drug therapy for pituitary and hypothalamic dysfunction Flashcards
describe the hypothalamus
- “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
the hypothalamus produces hormones to send to…
the pituitary
what are some factors that stimulate the pituitary
sent from the hypothalamus
- corticotropin-releasing hormone (CRH)
- growth hormone releasing hormones (GHRF)
- thyroid-releasing hormone (TRH)
- gonadotropin-releasing hormone (GnRH)
- prolactin-releasing hormone (PRH)
what are some factors that inhibit the pituitary
sent from the hypothalamus
- somatostatin (growth hormone release-inhibiting factor)
- prolactin-inhibiting factor (PIF)
what does corticotropin-releasing hormone (CRH) do
release of corticotropin during stress
what does growth hormone-releasing hormone (GHRH) do
release growth hormones
what does thyroid-releasing hormone (TRH) do
releases TH during stress
what does gonadotropin-releasing hormone (GnRH) do
releases FSH and LH
what does prolactin-releasing hormone (PRF) do
lactation and childbirth
what does somatostatin (growth hormone releasing inhibiting factor) do
inhibits release of growth hormone
what does prolactin-inhibiting factor (PIF) do
inhibits lactation
there are three lobes of the pituitary gland, what are they?
- anterior
- posterior
- intermediate (dont worry bout it)
what 6 hormones are released by the anterior pituitary
- GH
- ACTH
- FSH
- LH
- PRL
- TSH
what does the posterior pituitary store
- ADH (vasopressin)
- oxytocin
what does corticotropin (ACTH) do
stimulates production of corticosteroids
what does growth hormone AKA somatotropin (GH) do
stimulates growth of body tissues
what does thyroid stimulating hormone (TSH) do
regulates secretion of thyroid hormones
what does follicle stimulating hormone (FSH) do
stimulates function of sex glands
what does luteinizing hormone (LH) do
stimulates hormone production
what does prolactin hormone (PLH) do
milk production in mothers
what does antidiuretic hormone AKA vasopressin (ADH) do
regulates water balance
what does oxytocin do
uterine contractions, milk letdown
describe growth deficiency in children
- deficiency in growth hormone
- growth below 3rd percentile
describe diabetes insipidus
- dysfunction of posterior pituitary
- deficiency in ADH production
- large quantity of dilute urine (up to 30liters)
describe precocious puberty
- early development of sex charcteristics (prior to age 8)
- r/t excess gonatotropin or excess androgen/estrogen
- can be from exposure to estrogen
describe acromegaly
- gigantism
- r/t excess growth hormone
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
2) keeping estrogen out of childs reach
exposure to estrogen can lead to symptoms of early sexual maturation
which gland stores ADH and oxytocin?
1) adrenal
2) hypothalamus
3) posterior pituitary
4) anterior pituitary
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
name a drug used for growth deficiency
somatropin
describe the action of somatropin
replaces growth hormone, stimulates bone/muscle growth
what is somatropin used for
growth failure in children
what are some adverse effects of somatropin
- muscle pain
- hyperglycemia
what are some contraindications of somatropin
- closed epiphyses
- malignancy
what are some nursing considerations for somatropin
- 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
describe patient education for somatropin
- monitor height and weight at home
- monitor glucose at home if at risk
- teach proper injection technique
what drug is used for diabetes insipidus
desmopressin (DDAVP)
describe the action of desmopressin (DDAVP)
synthetic ADH, decreases urine volume
what is desmopressin (DDAVP) used for
treatment of diabetes insipidus
what are some adverse effects of desmopressin (DDAVP)
- 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
what are some nursing considerations for desmopressin (DDAVP)
- available in multiple routes (IM, SQ, IV, nasal)
- monitor I&O
- monitor electrolytes (Na, K)
- monitor urine osmolality (expect concentrated urine)
- assess hydration status
describe patient education for desmopressin (DDAVP)
- report HA, drowsiness, lethargy to MD
- rotate injection site of IM or SQ
- rotate nares for nasal spray
give an example of a drug for precocious puberty
leuprolide
describe the action of leuprolide
inhibits gonadotropin secretion: suppressing LH and FSH, decerasing testosterone in males
what is leuprolide used for
- treatment of early puberty
- treatment of prostate cancer
- treatment of endometriosis
what are some adverse effects of leuprolide
- pain at the injection site
- labile emotions
what are some nursing considerations for leuprolide
- 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
describe patient education for leuprolide
- teach proper injection technique
- report irritation at injection site
- keep track of monthly dosing
- use nonhormonal birth control
what drug therapy is used for acromegaly
octreotide
describe the action of octreotide
mimics somatostatin, inhibiting GH, insulin and some GI hormones
what is octreotide used for
- acromegalia
- GI bleeding
- diarrhea
- some tumors
what are some adverse effects of octreotide
- HA, dizziness
- bradycardia
- hyperglycemia
- diarrhea
what are some contraindications of octreotide
- pancreatitis
- diabetes
what are some nursing considerations for octreotide
- many drug to drug interactions
- IV or IM route
- rotate injection site
- monitor height and weight
- monitor blood glucose
describe patient education for octreotide
- teach proper injection technique
- monitor blood glucose if at risk
- monitor height and weight
- notify MD if severe GI upset
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
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
a patient received desmopressin (DDAVP). which is the most important electrolte to assess?
1) sodium
2) chloride
3) potassium
4) calcium
1) sodium
desmopressin (DDAVP) has a black box warning for hyponatremia that may lead to seizures and death
