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Pharm > Endocrine Medications > Flashcards

Endocrine Medications Flashcards

1
Q

what are the two types of hormones produced by endocrine system?

A

proteins/small peptides and steroids

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2
Q

what are the 7 endocrine glands

A

hypothalamus
pituitary
thyroid
parathyroid
adrenals
pancreas
ovaries or testis

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3
Q

what does the thyroid gland secrete?

A

secrete T3 and T4

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4
Q

what happens when the thyroid is stimulated

A

increase in cardiac output and O2 consumption

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5
Q

role of thyroid

A

metabolism

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6
Q

role of adrenal glands

A

regulate electrolytes, fluid volume

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7
Q

what is secreted by adrenal glands?

A

steroids

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8
Q

what is the role of the pancreas?

A

use of glucose

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9
Q

what is secreted by the pancreas?

A

insulin and digestive enzymes

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10
Q

8 side effects of hypothyroidism

A

lethargy
apathy
memory impairment
emotional changes
slow speech
dry skin
weight gain
cold intolerance

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11
Q

myxedema

A

very low thyroid levels

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12
Q

what would the labs of someone with hypothyroidism look like?

A

increased TSH hormone, low T3 and T4 levels

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13
Q

what is hyperthyroidism?

A

increase in T3 and T4

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14
Q

severe hyperthyroidism can cause___ and is an emergency

A

thyroid storm, vascular collapse

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15
Q

most common type of hyperthyroidism

A

Grave’s disease

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16
Q

7 side effects of hyperthyroidism

A

rapid pulse
palpitations
excessive perspiration
heat intolerance
weight loss
irritability
bulging eyes (exopthalmos)

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17
Q

what is the medication for hypothyroidism?

A

synthroid

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18
Q

what is Synthroid used for?

A

goiters
hypothyroidism
hashimoto (thyroiditis)

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19
Q

action of synthroid

A

increase levels of T3 and T4

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20
Q

7 side effects of synthroid

A

N/V
anorexia
diarrhea
H/A
weight loss
amenorrhea
tachycardia

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21
Q

when should synthroid be taken?

A

at the same time each day, on an EMPTY STOMACH (before breakfast)

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22
Q

important teaching regarding Synthroid

A

report symptoms of hyperthyroidism, report chest pain and rapid HR, wear alert bracelet

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23
Q

nursing considerations for synthroid

A

protein bound (interacts w/ several meds)
be careful w/ preexisting conditions (causes tachycardia)

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24
Q

what foods inhibit the thyroid and should be avoided with hypothyroidism

A

strawberries
peaches
pears
cabbage
kale
radishes
peas

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25
Q

what medications should be given for hyperthyroidism?

A

Tapazole
Propylthiouracil (PTU)
Iodine - potassium iodide (SSKI)

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26
Q

how does tapazole work

A

inhibits the synthesis of T3 and T4

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27
Q

how does PTU work

A

inhibits conversion of T4, T3

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28
Q

PTU may cause

A

severe liver damage, failure, death

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29
Q

who should not be given PTU

A

liver failure patients

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30
Q

what should be monitored with PTU

A

LFTs - AST and ALT

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31
Q

how does SSKI work?

A

reduce size and vascularity of thyroid

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32
Q

how is SSKI administered to PT.

A

Pt. must drink it through a straw

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33
Q

what does SSKI contain

A

iodine

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34
Q

dysfunctions of adrenal glands

A

cushing’s syndrome
Addison’s disease

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35
Q

what is Cushing’s Syndrome

A

adrenal hyper-secretion = body produces too much steroid

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36
Q

what can cause Cushing’s syndrome?

A

adrenal tumor or extended/long-term steroid use

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37
Q

S/S of adrenal hypersecretion

A

hyperglycemia
muscle wasting
moon face
buffalo hump
protruding abdomen
seizures
peptic ulcers
HTN
HF
cataracts
hypervolemia
hypernatremia
hypokalemia
increased RBCs
impaired clotting

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38
Q

what is Addison’s disease?

A

adrenal hyposecretion - not enough naturally occurring steroids

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39
Q

what is usually the cause of Addison’s disease

A

autoimmune

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40
Q

S/S of adrenal hypo secretion

A

hypoglycemia
muscle weakness
apathy
fatigue
N/V
tachycardia
hypovolemia
hyponatremia
hyperkalemia
anemia

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41
Q

what is used to treat adrenal hypersecretion

A

steroids

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42
Q

what is the action of steroids

A

suppress inflammation and adrenal function

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43
Q

6 side effects of steroids

A

hyperglycemia
moon face
HTN
psychosis
thin skin
peptic ulcer

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44
Q

teaching for steroids

A

must be tapered
watch for symptoms of hypokalemia

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45
Q

when should steroids be taken?

A

with meals

46
Q

what should the patient eat more of when taking steroids?

A

K+ foods

47
Q

what type of endocrine dysfunction is diabetes?

A

pancreas

48
Q

what are the symptoms of diabetes?

A

3 Ps:
polyuria
polydipsia
polyphagia

49
Q

what can diabetes lead to if not managed?

A

kidney failure
blindness
PAD
CAD
HTN
decreased wound healing
risk for infection

50
Q

S/S of hyperglycemia

A

thirst
increased urine output
sweet/fruity breath odor

51
Q

how is hyperglycemia treated?

A

insulin

52
Q

S/S of hypoglycemia

A

head ache
nervousness
sweating
tremors
rapid pulse
confusion

53
Q

how is hypoglycemia treated?

A

administer 10-15g simple carbs

54
Q

what type of diabetes does insulin treat

A

type 1

55
Q

2 side effects of insulin

A

insulin shock (increased HR, tremors, sweating)
hypoglycemia

56
Q

insulin injection sites should be _____

A

rotated

57
Q

stress can cause _____

A

hyperglycemia

58
Q

how do you store unopened insulin?

A

refrigerator

59
Q

5 types of insulin

A

rapid acting
short acting
intermediate acting
long acting
combination

60
Q

3 types of rapid acting insulin

A

Humalog
Novolog
Apidra

61
Q

onset of rapid acting insulin

A

5-15 mins

62
Q

when does rapid acting insulin peak

A

30 minutes - 3 hours

63
Q

how long does rapid acting insulin last

A

2-5 hours

64
Q

types of short acting insulin

A

regular insulin; Humulin R, Novolin R

65
Q

onset of short acting insulin

A

30 minutes -1 hour

66
Q

when does short acting insulin peak

A

2-4 hours

67
Q

how long does short acting insulin last

A

6-8 hours

68
Q

types of intermediate acting insulin

A

Humulin N
Novolin N

69
Q

onset of intermediate acting insulin

A

1-2 hours

70
Q

when does intermediate acting insulin peak?

A

6-12 hours

71
Q

how long does intermediate acting insulin last?

A

18-24 hours

72
Q

types of long lasting insulin

A

lantus

73
Q

what is the onset of lantus

A

1 hr

74
Q

what is the peak of lantus

A

more evenly distributed

75
Q

what is the duration of lantus

A

24 hours

76
Q

types of combination insulin

A

humulin 70/30

77
Q

oral antidiabetic agents for type II diabetes

A

sulfonylureas
biguanides

78
Q

action of sulfonylureas

A

stimulate beta cella to produce more insulin

79
Q

when should sulfonylureas be taken?

A

in the morning before breakfast

80
Q

who should you NOT give sulfonylureas to?

A

kidney or liver dysfunction pt.

81
Q

what should you teach a type II diabetic taking sulfonylureas?

A

balance diet
med alert bracelet
know signs of hyper and hypo glycemia

82
Q

what are some examples of sulfonylureas?

A

Glucotrol
DiaBeta
Amaryl

83
Q

what is an example of a biguanide?

A

metformin

84
Q

what is the action of biguanides?

A

decreases hepatic production of glucose from stored glycogen - diminishes increase in serum glucose following a meal

85
Q

what are the 6 side effects of biguanides (metformin)?

A

dizziness
fatigue
H/A
agitation
bitter, metalic taste
diarrhea

86
Q

what should you teach your patient regarding metformin?

A

hold for 48 hours before and after IV contrast or it will kill kidneys

87
Q

other type II diabetes medications

A

Sodium -Glucose Co transporter 2
Amylin Analogue
Glucagon-like Peptide-1 Agonists (GLP-1)

88
Q

what kind of medication is Invokana

A

sodium-glucose co transporter 2

89
Q

how does invokana work

A

works with kidneys to excrete glucose via urine

90
Q

what risk increases with invokana

A

UTIs

91
Q

invokana is pregnancy category ____

A

C

92
Q

Invokana should be combined with ____ and ____

A

exercise and diet

93
Q

3 side effects of Invokana

A

decreased BP
UTIs
electrolyte imbalance

94
Q

what should be monitored with invokana?

A

kidney function!!! monitor BUN and creatinine

95
Q

what type of medication is symlin

A

Amylin Analogue

96
Q

how does symlin work?

A

decreases post meal gucagon and glucose

97
Q

what does Symlin treat?

A

type I and type II diabetes, as adjunct to insulin therapy

98
Q

how and when should symlin be administered

A

SQ right before a meal

99
Q

where should you never administer Symlin

A

in the arm - interferes with absorption

100
Q

examples of GLP-1s

A

byetta, bydureon
trulicity
victozia

101
Q

how do GLP-1 work?

A

slows down glucose produced by liver

102
Q

what pregnancy category are GLP-1

A

C

103
Q

what can be 5 possible side effects caused by GLP-1

A

weight loss
dizziness
n/v
h/a
jittery

104
Q

GLP-1 are

A

prefilled injection pens

105
Q

what areas can be used as injection sites for trulicity or victozia

A

arm, thigh, abdomen

106
Q

how often are byetta and bydureon given

A

BID

107
Q

how often do you administer Victozia

A

SQ once a day

108
Q

How often is trulicity given

A

once a week

109
Q

what should you monitor for with GLP-1

A

thyroid C-cell tumors
pancreatitis

110
Q

who should you NOT give GLP-1 to

A

liver disease patient

Pharm (3 decks)

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