Endocrine Drugs And Hormones Flashcards
Normal blood glucose range
70-110 (this may vary by facility)
Rapid acting insulin
Example, route, nursing considerations
Humalog (Lisinopril)
Give sub Q
Give with meals because it acts within 5 minutes
Short acting insulin (example, route, when to give, onset, peak)
Regular (humulin R and Novolin R) Given based on a sliding scale Give with meals or before Onset is 30 minutes Peak is 2.5 hours Given IV or Sub Q
Intermediate acting insulin
NPH or Lente Cloudy Given at a specific scheduled time Onset is 1 hour Peak is 4-12 hours Check for low bs in late afternoon
Long acting Insulin
Lantus
Ultralente (levemir)
Onset is 1 hour
No peak
Combination insulin
Humulin or Novolin 70/30
This means 70 is NPH and 30 is R
Prevents the need to give multiple injections in those that receive both a short and intermediate acting insulin
How to correctly draw up insulin
Clear before cloudy
Not ready… ready now (air into NPH, air into Regular; draw up the Regular, draw up the NPH)
Side effects of insulin and the cause
Hypoglycemic (insulin shock) reactions: from too much insulin: HA, Lightheadedness, nervousness, tremor, diaphoresis; cold, clammy skin; tachycardia, slurred speech, memory lapse, confusion, seizures, blood glucose <60 mg/dL
Hyperglycemic reaction (Diabetic ketoacidosis): not enough insulin: extrm thirst,polyuria, fruity breath, Kussmal Resp, rapid thready pulse, dry mucous membrane, poor skin turgor, bs > 250 mg/dL
Describe Kussmal Respirations
Deep, labored, distressed, dyspneic breathing
Associated with diabetic ketoacidosis
List first and second generation sulfonylureas
1st gen: tolbutamine and acetohexamide
2nd generation: glipizide and glyburide
What class of drugs are sulfonylureas?
Oral antidiabetics
Nursing implications for patients prescribed oral antidiabetics such as sulfonylureas
Assess for sulfa allergies
Action of 1st generation sulfonylureas
Stimulate beta cells in the pancreas to produce more insulin
Action of second generation sulfonylureas
Stumulate beta cells in the pancreas to produce more insulin AND alter the sensitivity of insulin receptors allowing increased binding
Give an example of a non-sulfonylurea oral anti-diabetic medication
Metformin
Action of metformin
Increase binding of insulin to receptors
Improve tissue sensitivity to insulin
Increase transport into skeletal muscles & fatty tissue
Give an example of an alfa-glucosidase oral antidiabetic
Acarbose
Action of acarbose
Inhibits or delays absorption of sugar from the GI tract (this one is not like the other oral diabetics)
Give an example of thiazolidinediones (an oral antidiabetic)
Pioglitazone HCl
Rosialitazone Maleate
-zone drugs
Action of -zone drugs
Increase binding of insulin to receptors
Improves tissue sensitivity to insulin
Give example of combination oral antidiabetics
Glucovance (glyburide/ metformin)
Its a combination of a sulfonylureas and a nonsulfonylureas
Use of combination oral antidiabetics
Glucovance is used when more than one drug is necessary to control blood sugar
What drug is given to raise blood sugar ?
Glucogen- its a hyperglycemia drug that is used to raise blood sugar by stimulating glycogen in the liver
Nursing implications for persons taking glucogen
Teach diabetics that are prone to hypoglycemia to keep glucogen in the home
Teach family members how and when to administer
Role of growth hormone
Stimulates growth in tissue and bone
Drugs for growth hormone deficiency
Somatrem
Somatropin
Drugs for thyroid stimulating hormone (TSH) deficiency
Thyrotropin
Adrenocorticotropic hormone role and medication given when deficient
ACTH stimulates the adrenal gland to secrete cortisol
Corticotropin
Corticotropin is used for it’s _____ properties.
Anti-inflammatory
Corticotropin is contraindicated in which individuals
Don’t take with aspirin because of increased risk of ulcers
Decreases the effect of anti-diabetics
Side effects of corticotropin
Mood swings, increased appetite, edema, water and Na+ retention, GI distress, decreased wound healing, glaucoma/cataracts, ulcer perforation
ADH medications and their use
Desmopressin and vasopressin
Used to promote reabsorption of water
Used for maintenence of diabetes insipidus
Nursing implications for taking antidiuretic such as desmopressin/ vasopressin
I/O
Daily weights
Thyroid gland hormones
Function
What mineral is needed?
Thyroxine T4; triiodothyronine T3
- regulate protein synthesis; enzyme activity
- stimulate mitochondrial oxidation
- lesser extent; calcitonin for regulating serum calcium
Need iodine for synthesis of T3
Medication to treat hypothyroidism
Levothyroxin
Action of levothyroxin
Increase metabolism, body growth, & increase levels of T4
Use of levothyroxin
Treat hypothyroidism
Side effects of levothyroxin
Nervousness, insomnia, weight loss
Tachycardia, palpitations, HTN
Dysrhythmias, angina
Medication to treat hyperthyroidism
Action?
PTU
Inhibit secretions of hormone
Nursing implications for thyroid disorders
Monitor vs and weight
Admin thyroid replacement drug before breakfast
Check labels before using OTC meds
Advise reporting of symptoms of hyperthyroidism
Encourage med-alert tag
Warn of foods that inhibit thyroid secretion
Admin antithyroid drug w/ meds
Warn of iodine effects and presence in iodized salt, shellfish, OTC cough meds
Advise reporting symptoms of hypothyroidism
Action of parathyroid hormone
Correct blood calcium deficit
Use of calcitrol
Treat hypoparathyroidism, hypocalcemia
Action of calcitrol
Promote calcium absorption from GI tract and renal tubules
Contraindications for taking calcitrol
Hypercalcemia and hyperphosphatemia
Side effects of taking calcitrol
Drowsiness, HA, dizziness, lethargy, photophobia, GI distress, hypercalcuria, hyperphosphatemia, hematuria
Nursing interventions for persons prescribed calcitrol
Monitor calcium levels
Advise reporting of symptoms of hypocalcemia
Warn about checking OTC drugs for calcium content
Symptoms of hypocalcemia
Tetany, twitching, tingling, numbness of fingers, spasms
