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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
Q

What is contraindicated with conivaptan?

A

Allergic to corn

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26
Q

Test question
What medication do you not give to people allergic to corn?

A

Conivaptan

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27
Q

What is side effects about tolvaptan ( black box warning ) for who? (4)

Look at the L

A

Alcoholism
Liver disease
Malnutrition

( bad for liver and protein bound )
Toxicity!!

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28
Q

Somatropin should do what?
Decompression and vasopressin should do what?

A

Grow the child

Should reduce severe thirst and decrease urinary output

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29
Q

Thyroid !!

A
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30
Q

What are the 3 thyroid glands ?

A

T3,T4, calcitonin

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31
Q

What is the function of of thyroid glands?

A

Regulate metabolism and calcium

32
Q

If you thyroid doesn’t produce enough hormone, what symptoms will you see in a patient?

A

Cold
Constipation
Menstrual irregularities
Skin dry
Sleepy
Depression

33
Q

If you have thyroid produce too much hormone what we will see?

A

Palpitation
Insomnia
Diarrhea
Sweating

34
Q

HIGH TSH indicate what?

A

Need more thyroid hormones

35
Q

LOW Levels of TSH means what?

A

Excess of thyroid hormones

36
Q

What is the function is TSH?

A

To tell the thyroid to produce hormone !!

37
Q

What are the 4 hypothyroidism?

A

Levothyroxine ( synthroid )
Liothyronine ( cytomel )
Liotrix ( thyrolar )
Thyroid,desiccated (armour thyroid, westhroid)

Dried animal thyroid into a pill, usually pig ^

38
Q

All hypothyroidism medications, it’s colored coded and what type of grams doses?

A

Micro gram

( yellow ! )

39
Q

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

A

Radioactive iodine

Meaning usually a life long treatment

40
Q

Most of the time, patients who are treated for hyperthyroidism, usually they end up what?

A

On hypothyroidism medications

41
Q

What’s the most Significant adverse effects of hypothyroidism ?

A

Cardiac dysrhythmias !!

( tachycardia, palpitation, angina, hypertension, insomnia )

42
Q

There are some OTC medications that make our heart work harder, what are they?

This is a medication we used cautiously with thyroid meds

A

Cold medications
Decongestations
( Sudafed )

43
Q

How do we take hypothyroidism meds? (3)

A

Take in the morning
Take it on empty stomach & water

Avoid with iron & calcium
( no multi vitamin )

44
Q

Test question
Do we give thyroid medication with hyper thyroid?

A

No!

45
Q

There is a weight based thyroid medication, in which it may take ?

Then we do what?

A

4-6 weeks to start

( 2 years after )

46
Q

Hypo Thyroid medication increase what?
Hypo Thyroid medication is a what?

It decreases the effects of what?

It reduces the effects of what?

A

Bleeding ( anticoagulants )
( lower warfarin dose, or monitor threauptic range 2-3 )

Protein bound drug

Insulin ( hypoglycemic meds )
( increase the dosages )

Digoxin

47
Q

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

A
48
Q

Now hyperthyroidism !!

A
49
Q

What medication of hyper thyroid will we use? (3)

A

Radioactive iodine
Propyiyhiouradil (PTU)
Methinazole ( tapazole )
(Surgery )

50
Q

If you take the whole thyroid out, surgery! What will you be on and why?

A

Hypothyroidism medication
For life because you will no longer make thyroid

51
Q

Your thyroid uses iodine to make thyroid !!!

So we use radioiodine to lower that !

A
52
Q

Usually hyperthyroidism medication isn’t long term
Usually treat them to hypothyroid !

They wont prescribe the medication usually send to endo

A
53
Q

Why do we give beta blockers, like propranolol to hyperthyroidism?

A

Because thy have tachycardia and palpitation cause hyper makes you HYPER!!

54
Q

Why would we give hyperthyroidism medication before surgery?

A

To help shrink the thyroid for surgery to avoid hemorrhaging

55
Q

Note
Increase bleeding
Decrease anti diabetics
Increase digoxin & lithium

A
56
Q

Parathyroid hormone !!

A
57
Q

What is the 3 function of parathyroid gland?

A

Calcium release from bones
Calcium reabsorption in renal tubules
Calcium absorption in intestines by increasing production of vitamin D

58
Q

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

A

Check their calcium level

59
Q

What are signs of hypo calcium?

A

Tetany ( curling )
Chvoswek sign, the cheek
The blood pressure too

60
Q

What medication do we give for hypoparathyroidms?

A

Calcitriol
( help with that calcium )

61
Q

Hyperparathyroidism
- too much parathyroid hormone secretion

What’s the treatment?
- calcitonin-salmon
Calciminetic
Biphosphates

A

Usually removal of it too

62
Q

Adrenal glands !

A
63
Q

Adrenal glands are pretty much the steroids in your body!!

A
64
Q

When you’re stressed
Your body produces what?

A

Cortisol

65
Q

If a patient is on a steroid for 3-5 days
What is the most important thing?

A

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
Q

What medication are we going to talk about for glucocorticoids?

A

Prednisone

67
Q

Why would we use steroids?

A

Help with inflammation

68
Q

What are side effects of prednisone ?

A

Euphoria
Psychosis
Thin skin with purpura
Tachy cardia
Hypertension
Hyperglycemia
Edema
Glaucoma
Growth retardation
Adrenal trophy
Muscle eating

69
Q

Fludrocortisone - oral mineralcorticoid
- aid with inflammation

Hypertension
Hypokalemia
Gi distress
Fluid overload
Negative nitrogen balance

A
70
Q

The higher the dose the worst the side effects

Your on steroids - immune system is suppressed
- wash your hands
- wear masks
- vaccination !

A
71
Q

People on steroids
Their fasting blood sugar will be high!

A
72
Q

Steroid in the morning !!

A
73
Q

ALWAYS TAKE STEROIDD WITH FOOD

THIS CAN CAUSE ULCERS!!!!
ASSESS FOR GI

A
74
Q

Steroids !!
Take calcium supplements because the risk of osteoporosis

A
75
Q

Mineralscorticosteroid
Hypokalemia

Don’t give with digoxin !!

Toxic
Halo signs
Digit toxicity

A

343 Pharm Exam 4 (6 decks)

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