Drugs Affecting the Endocrine System Flashcards
Posterior Pituitary Gland
Extension of hypothalamus ( increase or decreases hormones in the pit. gland)
consists of nervous tissue
stores and secretes ( ADH & Ocytocin)
Anterior Pituitary Gland
makes and stores: growth hormone-releasing hormone growth hormone-inhibiting hormone thyrotropin-releasing hormone prolactin-releasing hormone prolactin-inhibiting hormone corticotropin-releasing hormone gonadotropin-releasing hormone
Growth Hormone
low amounts in children = dwarfism
low amounts in adults = reduced muscle mass CAD central obesity visceral fat (surrounding organs) insulin resistance dyslipidemia
prototype GH
somatatropin= treats growth hormone. not given orally. (Accretropin) (Genotropin) (Humatrope) (Norditropin) (Saizen) (Serostim) (Zorbtive)
Somatropin
adverse effects:
hyperglycemia (b/c of insulin resistance) hypothyroidism edema (monitor, eventually goes away) HTN joint pain progression of scoliosis
Somaropin
contraindications and precautions:
closure of epiphyseal plates in children
severe obesity, respiratory impairment, sleep apnea
patients with brain tumors, renal or liver disease (problems metabolizing)
caution in diabetes
Somatropin
Drug Interactions-
Nursing Interventions-
drug/drug interactions:
anabolic steroids
androgens and estrogens
thyroid hormones
nursing interventions:
monitor growth, glucose, thyroid levels
administer in evening
inform family of cost ($30-40-000)
GH Antagonists
excessive GH in children = gigantism
excessive GH in adults = acromegaly
bone deformity
insulin resistance
early death
treatment: GH Antagonists
prototype GH Antagonist:
Sandostatin
mimics GH inhibiting hormone
off-label uses: GI bleeding diarrhea flushing hepatic-portal venous pressure
adverse effects: NVD cholelithiasis elevated liver enzymes headache, fatigue edema hypo or hyperglycemia cardiac dysrhythmias, HF, chest pain
prototype GH Antagonist contraindications
contraindications: renal/liver impairment cardiac disease diabetes hypothyroidism precautions: cholelithiasis, cholecystitis biliary obstruction elderly patients
drug/drug interactions: antidiabetic agents anything that slows GI motility cardiac meds causing bradycardia antidiarrheals or opioids
Antidiuretic Hormone Disorders/ Prototype
diabetes insipidus
syndrome of inappropriate antidiuretic hormone (SIADH)
Prototype: Desmopressin- synthetic analog of human ADH milder vasoconstriction than natural ADH increases permeability of collecting tubules to water increases reabsorption of water
Antidiuretic Hormone Prototype adverse effects/ interventions
Desmopressin adverse effects: water intoxication headache, nausea, abdominal cramps HTN contraindications: nephrogenic DI, renal impairment precautions: HTN, CAD very young, very old
nursing interventions: use caution with route know S/S of water intoxication monitor for HF monitor sodium levels reduce water consumption Similar drug: vasopressin
Thyroid hormone
consists of 2 hormones:
T3 (tri-iodothyronine)
T4 (thyroxine)
iodine is needed to make more hormone molecules
secretion regulated by hypothalamus and anterior pituitary
Prototype: levothyroxine
Thyroid hormone adverse effects/interventions
levothyroxine oral synthetic T4 adverse effects: CNS excitability cardiac abnormalities contraindications/precautions: CV disease adrenal insufficiency diabetes (caution)
Nursing Interventions: pulse S/S hyper/hypothyroidism assess aspirin allergy monitor blood glucose do not D/C abruptly no not change brands
hyperthyroidism
Grave’s disease
cause: thyroid-stimulating immunoglobulins
exopthalmos and goiter
may cause thyrotoxicosis (thyroid crisis, thyroid storm)
treatment:
removal or partial gland removal
destruction of gland by radioactive iodide
antithyroid drugs (3-12 weeks to work)
