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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
rapid acting insulin administration
subQ
26
rapid acting insulin ADRs
hypoglycemia
27
rapid acting insulin contraindications and interactions
Hypoglycemia Lower dose needed for patients with renal disease
28
rapid acting insulin RN intervention and client education
How to store How to administer What to do if hypoglycemic
29
long acting insulin prototype
glargine insulin (Lantus)
30
long acting insulin therapeutic use
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
31
long acting insulin EPA
onset is about 2 hours and there is no peak, acts like basal insulin
32
long acting insulin administration
subQ
33
long acting insulin ADRs
hypoglycemia
34
long acting insulin contraindications and interactions
Hypoglycemia Lower dose needed for patients with renal disease
35
long acting insulin RN intervention and client education
How to store insulin How to administer What to do if hypoglycemic
36
hyperglycemics prototype and other drug name
glucagon (GlucaGen) Other: 50% glucose (D50-given IV)
37
hyperglycemics therapeutic use
hypoglycemia from an insulin overdose
38
hyperglycemics EPA
raises blood levels of glucose through glycogenesis
39
hyperglycemics ADRs
nausea and vomiting
40
hyperglycemics contraindications and interactions
hypersensative
41
hyperglycemics RN intervention and client education
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
Hypothyroid treatment: thyroid replacement prototype and other drug names
levothyroxine (Synthroid) Others: liothyronine (Cytomel), liotrix (Thyroloar)
43
thyroid replacement therapeutic use
hypothyroidism. Lifelong treatment
44
thyroid replacement EPA
synthetic T4 = increased metabolic rate
45
thyroid replacement adminsitration
PO - empty stomach (30 min before meal), IV
46
thyroid replacement ADRs
s/sx of hyperthyroidism, thyrotoxicosis
47
thyroid replacement RN intervention and client education
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
thyroid replacement contraindications and interactions
Thyrotoxicosis or recent MI MANY drug interactions Food decreases absoption
49
antithyroid drugs: thioamides prototype and other drug name
propylthiouracil (PTU) Others: methimazole (Tapazole)
50
thioamides therapeutic use
Grave’s disease, thyrotoxicosis, suppression of thyroid hormone production prior to thyroidectomy
51
thioamides EPA
blocks iodine from integrating into tyrosine = blocks conversion of T4 into T3
52
thioamides administration
PO at regular intervals. Q 8hrs. DO NOT discontinue abruptly. 3-12 weeks = euthyroid state, up to 12 months for stable hormone production
53
thioamides ADRs
s/sx of hypothyroidism. Agranulocytosis (PTU), aplastic anemia, hepatotoxicity. Rash. N/V. Arthralgia, HA, dizziness
54
thioamides RN intervention and client education
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
thioamides contraindications and interactions
Teratogenic Caution in pt’s with immunosuppression/infections, liver dysfunction
56
posterior pituitary hormone drug (PPHD) prototype and other drug names
desmopressin (DDAVP) Other: vasopressin (IV - short term)
57
PPHD therapeutic use
diabetes insipidus
58
PPHD EPA
synthetic ADH
59
PPHD administration
PO, intranasal, SQ, sublingual, IV
60
PPHD ADRs
think fluid retention - hyponatremia, edema, seizures
61
PPHD RN intervention and client education
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
PPHD contraindications and interactions
renal failure, nephrogenic, DI, electrolyte imbalances
63
Growth hormone (GH) prototype
somatropin
64
GH administration
Given subQ rotate sites
65
GH ADRs
hyperglycemia - check glucose levels
66
GH RN intervention and client education
Monitor urinary calcium d/t risk of hypercalciuria
67
glucocorticoids prototype and other drug names
hydrocortisone (Cortef, Solu-Cortel) Others: prednisone, dexamethasone
68
glucocorticoids therapeutic use
addisons disease/adrenal insufficiency. Autoimmune, inflammatory disorders, asthma
69
glucocorticoids EPA
synthetic cortisol
70
glucocorticoids administration
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
glucocorticoids ADRs
at low, replacement levels - minimal ADRs. High levels = many ADRs
72
glucocorticoids RN intervention and client education
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
glucocorticoids contraindications and interactions
Small doses = no contraindications/interactions w/ larger doses interactions = oral contraceptives, phenytoin, phenobarbital, rifampin
74
mineralocorticoids prototype and other drug names
fludrocorisone Usually given with hydrocortisone
75
mineralocorticoids therapeutic use
Addison's disease/adrenal insufficiency, primary hypoaldosteronism, congenital adrenal hyperplasia
76
mineralocorticoids EPA
synthetic aldosterone = Na+ and H20 retention
77
mineralocorticoids ADRs
at low, replacement levels - menial ADRs High levels = fluid and electrolyte imbalances - HTN, edema, HF, hypokalemia
78
mineralocorticoids RN intervention and client education
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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