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NURS 2514 > Chapter 6 Medications > Flashcards

Chapter 6 Medications Flashcards

1
Q

Thyroid hormones controls (3)

A
  • metabolic rate
  • Stimulates heart
  • in Childhood has role in growth and development
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2
Q

What is the Drug for Hypothyroidism

A

Levothyroxine

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3
Q

what is the other name of levothyroxine?

A

Synthroid

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4
Q

What is the class of levothyroxine (Synthroid)

A

Synthetic preparation of thyroxine (T4)

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5
Q

What is the MOA of Levothyroxine (Synthroid)

A

Identical action to naturally occurring hormone (regulates metabolism, stimulates heart, promotes growth and development)

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6
Q

What is the indication of Levothyroxine (Synthroid)

A

Used to treat all forms of hypothyroidism

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7
Q

What is the pharmacokinetics of Levothyroxine (Synthroid)

A

Highly protein bound so half life is 7 days, 1 month to plateau!
** Takes long time to have effect, important for patient education**

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8
Q

What are the adverse effects of Levothyroxine (Synthroid) (2)

A
  • At appropriate doses no adverse effect
  • If doses is too high then symptoms of thyrotoxicosis can occur ( tachycardia, angina, nervousness, insomnia, hyperthermia etc. )
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9
Q

What is the drug interaction of Levothyroxine (Synthroid)

A

Anything that changes the pH of stomach must be given 4 hours apart

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10
Q

Levothyroxine (Synthroid) IS AVAILABLE IN WHAT FORMS?

A

PO and IV forms

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11
Q

When should you administer Levothyroxine (Synthroid)? why?

A
  • On an empty stomach (30-60 mins before eating)

- Because anything that changes the pH of stomach affects absorption

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12
Q

What does diabetic people have to do when taking Levothyroxine (Synthroid) ?

A
  • They have to increase their insulin requirement

- Energy use increases = consuming more glucose when metabolism picks up

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13
Q

What lab works do we need for Levothyroxine (Synthroid) ?

A

Regular lab work to monitor T4 and T3

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14
Q

What are the patient education for Levothyroxine (Synthroid)? (3)

A
  • Teach patient about S&S of thyrotoxicosis
  • Length of time to take effects
  • Life long treatment
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15
Q

What is the drug for Hyperthyroidism? (2)

A

Methimazole and Propanolol

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16
Q

Methimazole Class?

A

Thionamides

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17
Q

Methimazole MOA

A

Suppresses synthesis of thyroid hormones

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18
Q

Methimazole Indication (3)

A
  • Treatment of Graves disease
  • prior to surgery/radiation
  • Thyroid crisis
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19
Q

Methimazole Adverse effects (3)

A
  • Hazardous to pregnant/breastfeeding women
  • Agranulocytosis
  • Hypothyrodism
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20
Q

what is Agranulocytosis (3)

A
  • dangerous low level of granulocytes
  • Happens in first 2 months
  • Sore throat and fever
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21
Q

What are other precautions nurses (female) have to do with Methimazole?

A
  • wear gloves due to hazardous effects on pregnancy and breastfeeding.
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22
Q

Methimazole drug interactions?

A

none :)

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23
Q

how long does the treatment (met) last?

A
  • Treatment usually for 1-2 years and then discontinue of hormone levels stay within normal range
  • If levels still rise then restart or do other permanent treatments
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24
Q

Methimazole available in what form?

A

PO

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25
Q

when do you take Methimazole? why?

A
  • Take at same time everyday with meals

- We want the levels to stay stable and prevent GI upset

26
Q

What do we need to monitor (lab) for Methimazole?

A

Monitor T3 and T4

27
Q

What do we need to educate the patient regarding Methimazole?

A
  • Educate regarding signs of hypothyroidism

- Monitor weight, pulse, mood

28
Q

What is the class of propanolol?

A

Beta- Adenergic Blocker

29
Q

What is the MOA of propanolol?

A

Non-Selective Beta blocker with negative inotropic chronotropic, dromotropic properties.

30
Q

What is the Indication of propanolol?

A

Controls tachycardia in hyperthyroidism (many other uses)

31
Q

What is the adverse effects of propanolol? (5)

A
  • Bradycardia
  • Hypotention
  • dizziness
  • Heart failure
  • Bronchoconstriction
32
Q

Who should you avoid giving propanolol to? why?

A
  • People with asthma or COPD

- Due to bronchoconstriction effect

33
Q

Adrenal gland is controlled by?

A

Hypothalamus and anterior pituitary gland

34
Q

Cortex secretes what?

A

Conticosteroids

  • Glucocorticoids
  • mineral corticoids
  • Androgens
35
Q

Corticosteroids controls what? (6)

A
  • carbohydrate
  • protein
  • fat metabolism
  • integrity of vascular system
  • sat and water balance
  • Expression of sexual characteristics
36
Q

What is the drug for adrenal hormone excess (Cushings)?

A
  • No specific drugs for this disorder
  • Treatment usually involves removing source of excess stimulation (ACTH or cortisol secreting tumours) or removing exogenous cortisol
37
Q

What is the drug for Adrenal Hormone Insufficiency (Addisons)?

A

Hydrocortisone

38
Q

what is the other name for hydrocortisone?

A

Cortef

39
Q

Hydrocortisone (Cortef) MOA

A

same action as cortisol ( stress hormone )

40
Q

Hydrocortisone (Cortef) class

A

Glucocorticoids but also have some mineral corticoids actions

41
Q

Hydrocortisone (Cortef) indication

A
  • Adrenal insufficiency - low dose

- Severe inflammation - high dose (IBD, asthma, SLE, UC, TB)

42
Q

Hydrocortisone (Cortef) Adverse effect

A
  • Low dose: no adverse effects

- Chronically high doses - adrenal suppression and cushing’s syndrome

43
Q

Hydrocortisone (Cortef) forms?

A

PO, IM, IV

44
Q

Cortif PO should be given with what? why?

A

With food or milk to avoid GI problems

45
Q

When should Hydrocortisone (Cortef) be taken? why?

A
  • Given in AM and early afternoon to mimic natural production of cortisol.
46
Q

What does a person do when theres extra stress while taking Hydrocortisone (Cortef)?

A
  • Take extra dose with stress (3x3)

- carry cortisol all the time just incase there is stress

47
Q

What does nurses have to monitor? Hydrocortisone

A
  • BP, HR, I & O

- Cushing’s or sign of infection

48
Q

What labs do we have to monitor for Hydrocortisone (Cortef)?

A
  • K+
  • Blood glucose
  • Urine glucose
49
Q

Patient teaching for Hydrocortisone (Cortef)

A
  • Never stop medication without tapering

- Wear medical bracelet

50
Q

Why cant we stop Hydrocortisone (Cortef) abruptly?

A

adrenal glands shrinks with the use of exogenous corticosteroids so stopping the drug abruptly will not give adrenal glands time to excrete enough/ decent amount of corticosteroids.

51
Q

What does posterior pituitary secrete?

A
  • Oxytocin and Antidiuretic hormone (ADH)
52
Q

Where is Oxytocin and Antidiuretic hormone (ADH) synthesized?

A
  • In the hypothalamus
53
Q

When too much ADH is produced what happens?

A

SIADH ( very little urine being formed and a lot of water being retained)

54
Q

When too little ADH is produced what happens?

A
  • Diabetes insipidus ( excessive diuresis to dehydration)
55
Q

What is the treatment for SIADH?

A
  • treat underlying cause of the disorder

- No drugs

56
Q

What is the drug for Pituitary Insufficiency (DI) ?

A

Antidiuretic Hormone (Vasopressin)

57
Q

What is the class of Antidiuretic Hormone (vasopressin)

A

pituitary hormone

58
Q

What is the MOA of Antidiuretic Hormone (vasopressin)

A

Acts on kidneys to cause reabsorption of water, can also stimulate contraction of vascular and GI smooth muscle (high doses)

59
Q

What is the indication of Antidiuretic Hormone (vasopressin)

A

Treatment of diabetes insipidus, cardiac arrest ( increase blood flow to the heart and brain)

60
Q

What is the adverse effect of Antidiuretic Hormone (vasopressin)

A
  • water intoxication ( drowsiness, listlessness, and headache)

NURS 2514 (11 decks)

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