Endocrine

Question 1

Treatment for hyperparathyroidism

Answer 1

• 0.9% saline infusion and furosemide

Question 2

Hydrochlorothiazide

Answer 2

• thiazide diuretic
• causes the retention of calcium
• diabetes insipidus
  
  • lowers urine output
• depletes potassium
  
  • give salt substitutes
• AVOID SUNLIGHT

Question 3

Dexamethasone

Answer 3

• asthma exacerbations
• rheumatoid arthritis
• pulmonary emphysema (lung damage to alveoli wall)
• thyroid storm
• itching/burning in perineal area is common

Question 4

Corticosteroid

Answer 4

• causes fluid retention
• edema/weight gain
• hypertension
• irritability/insomnia
• increase glucose
• gastrointestinal upset
  
  • give with food

rinse mouth after use

Question 5

Rapid insulin

Answer 5

• aspart, lispro, glulisine
• 5-10 minutes prior to the meal
• most common insulin used in insulin pumps

Question 6

Levothyroxine

Answer 6

• treats hypothyroidism
• causes heat intolerance, palpitations, and insomnia
• take in evening b/c of insomnia risk
• constipation

Question 7

Diabetic nephropathy meds

Answer 7

• ACE inhibitors (enalapril)
• decreases proteinuria

Question 8

Sevelamer

Answer 8

• lowers phosphate levels in CKD
• give with food

Question 9

Desmopressin

Answer 9

• can cause hyponatremia

Question 10

Sitagliptin

Answer 10

• treats type 2 diabeties
• reduces glucose by delaying gastric emptying
• most common severe adverse effect is pancreatitis
  
  • abdominal pain
  • nausea/ persistent vomiting

Question 11

Allopurinol

Answer 11

• treats gout and kidney stones
• reduces uric acid
• encourage 3L of fluid per day

Question 12

Propylthiouracil (PTU)

Answer 12

• treats hyperthroidism

Question 13

Thyroid storm meds

Answer 13

• dexamethasone
  
  • corticosteriod
    
    • stops conversion of T4 into T3
• propranolol
  
  • reduce HR and BP
• PTU
  
  • antithyroid

Question 14

Potassium iodide (Lugol’s solution)

Answer 14

• give 10 days before schdueled thyroidectomy
• lowers risk of blood loss
• reduces size and vascularity of thyroid

Question 15

Thyroid meds care

Answer 15

• take in morning d/t insomnia
• take at same time each day
• take on empty stomach
  
  • 30 min before breakfast
• constipation is common in hypothyroidism
  
  • increase fluids and fiber

Question 16

Methimazole & PTU a/e

Answer 16

• agranulocytosis
• monitor for infection
  
  • sore throat

Question 17

Metformin

Answer 17

• antidiabetic (type 2)
  
  • does not cause hypoglycemia
  • can help lose weight
• most common s/e is gastro upset
  
  • take med with meals to reduce s/e
• decreases absorption of vitamin B12
  
  • causes Vitamin B12 deficiency anemia
    
    • glossitis (swollen tongue)
    • cognitive slowing
• causes lactic acidosis
• can cause renal impairment
  
  • decreased GFR
  • REPORT

Biguanide

inhibits liver glucose production + reduce absoption of glucose

Question 18

Tolvaptan

Answer 18

• treats SIADH
• normalizes sodium levels (can cause hypernatremia)
• increases urine output
• monitor urine-specific gravity

Question 19

Dulaglutide

Answer 19

• long acting
• once a week, no peak
• may cause pancreatitis
• lowers HbA1C

Question 20

Sulfonylureas

Answer 20

• trigger beta cells to release insulin
• give just before meals
• Glimepiride
• Glyburide

Question 21

Insulin sensitizers

Answer 21

• reduces glucose production
• increase insulin receptor sensitivity
• increased risk for
  
  • heart failure
    
    • monitor daily weights and cardio
  • macular edema
    
    • report vision changes
• Rosiglitazone
• Pioglitazone

Thiazolidinediones

Question 22

Glilizide

Answer 22

• sulfonylurea
• lowers blood glucose
  
  • given with meals
    
    • cannot be NPO

Question 23

Radioactive iodine

Answer 23

• give for Grave’s disease
• AVOID IF PREGNANT