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Pharm > Endocrine drugs > Flashcards

Endocrine drugs Flashcards

1
Q

biguanides prototype

A

metformin (Glucophage)

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2
Q

biguanides therapeutic use

A

initial drug used to treat type II diabetes becayse does not cause weight gain like the other oral agents. Can be taken with other oral agents and insulin

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3
Q

biguanides EPA

A

reduces the production of glucose by the liver, decreases absorption of glucose from the intestines and increases sensitivity of insulin receptors in tissues

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4
Q

biguanides administration

A

PO

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5
Q

biguanides ADRs

A

lactic acidosis, N/V/D, metallic taste, does not cause hypoglycemia
BLACK BOX WARNING: risk for potentially fatal lactic acidosis for people with a history because increases procution of lactate

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6
Q

biguanides contraindications and interactions

A

Not given during severe illness, surgery, or hospitalization
Pregnancy
Renal and hepatic impairment
Hx of lactic acidosis
ETOH

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7
Q

biguanides RN intervention and client education

A

Take with meals to decrease stomach upset
Do not stop taking without consulting provider
Avoid ETOH
Can NOT be taken if client is having imaging done with contrast because it can cause kidney injury. Need to hold 48 hours before and after contrast is used

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8
Q

sulfonylureas prototype

A

glipizide (Glucotrol)

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9
Q

sulfonylureas therapeutic use

A

used in combination with diet to lower blood sugar levels in patients with type II diabetes

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10
Q

sulfonylureas EPA

A

stimulates pancreatic beta cells to produce more insulin, therefore increasing secretion of insulin

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11
Q

sulfonylureas administration

A

PO

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12
Q

sulfonylureas ADRs

A

hypoglycemia

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13
Q

sulfonylureas contraindications and interactions

A

Sulfa allergy - should not take
Pregnancy
Renal or hepatic dysfunction

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14
Q

sulfonylureas RN intervention and client education

A

Take 30 min before meals
Not given during severe illness, surgery, hospitalization or pregnancy (need to take insulin instead to control blood sugars)

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15
Q

short acting insulin prototype

A

regular insulin

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16
Q

short acting insulin therapeutic use

A

to control blood sugar in patients with type I diabetes or in patients with type II diabetes that could not get control with diet, exercise and oral agents

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17
Q

short acting insulin EPA

A

short-acting insulin with an onset of 30-60 minutes. Replaces endogenous insulin and has the same affect as the pancreatic hormone

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18
Q

short acting insulin adminsitration

A

SQ or IV - only insulin that can be given IV

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19
Q

short acting insulin ADRs

A

hypoglycemia

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20
Q

short acting insulin contraindications and interactions

A

Hypoglycemia
People with renal disease, dose will need to be lowered

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21
Q

short acting insulin RN intervention and client education

A

How to store insulin
How to administer
What to do if hypoglycemic

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22
Q

rapid acting insulin prototype and other drug names

A

lispro insulin (Humalog)
Others: aspart (Novolog)

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23
Q

rapid acting insulin therapeutic use

A

rapid acting insulin that is given with meals or to correct a high blood glucose level. Can be used in patients with type I or type II diabetes

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24
Q

rapid acting insulin EPA

A

onset is quick, about 15 minutes

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25
Q

rapid acting insulin administration

A

subQ

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26
Q

rapid acting insulin ADRs

A

hypoglycemia

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27
Q

rapid acting insulin contraindications and interactions

A

Hypoglycemia
Lower dose needed for patients with renal disease

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28
Q

rapid acting insulin RN intervention and client education

A

How to store
How to administer
What to do if hypoglycemic

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29
Q

long acting insulin prototype

A

glargine insulin (Lantus)

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30
Q

long acting insulin therapeutic use

A

to control blood sugar in patients with type I diabetes or in patients with type II diabetes that could not get control with diet, exercise and oral agents

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31
Q

long acting insulin EPA

A

onset is about 2 hours and there is no peak, acts like basal insulin

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32
Q

long acting insulin administration

A

subQ

33
Q

long acting insulin ADRs

A

hypoglycemia

34
Q

long acting insulin contraindications and interactions

A

Hypoglycemia
Lower dose needed for patients with renal disease

35
Q

long acting insulin RN intervention and client education

A

How to store insulin
How to administer
What to do if hypoglycemic

36
Q

hyperglycemics prototype and other drug name

A

glucagon (GlucaGen)
Other: 50% glucose (D50-given IV)

37
Q

hyperglycemics therapeutic use

A

hypoglycemia from an insulin overdose

38
Q

hyperglycemics EPA

A

raises blood levels of glucose through glycogenesis

39
Q

hyperglycemics ADRs

A

nausea and vomiting

40
Q

hyperglycemics contraindications and interactions

A

hypersensative

41
Q

hyperglycemics RN intervention and client education

A

Turn client on side if unconscious
Provide food after patient regains consciousness and able to swallow safely
Educate on signs and symptoms of hypoglycemia and how to treat

42
Q

Hypothyroid treatment: thyroid replacement prototype and other drug names

A

levothyroxine (Synthroid)
Others: liothyronine (Cytomel), liotrix (Thyroloar)

43
Q

thyroid replacement therapeutic use

A

hypothyroidism. Lifelong treatment

44
Q

thyroid replacement EPA

A

synthetic T4 = increased metabolic rate

45
Q

thyroid replacement adminsitration

A

PO - empty stomach (30 min before meal), IV

46
Q

thyroid replacement ADRs

A

s/sx of hyperthyroidism, thyrotoxicosis

47
Q

thyroid replacement RN intervention and client education

A

Monitor T3, T4, TSH levels
Measure baseline VS and weight - then periodicall
Monitor for and educate pt on s/sx of hyperthyroidism
Rapid heart rate, palpitations, chest pain
Nervousness
Tremors
Decreased appetite
Heat intolerance, fever, sweating
Weight loss

48
Q

thyroid replacement contraindications and interactions

A

Thyrotoxicosis or recent MI
MANY drug interactions
Food decreases absoption

49
Q

antithyroid drugs: thioamides prototype and other drug name

A

propylthiouracil (PTU)
Others: methimazole (Tapazole)

50
Q

thioamides therapeutic use

A

Grave’s disease, thyrotoxicosis, suppression of thyroid hormone production prior to thyroidectomy

51
Q

thioamides EPA

A

blocks iodine from integrating into tyrosine = blocks conversion of T4 into T3

52
Q

thioamides administration

A

PO at regular intervals. Q 8hrs. DO NOT discontinue abruptly. 3-12 weeks = euthyroid state, up to 12 months for stable hormone production

53
Q

thioamides ADRs

A

s/sx of hypothyroidism. Agranulocytosis (PTU), aplastic anemia, hepatotoxicity. Rash. N/V. Arthralgia, HA, dizziness

54
Q

thioamides RN intervention and client education

A

Monitor T3, T4, TSH
Baseline VS and weight - monitor periodically
Monitor for and educate client on s/sx hypothyroidism
Fatigue, weakness
Weight gain
Cold intolerance
Monitor CBC - baseline and periodically
Would see decreased leukocytes/neutrophils
Client should report fever, sore throat
Monitor for rash, joint/muscle pain

55
Q

thioamides contraindications and interactions

A

Teratogenic
Caution in pt’s with immunosuppression/infections, liver dysfunction

56
Q

posterior pituitary hormone drug (PPHD) prototype and other drug names

A

desmopressin (DDAVP)
Other: vasopressin (IV - short term)

57
Q

PPHD therapeutic use

A

diabetes insipidus

58
Q

PPHD EPA

A

synthetic ADH

59
Q

PPHD administration

A

PO, intranasal, SQ, sublingual, IV

60
Q

PPHD ADRs

A

think fluid retention - hyponatremia, edema, seizures

61
Q

PPHD RN intervention and client education

A

Monitor for s/sx of H2O intoxications = HA, AMS/confusion, etc. - educate pt on s/sx
Decrease PO H2O intake
Strict intake and output measuring
Monitor serum Na+ levels

62
Q

PPHD contraindications and interactions

A

renal failure, nephrogenic, DI, electrolyte imbalances

63
Q

Growth hormone (GH) prototype

A

somatropin

64
Q

GH administration

A

Given subQ rotate sites

65
Q

GH ADRs

A

hyperglycemia - check glucose levels

66
Q

GH RN intervention and client education

A

Monitor urinary calcium d/t risk of hypercalciuria

67
Q

glucocorticoids prototype and other drug names

A

hydrocortisone (Cortef, Solu-Cortel)
Others: prednisone, dexamethasone

68
Q

glucocorticoids therapeutic use

A

addisons disease/adrenal insufficiency. Autoimmune, inflammatory disorders, asthma

69
Q

glucocorticoids EPA

A

synthetic cortisol

70
Q

glucocorticoids administration

A

PO with meals to decrease GI upset. Ideally take full dose in AM - if PM fatigue give in divided doses
IV in acute/emergent settings

71
Q

glucocorticoids ADRs

A

at low, replacement levels - minimal ADRs. High levels = many ADRs

72
Q

glucocorticoids RN intervention and client education

A

Monitor labs and periodically
- CBC
- Electrolytes
- Glucose
- Glucocorticoids
May need supplemental doses in times of physiological or emotional stress
Client needs to wear medical alert bracelet and carry supply of glucocorticoids
Instruct client to call provider if signs of infection and prior to vaccines

73
Q

glucocorticoids contraindications and interactions

A

Small doses = no contraindications/interactions
w/ larger doses interactions = oral contraceptives, phenytoin, phenobarbital, rifampin

74
Q

mineralocorticoids prototype and other drug names

A

fludrocorisone
Usually given with hydrocortisone

75
Q

mineralocorticoids therapeutic use

A

Addison’s disease/adrenal insufficiency, primary hypoaldosteronism, congenital adrenal hyperplasia

76
Q

mineralocorticoids EPA

A

synthetic aldosterone = Na+ and H20 retention

77
Q

mineralocorticoids ADRs

A

at low, replacement levels - menial ADRs
High levels = fluid and electrolyte imbalances - HTN, edema, HF, hypokalemia

78
Q

mineralocorticoids RN intervention and client education

A

Monitor for adverse effects related to fluid retention - daily weight
Monitor BP
Monitor K+ levels, watch fpr s/sx of hypokalemia
Monitor for s/sx of inadequate dosage: weight loss, poor appetite, fatigue, muscle weakness, hypotension

Pharm (13 decks)

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