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Pharm > Endocrine > Flashcards

Endocrine Flashcards

1
Q

hormone: corticosteroids
secreted by: ___________
disorder: ______________

A

secreted by: adrenal cortex
hypersecretion: Cushing syndrome
hyposecretion: Addison disease

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2
Q

hormone: insulin
secreted by: _______________
disorder: _______________
drug therapy: _______________

A

secreted by: Pancreatic islets
hyposecretion: diabetes mellitus
drugs: insulin & oral antidiabetic drugs

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3
Q

hormone: antidiuretic hormone

secreted by:_______________

hypoactive disorder:________

drug therapy:_______________

A

secreted by: pituitary

hyposecretion: diabetes insipidus

drugs: desmopressin and vasopressin

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4
Q

hormone: growth hormone

secreted by: ________________

hypoactive disorder: _______

drug therapy: _______________

A

secreted by: pituitary

hyposecretion: small stature

drugs: somatropin

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5
Q

hormone: thyroid hormone

secreted by: ___________________

hyperactive disorder: _______________

drug therapy: ___________________

A

secreted by: thyroid

hypersecretion: Graves disease

drugs: propylthiouracil

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6
Q

hormone: thyroid hormone

secreted by: ___________________

hypoactive disorder: ___________________

drug therapy: ___________________

A

secreted by: thyroid
hyposecretion: hypothyroidism - myxedema (adults) & cretinism (children)
drugs: thyroid hormone and levothyroxine

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7
Q

what’s the hypothalamus & what’s it do?

A

*“master gland”
*Hypothalamus secretes “releasing hormones”
which tell pituitary gland which hormones should be released

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8
Q

antidiuretic hormone prototype, MOA, side effects, interventions

A

*desmopressin
*Promotes reabsorption of h20 by kidneys
*Vasoconstriction to raise BP
*used for: Diabetes Insipidus, cardiac arrest and nocturnal enuresis (nasal spray form)
*side effects: Hyponatremia, seizures, coma
*intervention: Monitor urine specific gravity, BP, urinary output, Na levels

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9
Q

growth hormone

A

*somatropin
use: to treat growth hormone deficiency
**Use discontinued before epiphyseal closure (long bones)
*Contraindicated in obese clients
*Adverse: Hyperglycemia, Hypothyroidism
*Interventions: Dose is individualized, given SQ, monitor growth patterns

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10
Q

thyroid agent for hypothyroidism

A

*levothyroxine
*MOA: replaces (so same as) thyroid hormones
*Take 30 minutes before food in AM
*Take with plenty of water
*Adverse: hyperthyroidism, palpitations, dysrhythmias, anxiety, insomnia, weight loss, heat intolerance, menstrual irregularities and osteoporosis in women, *ONSET 1-3 weeks
*Interventions: Monitor cardiac system, start low dose (increase as needed), *Monitor: T4 and TSH levels

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11
Q

s/s of hypothyroidism (AKA _____)

A

*“Myxedema”
*Early symptoms: weakness, muscle cramps, and dry skin
*severe symptoms (Myxedema):
Slurred speech, bradycardia, weight gain (slowed metabolism), intolerance to cold environments, low body temp

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12
Q

S/s of hyperthyroidism (AKA: ______)

A

*Graves disease
*Hypersecretion of thyroid hormone, increased body metabolism, tachycardia, weight loss, increased body temperature, anxiety, bulging eyes

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13
Q

thyroid agent for hyperthyroidism (= “antithyroid agent”)

A

*propylthiouracil (PTU) & Methimazole
*Educate: Taken with food same time each day, increase fluids to 3L daily to avoid constipation, avoid OTC products w/ iodine, taper off if discontinuing
*Interventions: Monitor pulse, report dizziness, palpitations, intolerance to temp changes, monitor thyroid levels, monitor weekly weight
*Overdose signs: periorbital edema, cold intolerance, mental depression.

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14
Q

what is Addison’s disease?

A

*Primary adrenocortical insufficiency, deficiency of both mineralocorticoids and glucocorticoids
*s/s: N & V, lethargy, bronze skin, confusion, and coma
*treatment: steroids (do not skip doses)
*Intervention: Monitor BP, fluid, electrolytes and weight. Monitor for signs of bleeding or GI issues.
*Teach: client to take calcium supplements and maintain Vitamin D levels, taper off dose, protect the immune system

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15
Q

primary adrenocorticol insufficiency = _________(short answer)

secondary adrenocorticol insufficiency = __________ (long answer)

A

primary: For some reason your adrenal glands aren’t working

secondary: Results from long-term therapy with glucocorticoids. The pituitary receives a message through the negative feedback mechanism to stop secreting adrenocorticotropic hormone (ACTH).
Without stimulation from ACTH, the adrenal cortex shrinks in size and stops secreting endogenous glucocorticoids.

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16
Q

Cushing’s syndrome: cause, s/s

A

cause: Overuse and long term use of steroids.

s/s: Increased risk of infections, delayed wound healing, peptic ulcers, increased appetite, mood & personality changes, retention of sodium and water, Adrenal atrophy, osteoporosis, hypertension, acne, general obesity, redistribution of fat: (moon face, buffalo hump)

17
Q

Cushing’s syndrome: pharmacotherapy

A

*Treat cause of excess corticosteroid
*Discontinue use of corticosteroid drugs

18
Q

hypoglycemia: what is it?

*hormone and organs involved

A

*a very low level of glucose in the blood which can cause neurological side effects and arousal of sympathetic NS

*blood glucose is low so pancreas secretes glucagon. Liver breaks down glycogen, returning glucose to the blood. Homeostasis restored

19
Q

hyperglycemia: what is it?

*hormone and organs involved

A

*Insufficient production or ineffective use of insulin causing an elevated blood glucose level

*blood glucose is high so pancreas secretes insulin. Cells take up glucose for energy/storage. Homeostasis restored.

20
Q

what is Type 1 Diabetes Mellitus?

A

*Lack of insulin from pancreas, autoimmune disease
*Treatment: diet restrictions (carbs raise blood sugar/glucose levels) exercise (after exercise, your body doesn’t need as much insulin to process carbohydrates), insulin
*Weight loss, fatigue, Polyuria (excessive urination)
Polyphagia (increased hunger)
Polydipsia (increased thirst), fasting hyperglycemia on 2+ occasions
**Excess glucose attacks nerves = neuropathy
*they don’t heal well due to high blood sugars

21
Q

labs to look at for diabetes

A

*Blood Sugar (normal = 70-110)
*Hemoglobin A1C (HA1C)

22
Q

What’s Type 2 Diabetes Mellitus?

A

*Insulin resistance

Target cells become unresponsive to insulin; blood glucose levels rise, Pancreas secretes more insulin; hypersecretion leads to beta cell exhaustion and death (which eventually leads to deficiency in insulin secretion + insulin resistance)
*can be reversed w/ diet & exercise
*If untreated, type 2 DM results in same chronic conditions as type 1 DM

23
Q

Rapid acting insulin

A

*aspart & lispro
*onset: less than 15 minutes (-30 minutes)
*peak: 1-3 hours (30-60 min. for lispro)
*duration: 3-5 hours
*SubQ
*give when food is in front of patient

24
Q

Short acting insulin

A

*Regular insulin
*onset: 30 min - 60 min
*peak: 2-4 hours
*duration: 5-8 hours
*SubQ and IV (ONLY insulin given IV)

25
Q

Intermediate acting insulin

A

*isophane (NPH, etc)
*onset: 1-2 hours
*peak: 4-12 hours
*duration: 18-24 hours

26
Q

long lasting insulin

A

*degludec, determir, glargine
*onset: 1.5/1.6 hours
*peak: no peak
*duration: 24 hours (42 for degludec)
**DO NOT MIX WITH ANY OTHER INSULIN

27
Q

hypoglycemia can result from __________

s/s: ______________________________________

A

*Can result from: Insulin overdose, improper timing of insulin dose, skipping a meal, taking insulin and then exercising, taking insulin and then not eating
*S/s: Sweating, tachycardia, confusion, drowsiness, convulsions, coma, death

28
Q

hyperglycemia can result from __________

s/s: _________________________

A

*Can result from underdose of insulin or oral hypoglycemic
*s/s: polyuria, polydipsia, polyphagia, glucosuria, weight loss/gain, fatigue

29
Q

Biguanides

A

*metformin
*antidiabetic/hypoglycemic drug
*MOA: DECREASES hepatic glucose/sugar production and intestinal glucose absorption. INCREASES sensitivity to insulin & doesn’t promote insulin release from pancreas
considerations: Usually used 1st for therapy; tolerated well, take w/ meals to avoid minor GI upset
**NOT to be taken 24 hours before, or 48 hours after IV contrast (or renal failure)
*metformin is also indicated to increase fertility

30
Q

sulfonylureas

A

*glipizide, glyburide
*end in -zide or -buride
*ORAL antidiabetic drug
*stimulate the release of insulin from the pancreas; increases the sensitivity to insulin at receptor sites.
*adverse: hypoglycemia (usually caused by taking too much medication or not eating enough food), photosensitivity
*Interventions: NOT for preggos, take 30 minutes before eating

31
Q

Alpha-Glucosidase Inhibitors

A

*acarbose, miglitol
*antidiabetic/hypoglycemic drug
*MOA: Block enzymes in small intestine that break down complex carbs
*Excess glucose pooped out
*side effects: minimal, usually GI-related
*considerations: If hypoglycemia does occur, treat with GLUCOSE, not sucrose
*taken 3x/day WITH meal
*Not to be used w/ intestinal disease or problems with kidneys

32
Q

Thiazolidinediones

A

*pioglitazone, rosiglitazone
*antidiabetic/hypoglycemic drug
*increase cell sensitivity to insulin
*3–4 month ZONE to lower bl. glucose
*Adverse: fluid retention, HA, weight gain
*Hypoglycemia DOES NOT occur with drugs in this class
*BLACK BOX warning: cause fluid retention (heart problems)

33
Q

incretin enhancers

A

*sitagliptin
*antidiabetic/hypoglycemic drug
*Enhancers and mimetics do the same thing
*Mimic effects of incretins
*incretins tell pancreas to release insulin and liver to stop producing glucagon; delays gastric emptying
*lose weight b/c of decreasing gastric emptying and increasing sense of “fullness”
*Take prior to meal

34
Q

Incretin Mimetics

A

*Exenatide
*dulaglutide
*Enhancers and mimetics do the same thing

35
Q

Meglitinides

A

*repaglinide & nateglinide
*antidiabetic/hypoglycemic drug
*Act by stimulating release of insulin from pancreatic islet cells
*short durations of action of 2–4 hours
*Adverse: hypoglycemia
*Take 30 minutes before a meal
*Can make you dizzy b/c your BP is going to drop

36
Q

what tells you a person’s blood sugar over 100-120 days (a true measure of blood sugar)?

A

glycosylated hemoglobin (HA1C)

37
Q

what’s an insulin reaction?

A

it occurs when a person with diabetes becomes confused or unconscious due to low blood sugar (hypoglycemia) caused by insulin or oral diabetic medications

38
Q

what allows glucose to enter the cell?

A

insulin

39
Q

glucagon

A

*blocks insulin
*moves glucose from cells, primarily in liver, to the blood
*secreted when levels of glucose are low

Pharm (8 decks)

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