Endocrine Drugs - Exam 3 Flashcards
Somatropin
(Humatrope)
Mech: Identical to GH, stim protein synthesis by increasing amino acid uptake
Reduces carb use by cells
Use: In children, stop use when epiphyseal plates close
SE: hyperglycemia, careful w/ DM !
Notes: Corticosteriods can oppose effects of GH!
Vasopressin
(Pitressin)
Synthetic ADH
Mech: Increases collecting duct perm to water causing increased reabsoprtion of water in to bloodstream -> Increased BP.
Use: Given IV, used for DI & Cardiac arrest
SE: Water intox!! Neurologic signs of drowsiness, headache, convulsions, coma
Desmopressin
(DDAVP)
Synthetic ADH
Mech: Increases perm in collecting duct to water causing increased reabsoprtion of water in to bloodstream -> Increased BP. less vascular activity
Use: Main Tx in DI! NOT USED FOR CARDIAC RESUSCITATION!
SE: Water intox!
Levothyroxine
(Levothroid, Synthroid)
Hypothyroid drug
Mech: Synthetic version of thyroxine (T4)
Use: HIGHLY PROTEIN BOUND!
-Half life of 7 days
-Levels stay steady, just takes a while to get there
-Edu pt that taken for life.
MUST BE TAKEN ON EMPTY STOMACH
SE: Thyrotoxicosis
-Tachy
-Angina
-Tremor
-Hyperthermia
-Heatintolerance
Notes: Monitored by checking TSH levels.
TSH 0.5- 2.0mu/mL is desired!
Low TSH = decrease dose , High TSH = increase dose
Radioactive Iodine
Hyperthyroid drug
Mech: Emits beta particles & gamma rays
Destroys thyroid tissue with minimal damage to surrounding tissues
Use: Given outpt! Concerned about their body fluids!
-Private toilet or flush 2-3x
-Launder bed linens separately!
-Avoid close contact w/ preg women or child for 7 days after therapy
SE: Risk for delayed HYPOthyroidism
Notes: Should NOT be used in preg or lactating women!
Methimazole
(Tapazole)
Antithyroid drug
Mech: Inhibits peroxidase (enzyme responsible for the synthesis of thyroid hormone) Does not destroy TH already in existence !
Use: 1st line drug for hyperthyroidism
SE: AGRANULOCYTOSIS!! Will NOT see increased WBC w/ infection!
Too much can cause hypothyroidism
Notes: Contraindicated in PREGNANCY
Should not be used in 1st trimester, can cross placenta and interfere w/ thyroid synthesis.
If given can cause cretinism
Propylthiouracil (PTU)
Antithyroid drug
“Protect The Unborn”
Mech: inhibits oxidation of iodide by peroxidase
Use: short half life, has to be admin 2-3x/day
SE: Agranulocytosis
Hypothyroidism
Liver injury!!! Watch for jaundice or urine changes
Notes: Can use in 1st Trimester ONLY then switch to methimazole for rest of pregnancy
Lugol’s Solution
(Non-Radiactive Iodine)
Antithyroid drug
Mech: High concentration causes paradoxical effect on thyroid.
-reduces iodine uptake by thyroid
-results in decreased t3/t4 production
Use: Rarely used on its own, typically used with another anti-thyroid med
SE: Iodism = brassy taste, burning sensation on throat, frontal headache, salivation
-Corrosion of GI tract
Hydrocortisone
(Solu-Cortef)
Glucocorticoid
Adrenal hormone insufficiency drug
Mech: Mimics cortisol! Also has small mineralcorticoid effect
Use: Used for allergic reactions, inflammation, cancer, organ transplant
-Admin PO or IV
If PO, give 2/3 in morning, 1/3 in evening
(mimics body’s natural release)
SE: CHAOS =
Cushing syndrome Hyperglycemia Adrenal insufficiency Osteoporosis Suppressed immune system
Notes: Edu pt to NOT withdraw rapidly from high dose
Dose must be increased in times of stress
Fludrocortisone
(Florinef)
Mineralcorticoid
Adrenal hormone insufficiency drug
Mech: Mimics aldosterone (possess small glucocorticoid effect)
SE: HTN, Hypokalemia
Cosyntropin
(Cortrosyn)
Adrenal diagnostic drug
Mech: Synthetic version of ACTH
Stim adrenal gland to secrete cortisol
Use: 1.Plasma cortisol level is checked
2. Cosyntropin is injected
3. Plasma cortisol level is checked again, after 30-60 mins
Normal person = rise in cortisol level
Dexamethasone
(Decadron)
Adrenal diagnostic drug
Mech: Mimic’s cortisol
Use: Used to diagnose Cushing’s syndrome!
Low dose tests are done first
If low dose is abnormal, a high dose test is done to
identify the source
Low dose = 1mg before bed, cortisol lvl check next AM. Cortisol should drop If not, do high dose
High dose = 8mg before bed, cortisol lvl check next AM
drop in cortisol = pituitary cause
No drop = paraneoplastic or adrenal cause
Insulin lispro (humalog)
Insulin aspart (NovoLog)
Insulin glutilisine (Apidra)
Rapid Acting Insulin
Onset: 10-30min
Peak: 30min-3hrs
Duration: 3-6
Give with
meals!!
Can Give with
intermediate
or long acting
insulin
May be given
IV, but rare
Regular insulin
(Humulin R, Novolin R)
Short acting insulin
Onset: 30-60mins
Peak: 1-5hrs
Duration: 6-10hrs
May be given IV!
NPH insulin
(Humulin N, Novolin N
Intermediate Insulin
Onset: 60-120mins
Peak: 6-14hrs
Duration: 16-24hrs
Cloudy!! May be given with regular or rapid insulin
