Endocrinal Drugs Flashcards
base of the brain
pituitary gland
master gland of pituitary
anterior or adenohypophysis
ADH or vasopressin and oxytocin
porterior or nuerohypophysis
Anterior Pituitary hormones
are regulated by
negative
feedback: TSH, ACTH, FSH,
LH, GH, PL and MSH
released because of TRH from hypothalamus
- T4 Thyroxine
- T3 Triiodothyronine
Thyroid-stimulating hormone/Thyrotropic
released because of Corticotropin Releasing Factor from hypothalamus
Adrenocorticotropic hormone
2 Hormones Regulate GH:
Growth hormone-releasing hormone (GN-RH)
2. Growth hormone-inhibiting hormone
(GN-IH; somatostatin)
SE and Admin of Growth Hormone
NOT given orally
given thru SQ or IM
* Can cause DM
Drugs for Deficiency of GH
somatrem (Protropin)
somatropin (Humatrope)
somatropin (Humatrope) is for
C/I for pedia patients
with growth deficiency due to Prader Willi
syndrome, severely obese, severe respiratory
impairment
a drug that Promotes bone growth at epiphyseal
plates of long bones
Acts on newly forming bone
GH can increase height by a foot
somatropin (Humatrope)
Excess of GH
Gigantism – during childhood
Acromegaly – after puberty
cause of excess of GH
Due to GH hypersecretion or pituitary tumor
drugs for excess GH
bromocriptine mesylate (Parlodel) – inhibits the
release of GH
octreotide (Sandostatin) – potent synthetic
somatostatin.GI side effects are COMMON
Releases thyroxine (T4) and triiodothyronine (T3)
Thyroid-Stimulating Hormone (TSH)
Hypothyroidism. Maybe caused by
thyroid gland disorder (primary) or
decrease in TSH secretion (secondary)
Deficit TSH
drugs for Thyroid-Stimulating Hormone (TSH)
thyrotropin (Thyropar) – purified extract of TSH
used to diagnose primary and secondary
hypothyroidism
Stimulates the release of the ff:
- glucocorticoids (cortisol) - follows diurnal rythmn
- mineralocorticoids (aldosterone)
- androgen
Adrenocorticotropic hormone (ACTH)
drugs of Adrenocorticotropic hormone (ACTH)
corticotropin (Acthar) given IV or IM
corticotropin (Acthar) given IV or IM side effects and use
Agent in the diagnosis of adrenal gland disorder
Used in the treatment of adrenal gland
insufficiency
Suppresses inflammatory and immune response
SE: sodium and water retention
secretes Antidiuretic Hormone/Vasopressin AND
Oxytocin
neurohypophysis
ADH side effects
ADH promotes water reabsorption
ADH deficit leads to Diabetes Insipidus
drugs of Antidiuretic Hormone/Vasopressin AND
Oxytocin
desmopressin (DDAVP)
vasopressin (Pitressin)
Given intranasally or injection
NX for ADH drugs
Monitor v/s and UO - Increasing HR, decreasing
systolic pressure
NX for ACTH
Observe client’s weight for possible edema
Taper the dose
Electrolyte monitoring
NX of drugs for GH
Monitor blood sugar and electrolyte levels
possible hyperglycemia
stimulate metabolism and cardiac
function.
Thyroid hormones
Caused of Hypothyroidism
Primary cause (thyroid gland disorder – decreased
T4 and elevated TSH)
Secondary cause (lack of TSH secretion)
is hypothyroidism in
infants. Infant will be short in stature and
delayed in mental and physical
development
Cretinism
is hypothyroidism in adults
Myxedema i
Manifestations: of hypothyroidism
bradycardia, cold and dry skin, brittle hair, low
body temperature, fatigue, cold intolerance, flat
affect, slowed cognition, and weight gain
Drug Therapy: of hypothyrodism
levothyroxine (Synthroid, Levothroid) commonly
used, increases T3 and T4. Drug of choice. With
longer half-life and highly protein bound drugs.
Excreted in the bile and feces.
liothyronine (Cytomel), synthetic T3, useful as initial
treatment for Myxedema. Shorter half-life
liotrix (Euthroid, Thyrolar)
Mixture of levothyroxine and liothyronine
Mixture of levothyroxine and liothyronine
liotrix (Euthroid, Thyrolar
manifestations of Hyperthyroidism
tachycardia, dysrhythmias,
palpitations, excessive perspiration, heat intolerance,
nervousness, irritability, exopthalmos, weight loss
surgery of hyperthyroidism
Subtotal Thyroidectomy
drugs for cardiac symptoms of hyperthyroidism
propanolol (Inderal)
drug therapy for Hyperthyroidism
Thiourea derivatives (Thioamides) – drug of choice. Blocks thyroid hormone. No effect with thyroid tissue
2 thioamides:
propylthiouracil (PTU) for thyrotoxic crisis
methimazole (Tapazole) –
have been used to suppress
thyroid function for those who have undergone
subtotal thyroidectomy
Iodide preparations
strong iodine solution
(Lugol’s solution,
Potassium iodide solution) SE: teeth discoloration
Thyroid drugs increases
the effect of
anticoagulants
and decreases insulin
effects
Client health teaching:
For hypothyroidism
-Take drug same time each day, pre-breakfast
-To report signs of hyperthyroidism
-Avoid foods that can inhibit thyroid
secretions(strawberry, peach, pear, cabbage,
cauliflower, radish, peas)
Client teaching: For hyperthyroidism
-Taken with meals
-Avoid iodine and iodine-containing food, OTC
cough meds
- To report signs of hypothyroidism
-Avoid the drugs if pregnant or breastfeeding
regulates calcium levels
in the blood.
Decrease in serum calcium stimulates the
release of PTH
Parathyroid hormone (PTH)
PTH agents treat
hypoparathyroidism
PTH agents promotes
Promotes calcium absorption from the GI tract
• Promote reabsorption of calcium from renal tubules
• Activates Vitamin D
Hypoparathyroidism and Hypocalcemia Agents
calcitriol (Rocaltrol) – Vitamin D analogue.
Increases serum calcium with long onset, peak &
duration of action
calcifediol (Calderol) – bone disease and
hypocalcemia associated with chronic renal disease
and dialysis
caused by malignancies of the
parathyroid glands or ectopic PTH secretion from
lung cancer, hyperthyroidism or prolonged
immobility
Hyperthyroidism
Hyperparathyroidism and Hypercalcemia Agents
calcitonin (human) (Cibacalcin) – Paget’s disease
calcitonin (salmon) (Calcimar) – more potent
Etidronate (Didronel)
Body absorbs old bone and forms
abnormal new bone
PAGET’S DISEASE
Client teaching: HYPOPARATHYROIDISM
Report symptoms of tetany
Client teaching: HYPERPARATHYROIDISM
Report signs: bone pain, anorexia, NV, thirst,
constipation, lethargy, bradycardia and polyuria
• Check OTC drugs for calcium content (vitamins and
antacid)
Adrenal cortex produces two hormones or
corticosteroids:
glucocorticoids (cortisol) and
mineralocorticoids (aldosterone)
decrease in corticosteroid disease
Addison’s disease
increase in corticosteroid syndrome
Cushing’s syndrome
increase in corticosteroid syndrome
Cushing’s syndrome
S/S of addison’s disease
weight loss, fatigue,
hyperpigmentation, muscle
weakness, low blood pressure
Glucocorticoids/ Cortisone drugs
Short-acting cortisone acetate (Cortone Acetate) hydrocortisone (Cortef) Intermediate-acting methylprednisolone (Medrol, Solu-Medrol) prednisolone (Hydeltrasol) prednisone (Deltasone) – “inexpensive” Long-acting betamethasone (Celestone) dexamethasone (Decadron) – potent glucocorticoid
Interventions: Glucocorticoids/ Cortisone drugs
Check BP, Na and water retention
- Record weight (5lbs in several days)
- Check electrolytes and blood sugar level
- Check s/Sx of increased Osteoporosis
Used in treating clients with Cushing’s syndrome
Glucocorticoid Inhibitors
Glucocorticoid Inhibitors drugs
ketoconazole (Nizoral) – adjunct to surgery or
radiation
aminoglutethimide (Cytadren) – used as temporary
treatment
Mitotane (Lysodren) – ANTINEOPLASTIC hormone
antagonist
Given with a glucocorticoid
Secrete aldosterone that maintain fluid balance by
promoting the reabsorption of Na from the renal
tubules
Mineralocorticoids (aldosterone)
Mineralocorticoids (aldosterone) drug
fludrocortisone (Florinef) – oral mineralocorticoid,
given with glucocorticoid
