drug therapy for pituitary and hypothalamic dysfunction Flashcards

1
Q

describe the hypothalamus

A
  • “master gland”
  • constantly monitors body’s homeostasis
  • coordinates responses through autonomic, endocrine, and nervous systems
  • receives input from the rest of the brain (acts as a sensor for electrolytes, chemicals, and hormones)
  • stimulates or suppressess endocrine, autonomic, and CNS activity
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2
Q

the hypothalamus produces hormones to send to…

A

the pituitary

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3
Q

what are some factors that stimulate the pituitary

sent from the hypothalamus

A
  • corticotropin-releasing hormone (CRH)
  • growth hormone releasing hormones (GHRF)
  • thyroid-releasing hormone (TRH)
  • gonadotropin-releasing hormone (GnRH)
  • prolactin-releasing hormone (PRH)
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4
Q

what are some factors that inhibit the pituitary

sent from the hypothalamus

A
  • somatostatin (growth hormone release-inhibiting factor)
  • prolactin-inhibiting factor (PIF)
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5
Q

what does corticotropin-releasing hormone (CRH) do

A

release of corticotropin during stress

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6
Q

what does growth hormone-releasing hormone (GHRH) do

A

release growth hormones

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7
Q

what does thyroid-releasing hormone (TRH) do

A

releases TH during stress

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8
Q

what does gonadotropin-releasing hormone (GnRH) do

A

releases FSH and LH

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9
Q

what does prolactin-releasing hormone (PRF) do

A

lactation and childbirth

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10
Q

what does somatostatin (growth hormone releasing inhibiting factor) do

A

inhibits release of growth hormone

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11
Q

what does prolactin-inhibiting factor (PIF) do

A

inhibits lactation

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12
Q

there are three lobes of the pituitary gland, what are they?

A
  • anterior
  • posterior
  • intermediate (dont worry bout it)
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13
Q

what 6 hormones are released by the anterior pituitary

A
  • GH
  • ACTH
  • FSH
  • LH
  • PRL
  • TSH
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14
Q

what does the posterior pituitary store

A
  • ADH (vasopressin)
  • oxytocin
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15
Q

what does corticotropin (ACTH) do

A

stimulates production of corticosteroids

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16
Q

what does growth hormone AKA somatotropin (GH) do

A

stimulates growth of body tissues

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17
Q

what does thyroid stimulating hormone (TSH) do

A

regulates secretion of thyroid hormones

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18
Q

what does follicle stimulating hormone (FSH) do

A

stimulates function of sex glands

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19
Q

what does luteinizing hormone (LH) do

A

stimulates hormone production

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20
Q

what does prolactin hormone (PLH) do

A

milk production in mothers

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21
Q

what does antidiuretic hormone AKA vasopressin (ADH) do

A

regulates water balance

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22
Q

what does oxytocin do

A

uterine contractions, milk letdown

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23
Q

describe growth deficiency in children

A
  • deficiency in growth hormone
  • growth below 3rd percentile
24
Q

describe diabetes insipidus

A
  • dysfunction of posterior pituitary
  • deficiency in ADH production
  • large quantity of dilute urine (up to 30liters)
25
Q

describe precocious puberty

A
  • early development of sex charcteristics (prior to age 8)
  • r/t excess gonatotropin or excess androgen/estrogen
  • can be from exposure to estrogen
26
Q

describe acromegaly

A
  • gigantism
  • r/t excess growth hormone
27
Q

a nurse is educating grandparents about child safety. which of the following prevents precocious puberty?

1) keeping acetaminophen out of childs reach
2) keeping estrogen out of childs reach
3) keeping nitro paste out of childs reach
4) keeping hydrocortison out of childs reach

A

2) keeping estrogen out of childs reach

exposure to estrogen can lead to symptoms of early sexual maturation

28
Q

which gland stores ADH and oxytocin?

1) adrenal
2) hypothalamus
3) posterior pituitary
4) anterior pituitary

A

3) posterior pituitary

the adrenal gland releases steroid hormones, the hypothalamus produces 5 releasing and 2 inhibiting hormones, and the anterior pituitary releases 6 hormones but only the posterior pituitary stores ADH and oxytocin

29
Q

name a drug used for growth deficiency

A

somatropin

30
Q

describe the action of somatropin

A

replaces growth hormone, stimulates bone/muscle growth

31
Q

what is somatropin used for

A

growth failure in children

32
Q

what are some adverse effects of somatropin

A
  • muscle pain
  • hyperglycemia
33
Q

what are some contraindications of somatropin

A
  • closed epiphyses
  • malignancy
34
Q

what are some nursing considerations for somatropin

A
  • monitor for hyperglycemia
  • med is given IM or SQ
  • rotate injection sites
  • monitor height and weight
  • med given until desired height reached
  • xrays need to monitor for epiphyseal closure
35
Q

describe patient education for somatropin

A
  • monitor height and weight at home
  • monitor glucose at home if at risk
  • teach proper injection technique
36
Q

what drug is used for diabetes insipidus

A

desmopressin (DDAVP)

37
Q

describe the action of desmopressin (DDAVP)

A

synthetic ADH, decreases urine volume

38
Q

what is desmopressin (DDAVP) used for

A

treatment of diabetes insipidus

39
Q

what are some adverse effects of desmopressin (DDAVP)

A
  • swelling and burning at injection site
  • nasal irritation
  • black box warning for cardiac arrest d/t rapid fluid volume shifts
  • black box warning for risk of hyponatermia leading to seizures and death
40
Q

what are some nursing considerations for desmopressin (DDAVP)

A
  • available in multiple routes (IM, SQ, IV, nasal)
  • monitor I&O
  • monitor electrolytes (Na, K)
  • monitor urine osmolality (expect concentrated urine)
  • assess hydration status
41
Q

describe patient education for desmopressin (DDAVP)

A
  • report HA, drowsiness, lethargy to MD
  • rotate injection site of IM or SQ
  • rotate nares for nasal spray
42
Q

give an example of a drug for precocious puberty

A

leuprolide

43
Q

describe the action of leuprolide

A

inhibits gonadotropin secretion: suppressing LH and FSH, decerasing testosterone in males

44
Q

what is leuprolide used for

A
  • treatment of early puberty
  • treatment of prostate cancer
  • treatment of endometriosis
45
Q

what are some adverse effects of leuprolide

A
  • pain at the injection site
  • labile emotions
46
Q

what are some nursing considerations for leuprolide

A
  • decreases effects of antidiabetic drugs
  • give med until 11-12 years old
  • IM or SQ injection
  • rotate site
  • effects will take 2-4wks
  • usually given monthly
47
Q

describe patient education for leuprolide

A
  • teach proper injection technique
  • report irritation at injection site
  • keep track of monthly dosing
  • use nonhormonal birth control
48
Q

what drug therapy is used for acromegaly

A

octreotide

49
Q

describe the action of octreotide

A

mimics somatostatin, inhibiting GH, insulin and some GI hormones

50
Q

what is octreotide used for

A
  • acromegalia
  • GI bleeding
  • diarrhea
  • some tumors
51
Q

what are some adverse effects of octreotide

A
  • HA, dizziness
  • bradycardia
  • hyperglycemia
  • diarrhea
52
Q

what are some contraindications of octreotide

A
  • pancreatitis
  • diabetes
53
Q

what are some nursing considerations for octreotide

A
  • many drug to drug interactions
  • IV or IM route
  • rotate injection site
  • monitor height and weight
  • monitor blood glucose
54
Q

describe patient education for octreotide

A
  • teach proper injection technique
  • monitor blood glucose if at risk
  • monitor height and weight
  • notify MD if severe GI upset
55
Q

a patient with type 1 diabetes is started on somatostatin. how will this med affect their blood sugar?

1) the insulin need will decrease
2) they will need to start an oral antihyperglycemic
3) the insulin need will stay the same
4) the insulin need will increase

A

4) the insulin need will increase

somatostatin will increase glucose levels. hyperglycemia is a common side effect. type 1 diabetics are insulin dependent so an oral med will not do shit

56
Q

a patient received desmopressin (DDAVP). which is the most important electrolte to assess?

1) sodium
2) chloride
3) potassium
4) calcium

A

1) sodium

desmopressin (DDAVP) has a black box warning for hyponatremia that may lead to seizures and death