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Endocrine Drugs Flashcards

1
Q

Glucocorticoids indications

A
  • inflammation
  • arthritis
  • skin disorders
  • blood disorders
  • kidney disorders
  • eye disorders
  • thyroid disorders
  • intestinal disorders (colitis)
  • severe allergies
  • asthma
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2
Q

Prednisone

A
  • most common oral drug
  • anti-inflammatory and immunosuppressing

Corticosteroid

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3
Q

Methylprednisone

A
  • most common injectable
  • anti-inflammatory and immunosuppressing

Corticosteroid

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4
Q

Hydrocortisone

A
  • less common injectable
  • commonly a topical cream
  • PO for Addison’s dz

Corticosteroid

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5
Q

Dexamethasone

A
  • less common injectable

Corticosteroid

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6
Q

Betamethasone

A
  • drug of choice frmo premature labor
  • accelerates fetal lung maturation

corticosteroid

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7
Q

Long-acting insulin

A
  • Detemir
  • Glargine
  • 1x or 2x a day
  • continuous
  • no peak action
  • can’t be mixed
  • type 1 (with meals)
  • sometimes type 2

Basal insulin

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8
Q

Intermediate-acting insulin

A
  • aka NPH
  • often mized with short-acting
  • cloudy

Basal insulin

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9
Q

Short-acting insulin

A
  • aka regular insulin
  • onset 30-60min
  • inject 30-45min before meal
  • can only be mixed with NPH
  • hypoglycemia is more common with short-acting

Prandial insulin

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10
Q

Rapid-acting insulin

A
  • Aspart
  • Glulisine
  • Lispro
  • onset 15min
  • within 15min of meal

Prandial insulin

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11
Q

Metformin (Glucophage)

A
  • a biguanide drug
  • # 1 for type 2 DM
  • decreases glucose production in liver
  • enhance insulin snesitivity
  • also preventative
  • can cause weight loss

antidiabetics

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12
Q

Metformin drug alert

A
  • withold for surgery
  • withold for radiologic procedure with contrast medium (iodine) which could cause lactic acidosis and AKI
  • 1-2 day before, 2 day after when creatinine is within normal limits
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13
Q

Glucagon

A
  • indication: severe hypoglycemia
  • can be given IM, SC, or IV if PO is not an option
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14
Q

Glipizide, Glyburide, and Glimepiride

A
  • Sulfonylureas drugs
  • increase insulin production
  • decrease glucagon secretion
  • contraindications: use of insulin, advanced DM, sulfa drug allergy, NPO, alcohol, advanced age

antidiabetics

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15
Q

Levothyrozine

A
  • indicated in hypothyroidism
  • taken 30-60min before breakfast (empty stomach)
  • AE: tachycardia, angina, tremors, intensify warfarin (check INR)

Thyroid replacement drug

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16
Q

Propythiouracil (PTU)

A
  • indicated in hyperthyroidism

Antithyroid medication

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17
Q

Methimazole

A
  • indicated in hyperthyroidism

Antithyroid medication

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18
Q

Cushing’s disease

A
  • hypersecretion of corticosteroids
  • increased Na and water retention
  • muscle weakness d/t K loss
  • moon face and hump back
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19
Q

Addison’s disease

A

Hyposecretion of corticosteroids, decrease blood Na, glucose, increase K, dehydration, weight loss

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20
Q

Cortisol causes…

A
  • glycogen to glucose
  • tryglycerides into fatty acids & glycerol
  • muscle proteins into amino acids
  • synthesis of more glucose and ketones for body fuel
  • results in muscle weakness & atrophy
  • poor healing
  • immunosuppresion
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21
Q

Glucocorticoid contraindications

A
  • cataracts
  • glaucoma
  • PUD
  • mental health problems
  • DM
  • serious infections (because of immunosuppression)
  • septicemia
  • fungal infx
  • varicella
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22
Q

Glucocorticoid AE

A
  • moon facies (extra fluid volume)
  • hyperglycemia
  • psychosis (roid rage)
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23
Q

Glucocorticoid caution

A
  • HF (fluid retention forces heart to work harder)
  • can cross placenta barrier
  • can be secreted in breast milk
  • cause fetal/infant abnormalities
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24
Q

conditions exacerbated by glucocorticoids and what to look for in a health history

A
  • diabetes
  • dyslipidemia
  • CVD
  • GI disorders
  • affective (mood) disorders
  • osteoporosis
  • sx of/exposure to infx
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25
baseline measures to take before glucoccorticoids
- weight - height - bone mineral density - BP - CBC - blood glucose - lipid profile
26
Glucocorticoids nursing implications
- don't stop taking abruptly, taper off - may need concurrent treatment for osteoporosis or high blood glucose - monitor for adrenal suppression (like sx of Addison's disease)
27
Metformin drug alert
- withold for surgery - withold for radiologic procedure with contrast medium (iodine) which could cause lactic acidosis and AKI - 1-2 day before, 2 day after when creatinine is within normal limits
28
Rule of 15
- for hypoglycemia - pt consume 15g of carbs - check BG after 15min - is BG is still low, another 15g - repreat until BG >70mg/dL
29
Posterior pituitary function
- stores and secretes oxytocin and ADH
30
Vasopressin
- Indications: diabetes insipidus, hypotensive crisis like septic shock, bleeding og esophageal varices - mimic ADH - vasoconcstrictor - *should* reduce severe thirst and decrease urine output | Posterior pituitary drug
31
Desmopressin
- Indications: diabetes insipidus, nocturnal enuresis, bleeding d/t hemophilia and Willebrand sz - mimic action of ADH - *should* reduce severe thirst and decrease urine output | Posterior pituitary drug
32
Hypothyroidism
- low metabolic rate - weight gain - cold extremities - constipation - reduced libido - menstrual irregularities
33
Hyperthyroidism
- Graves disease - increased metabolic rate - increased body heat and sweating - diarrhea - weight loss - tremors - increased heart rate - goiter - bulging eyes
34
Cosyntropin (Cortrosyn)
- Indication: adrenocortical insufficency (diagnostic) - stimulates release of cortisol - anti-inflammatory - AE: Na retention, edema, HTN | Anterior pituitary drug
35
Somatropin and somatrem
- Indication: GH deficiency, hypopituitary dwarfism - growth hormone | Anterior pituitary drug
36
Octreotide (Sandostatin)
- Indication: carcinoid crisis and related severe diarrhea, flushing, and hypotension - can alter blood glucose
37
- inflammation - arthritis - skin disorders - blood disorders - kidney disorders - eye disorders - thyroid disorders - intestinal disorders (colitis) - severe allergies - asthma
Glucocorticoids indications
38
- most common oral drug - anti-inflammatory and immunosuppressing | Corticosteroid
Prednisone
39
- most common injectable - anti-inflammatory and immunosuppressing | Corticosteroid
Methylprednisone
40
- less common injectable - commonly a topical cream - PO for Addison's dz | Corticosteroid
Hydrocortisone
41
- less common injectable | Corticosteroid
Dexamethasone
42
- corticosteroid - drug of choice for premature labor - accelerates fetal lung maturation
Betamethasone
43
- Detemir - Glargine - 1x or 2x a day - continuous - no peak action - can't be mixed - type 1 (with meals) - sometimes type 2 | Basal insulin
Long-acting insulin
44
- aka NPH - often mized with short-acting - cloudy | Basal insulin
Intermediate-acting insulin
45
- aka regular insulin - Humulin and Novolin - onset 30-60min - inject 30-45min before meal - can only be mixed with NPH - hypoglycemia is more common with short-acting | Prandial insulin
Short-acting insulin
46
- Aspart - Glulisine - Lispro - onset 15min - within 15min of meal | Prandial insulin
Rapid-acting insulin
47
- a biguanide drug - #1 for type 2 DM - decreases glucose production in liver - enhance insulin snesitivity - also preventative - can cause weight loss | antidiabetics
Metformin (Glucophage)
48
- withold for surgery - withold for radiologic procedure with contrast medium (iodine) which could cause lactic acidosis and AKI - 1-2 day before, 2 day after when creatinine is within normal limits
Metformin drug alert
49
- indication: severe hypoglycemia - can be given IM, SC, or IV if PO is not an option
Glucagon
50
- Sulfonylureas drugs - increase insulin production - decrease glucagon secretion - contraindications: use of insulin, advanced DM, sulfa drug allergy, NPO, alcohol, advanced age | antidiabetics
Glipizide, Glyburide, and Glimepiride
51
- indicated in hypothyroidism - taken 30-60min before breakfast (empty stomach) - AE: tachycardia, angina, tremors, intensify warfarin (check INR) | Thyroid replacement drug
Levothyroxine
52
- indicated in hyperthyroidism | Antithyroid medication
Propythiouracil (PTU)
53
- indicated in hyperthyroidism | Antithyroid medication
Methimazole
54
- hypersecretion of corticosteroids - increased Na and water retention - muscle weakness d/t K loss - moon face and hump back
Cushing's disease
55
Hyposecretion of corticosteroids, decrease blood Na, glucose, increase K, dehydration, weight loss
Addison's disease
56
- glycogen to glucose - tryglycerides into fatty acids & glycerol - muscle proteins into amino acids - synthesis of more glucose and ketones for body fuel - results in muscle weakness & atrophy - poor healing - immunosuppresion
Cortisol causes...
57
- cataracts - glaucoma - PUD - mental health problems - DM - serious infections (because of immunosuppression) - septicemia - fungal infx - varicella
Glucocorticoid contraindications
58
- moon facies (extra fluid volume) - hyperglycemia - psychosis (roid rage)
Glucocorticoid AE
59
- HF (fluid retention forces heart to work harder) - can cross placenta barrier - can be secreted in breast milk - cause fetal/infant abnormalities
Glucocorticoid caution
60
- diabetes - dyslipidemia - CVD - GI disorders - affective (mood) disorders - osteoporosis - sx of/exposure to infx
conditions exacerbated by glucocorticoids and what to look for in a health history
61
- weight - height - bone mineral density - BP - CBC - blood glucose - lipid profile
baseline measures to take before glucoccorticoids
62
- don't stop taking abruptly, taper off - may need concurrent treatment for osteoporosis or high blood glucose - monitor for adrenal suppression
Glucocorticoids nursing implications
63
- withold for surgery - withold for radiologic procedure with contrast medium (iodine) which could cause lactic acidosis and AKI - 1-2 day before, 2 day after when creatinine is within normal limits
Metformin drug alert
64
- for hypoglycemia - pt consume 15g of carbs - check BG after 15min - is BG is still low, another 15g - repreat until BG >70mg/dL
Rule of 15
65
- stores and secretes oxytocin and ADH
Posterior pituitary function
66
- Indications: diabetes insipidus, hypotensive crisis like septic shock, bleeding og esophageal varices - mimic ADH - vasoconcstrictor - *should* reduce severe thirst and decrease urine output | Posterior pituitary drug
Vasopressin
67
- Indications: diabetes insipidus, nocturnal enuresis, bleeding d/t hemophilia and Willebrand sz - mimic action of ADH - *should* reduce severe thirst and decrease urine output | Posterior pituitary drug
Desmopressin
68
- low metabolic rate - weight gain - cold extremities - constipation - reduced libido - menstrual irregularities
Hypothyroidism
69
- Graves disease - increased metabolic rate - increased body heat and sweating - diarrhea - weight loss - tremors - increased heart rate - goiter - bulging eyes
Hyperthyroidism
70
- Indication: adrenocortical insufficency (diagnostic) - stimulates release of cortisol - anti-inflammatory - AE: Na retention, edema, HTN | Anterior pituitary drug
Cosyntropin (Cortrosyn)
71
- Indication: GH deficiency, hypopituitary dwarfism - growth hormone | Anterior pituitary drug
Somatropin and somatrem
72
- Indication: carcinoid crisis and related severe diarrhea, flushin, and hypotension - can alter blood glucose
Octreotide (Sandostatin)

Pharm 4 (4 decks)

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