Endocrine

Question 1

adrenal hormone replacement

Answer 1

hydrocortisone

Question 2

hydrocortisone mimics naturally occurring cortisol by

Answer 2

maintaining BP, regulate metabolism and inflammatory response

Question 3

SE of hydrocortisone

Answer 3

bone loss, peptic ulcers, infection, GI issues, weight gain, adrenal suppression, skin fragility

Question 4

Key points of hydrocortisone

Answer 4

Monitor for signs of peptic ulcer ( coffee ground emesis, tarry stools), increase dose during stress, monitor for infection, avoid NSAIDS and alcohol, take calcium and VD

Question 5

bromocriptine mesylate

Answer 5

GH suppressent

Question 6

antidiuretic hormone

Answer 6

vasopressin and desmopressin

Question 7

MOA of ADH and SE

Answer 7

mimics ADH. reabsorption of water in kidneys, decrease UOP and increase urine osmolality. SE: overhydration (headache)

Question 8

somatropin

Answer 8

growth hormone

Question 9

MOA and SE of somatropin (growth hormone)

Answer 9

stimulates growth, protein synthesis. SE: hyperglycemia

Question 10

key points of somatropin (GH)

Answer 10

IM or SQ and rotate injection site. Stop prior to epiphyseal closure

Question 11

lispro (humalog), aspart

Answer 11

Rapid acting. onset - 15. Peak - 30-1hr. duration - 3-4

Question 12

regular (Humalin R)

Answer 12

short acting. onset 30m. Peak 2-3 hr. Duration - 5-7. Only one that can be given IV

Question 13

NPH (humulin N)

Answer 13

intermediate acting. Cloudy. onset - 1-2. peak - 4-12. duration 18-24

Question 14

insulin glargine (Lantus)

Answer 14

long acting. onset 1 hr. Peak - none. duration is 24hrs

Question 15

how to draw insulin

Answer 15

short acting insulin in syringe first, then long acting. clear before cloudy.

Question 16

do not mix long acting insulin (glargine) with

Answer 16

any other insulins

Question 17

levothyroxine

Answer 17

hypothyroid. Synthetic form of T3 and T4. SE: anxiety, GI, sweating, weight loss, heat intolerance

Question 18

given with severe hypoglycemia when patient is unable to take oral glucose

Answer 18

glucagon. Provide food as soon as patient is able to safely swallow

Question 19

oral antidiabetic. Biguanides

Answer 19

metformin

Question 20

MOA and SE of metformin (a Biguanides)

Answer 20

decrease glucose production in liver and increase glucose uptake. SE: GI upset (take with food), B12 def., lactic acidosis, metallic taste

Question 21

Key points of metformin

Answer 21

No ETOH. Meal, B12 supplement, D/C for procedures NPO or contrast dye. Monitor for signs of lactic acidosis (diarrhea, dizzy, hypotension, brady, weakness). Do not give in renal impairment

Question 22

oral antidiabetic Thiazolidinediones

Answer 22

pioglitazone and rogiglitazone

Question 23

MOA and SE of “zone” antidiabetics. (Thiazolidinediones)

Answer 23

decrease insulin resistance, increases glucose uptake, decreases glucose production. SE: fluid retention, elevated LDL, hepatotoxicity. Contraindicated in HF.

Question 24

oral antidiabetics Meglitinides

Answer 24

repaglinide and natelinide. increases insulin release from pancreas

Question 25

SE and Key points for repaglinide and natelinide

Answer 25

Meglitinides (antidiabetics). SE: hypoglycemia and angina. 3x day with food within 30m. Do not give with liver dysfunction due to hypoglycemia

Question 26

oral antidiabetics. Sulfonylureas 2nd generation

Answer 26

glipizide. Increase insulin from pancreas. GI upset and hypoglycemia. 30m before meal. Sunscreen

Question 27

1st generation sulfonylureas

Answer 27

MIDE. tolbutamide, tolazamide, chlorpropamide

Question 28

propylthiouracil

Answer 28

antithyroid. Graves. Blocks thyroid hormones.

Question 29

SE of propylthiouracil.

Answer 29

antithyroid. agranulocytosis, GI upset, hepatotoxicity, hypothyroidism (lethargy, weight gain, cold intolerance brady, depression). Monitor CBC, liver function