Endocrine Flashcards
Drugs of the Endocrine System
● Steroids
● Thyroid Medications
○ Thyroid hormone replacements
○ Anti-thyroids
● Parathyroid Medications
○ Calcium
○ Bisphosphonates
○ Calcitonin
● Posterior-Pituitary Hormones
○ ADH
○ Oxytocin
● Diabetes
○ Insulin
○ Oral antidiabetics
Steroids
Short Acting - Cortisone, hydrocortisone
Intermediate Acting - methylprednisolone, prednisone, triancinalone
Long Acting - betamethasone, dexamenthasone
Steroids - Cortisone, hydrocortisone, methylprednisolone, prednisone…
Cortisone, hydrocortisone, methylprednisolone, prednisone…
Indication: Addison’s disease, inflammation, allergy, autoimmune disorders
Action: Suppress inflammation in the immune system, increase blood glucose, cause
retention of water and sodium (increasing BP), cause excretion of potassium
Nursing Considerations:
● Monitor for too much steroids
○ Cushing’s symptoms; buffalo hump
● Side effects
○ Immunosuppression
○ Hyperglycemia
○ Osteoporosis
○ Delayed wound healing
Thyroid Hormone Replacements
Names: Levothyroxine
Indication: Hypothyroidism
Action: Replacement for thyroid hormone
Nursing Considerations:
● Take every day, at the same time, on an empty stomach
● Separate from other medications
● Don’t stop taking abruptly
Anti-Thyroid Medications
Iodine (Lugol’s Solution), Radioactive iodine, Methimazole, Propylthiouracil
Indication: Hyperthyroidism
Action: reduces size and vascularity of the thyroid gland, or kills thyroid gland cells, to
decrease the amount of T₃ and T₄ that are secreted
Nursing Considerations:
● Monitor for signs and symptoms of hypothyroidism
Parathyroid Medications
● Increase serum calcium
○ Calcium chloride, gluconate, lactate
○ Vitamin D
■ Calcitriol
● Decrease serum calcium
○ Bisphosphonates
■ Alendronate
■ Risedronate
○ Calcitonin
Posterior Pituitary Gland Hormones:
Antidiuretic Hormone
Names: Vasopressin, Desmopressin
Indication: DI, Shock
Action: Causes the body to retain water, increasing the blood volume, decreasing the UOP,
and increasing BP
Nursing Considerations:
● Monitor BP and UOP
Posterior Pituitary Gland Hormones:
Oxytocin
Names: Carboprost, Pitocin, Oxytocin
Indication: Induction of labor; PPH
Action: Stimulates uterine smooth muscle causing it to contract
Nursing Considerations:
● Monitor contractions
● Monitor fetus
● Warn mother contractions will be more painful
● Monitor BP, HR, glucose, and K
Oral Anti-diabetic
Biguanides
Metformin
Inhibit liver glucose
production & reduce
intestinal absorption of
glucose
Increased risk for kidney issues
and lactic acidosis: hold
before/after imaging tests with
contrast & teach client to avoid
alcohol
Common side effect: GI issues
Oral Anti-diabetic
Sulfonylureas
Trigger beta cells to
release insulin
Glimepiride
Glyburide
Administer with or just prior to
meals to avoid hypoglycemia
Instruct client to consult PCHP
before combining with OTC
medications (interact with
many other medications)
Oral Anti-diabetic
Insulin sensitizers
(Thiazolidinediones)
Reduce glucose
production & increase
insulin receptor sensitivity
Rosiglitazone
Pioglitazone
Increased risk for heart failure:
monitor daily weight for clients
with any cardiovascular
problems
Increased risk for macular
edema: teach clients to report
changes in vision
Insulin
Rapid-Acting
Used to manage blood
sugar during snacks/meals
and to correct high blood
glucose levels
Insulin aspart
Onset Peak Duration
15 min 1-3 hrs 3-5 hrs
Insulin lispro
Onset Peak Duration
15 min 30-90 min 5 hrs
Insulin
Short-Acting
Used to manage blood
sugar during snacks/meals
and to correct high blood
glucose levels
Regular Insulin
Onset Peak Duration
Regular 30 min 2-4 hrs 5-12 hrs
Insulin
Intermediate-Acting
Used to control blood
sugar between meals, while fasting, and
overnight
NPH
Intermediate-Acting
Onset Peak Duration
1-4 hrs 4-12 hrs 10-24+ hrs
Insulin
Long-Acting
Used to control blood
sugar between meals, while fasting, and
overnight
Glargine
Onset Peak Duration
2-4 hrs None 24 hrs
Water deprivation test
DI can be divided into either neurogenic (central) or nephrogenic. The water deprivation test is used to help differentiate whether the DI is neurogenic or nephrogenic. In this test, the client is deprived of water for up to eight hours (they may still eat dry foods). Serial labs, including plasma and urine osmolality measurements, are obtained during that time. Additionally, the client’s urine volume and weight are meticulously measured hourly. If the client’s body weight should decrease, this supports the diagnosis of DI. At the end of the eight hours, a dose of desmopressin is administered. If there is an increase in urine osmolarity and a decrease in urine volume, it is considered central/neurogenic DI (because the problem responded to the DDAVP). If no response is observed after the DDAVP is administered, nephrogenic DI is likely.
DI
DI is a condition that may be central or nephrogenic
✓ The client is at risk for fluid volume deficit because the client may experience polyuria
✓ This may manifest as tachycardia, hypotension, and a thread pulse
✓ Common laboratory findings for an individual with DI include hypernatremia, decreased urine specific gravity (it is dilute), and increased hematocrit (hemoconcentration)
✓ Treatment for central diabetes insipidus is by administering desmopressin (intranasal or tablet)
✓ Nephrogenic diabetes insipidus is treated by withdrawing the offending agent (such as lithium) and administration of thiazide diuretics or NSAIDs
