( hyper )
If you have too little ADH? What does it mean?
( hypo )

A

Not losing enough fluid

Too much fluid

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17
Q

ADH deficiency is also known as what?

A

Diabetes insipidus
( large amount of water excreted, can lead to severe fluid volume deficit and electrolyte imbalances )

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18
Q

What are the medication to help with ADH replacement? (2)

A

Vasopressin
Desmopressin acetate

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19
Q

DDAVP is a medication that comes as a nasal spray with children who have bed wettest and also for?

A

Diabetic insipidus

( bed wetters too ! )

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20
Q

Vasopressin is also used to treat shock and hypotension

What side effect do you think it will have ?

A

Hypertension!!!

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21
Q

What two people will vasopressin and desmopresin acetate should not be given?

A

Renal failure
Hyponatremia

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22
Q

What is syndrome inappropriate ADH?

A

You’re holding onto fluid
Excess amount of water retention

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23
Q

What are the 3 medication for SIADH?

A

Democlycoycline
Conivaptan
Tolvaptan

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24
Q

Democlocycline is a tetracycline so what side effects?

A

Photosensitive
Don’t give to kids under age of 8
Binds to calcium
Antibiotic

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25
What is contraindicated with conivaptan?
Allergic to corn
26
Test question What medication do you not give to people allergic to corn?
Conivaptan
27
What is side effects about tolvaptan ( black box warning ) for who? (4) Look at the L
Alcoholism Liver disease Malnutrition ( bad for liver and protein bound ) Toxicity!!
28
Somatropin should do what? Decompression and vasopressin should do what?
Grow the child Should reduce severe thirst and decrease urinary output
29
Thyroid !!
30
What are the 3 thyroid glands ?
T3,T4, calcitonin
31
What is the function of of thyroid glands?
Regulate metabolism and calcium
32
If you thyroid doesn’t produce enough hormone, what symptoms will you see in a patient?
Cold Constipation Menstrual irregularities Skin dry Sleepy Depression
33
If you have thyroid produce too much hormone what we will see?
Palpitation Insomnia Diarrhea Sweating
34
HIGH TSH indicate what?
Need more thyroid hormones
35
LOW Levels of TSH means what?
Excess of thyroid hormones
36
What is the function is TSH?
To tell the thyroid to produce hormone !!
37
What are the 4 hypothyroidism?
Levothyroxine ( synthroid ) Liothyronine ( cytomel ) Liotrix ( thyrolar ) Thyroid,desiccated (armour thyroid, westhroid) Dried animal thyroid into a pill, usually pig ^
38
All hypothyroidism medications, it’s colored coded and what type of grams doses?
Micro gram ( yellow ! )
39
Indications notes - to treat all forms of hypothyroidism - Levothyroxine is preferred because its hormonal content is standardized ; therefore its effect is predictable Used for thyroid replacement in patients whose thyroid glands have been surgical removed or destroyed by _____ in the treatment of thyroid cancer or hyper thyroid
Radioactive iodine Meaning usually a life long treatment
40
Most of the time, patients who are treated for hyperthyroidism, usually they end up what?
On hypothyroidism medications
41
What’s the most Significant adverse effects of hypothyroidism ?
Cardiac dysrhythmias !! ( tachycardia, palpitation, angina, hypertension, insomnia )
42
There are some OTC medications that make our heart work harder, what are they? This is a medication we used cautiously with thyroid meds
Cold medications Decongestations ( Sudafed )
43
How do we take hypothyroidism meds? (3)
Take in the morning Take it on empty stomach & water Avoid with iron & calcium ( no multi vitamin )
44
Test question Do we give thyroid medication with hyper thyroid?
No!
45
There is a weight based thyroid medication, in which it may take ? Then we do what?
4-6 weeks to start ( 2 years after )
46
Hypo Thyroid medication increase what? Hypo Thyroid medication is a what? It decreases the effects of what? It reduces the effects of what?
Bleeding ( anticoagulants ) ( lower warfarin dose, or monitor threauptic range 2-3 ) Protein bound drug Insulin ( hypoglycemic meds ) ( increase the dosages ) Digoxin
47
Notes Fetal growth may be retarded if maternal hypothyroidism is untreated during pregnancy During pregnancy, treatment for hypothyroidism should continue Adjust dosage ever 4 weeks to keep TSH at the lower end of the normal range 30-60 mins before breakfast ( morning time too ) Don’t expose medication to light
48
Now hyperthyroidism !!
49
What medication of hyper thyroid will we use? (3)
Radioactive iodine Propyiyhiouradil (PTU) Methinazole ( tapazole ) (Surgery )
50
If you take the whole thyroid out, surgery! What will you be on and why?
Hypothyroidism medication For life because you will no longer make thyroid
51
Your thyroid uses iodine to make thyroid !!! So we use radioiodine to lower that !
52
Usually hyperthyroidism medication isn’t long term Usually treat them to hypothyroid ! They wont prescribe the medication usually send to endo
53
Why do we give beta blockers, like propranolol to hyperthyroidism?
Because thy have tachycardia and palpitation cause hyper makes you HYPER!!
54
Why would we give hyperthyroidism medication before surgery?
To help shrink the thyroid for surgery to avoid hemorrhaging
55
Note Increase bleeding Decrease anti diabetics Increase digoxin & lithium
56
Parathyroid hormone !!
57
What is the 3 function of parathyroid gland?
Calcium release from bones Calcium reabsorption in renal tubules Calcium absorption in intestines by increasing production of vitamin D
58
If you had a patient who has their thyroid removed, hard to breathe and can’t swallow ? What do we do? Because parathyroid may be removed too
Check their calcium level
59
What are signs of hypo calcium?
Tetany ( curling ) Chvoswek sign, the cheek The blood pressure too
60
What medication do we give for hypoparathyroidms?
Calcitriol ( help with that calcium )
61
Hyperparathyroidism - too much parathyroid hormone secretion What’s the treatment? - calcitonin-salmon Calciminetic Biphosphates
Usually removal of it too
62
Adrenal glands !
63
Adrenal glands are pretty much the steroids in your body!!
64
When you’re stressed Your body produces what?
Cortisol
65
If a patient is on a steroid for 3-5 days What is the most important thing?
Slowly taper off Because our body’, adrenal glands gets lazy and stop produces steroid So if you stop taking it, your body will shut down
66
What medication are we going to talk about for glucocorticoids?
Prednisone
67
Why would we use steroids?
Help with inflammation
68
What are side effects of prednisone ?
Euphoria Psychosis Thin skin with purpura Tachy cardia Hypertension Hyperglycemia Edema Glaucoma Growth retardation Adrenal trophy Muscle eating
69
Fludrocortisone - oral mineralcorticoid - aid with inflammation Hypertension Hypokalemia Gi distress Fluid overload Negative nitrogen balance
70
The higher the dose the worst the side effects Your on steroids - immune system is suppressed - wash your hands - wear masks - vaccination !
71
People on steroids Their fasting blood sugar will be high!
72
Steroid in the morning !!
73
ALWAYS TAKE STEROIDD WITH FOOD THIS CAN CAUSE ULCERS!!!! ASSESS FOR GI
74
Steroids !! Take calcium supplements because the risk of osteoporosis
75
Mineralscorticosteroid Hypokalemia Don’t give with digoxin !! Toxic Halo signs Digit toxicity

343 Pharm Exam 4 (6 decks)

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