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Oral Medications > Endocrine Medications > Flashcards

Endocrine Medications Flashcards

1
Q

Endocrine system:

A
  • consists of ductless glands
  • produces hormones that regulate and control metabolic activities maintaining homeostasis
  • digestion
  • growth and development
  • electrolyte and water metabolism
  • reproductive functions
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2
Q

Major endocrine glands:

A
  • Pineal
  • Adrenal
  • Hypothalamus
  • Thymus
  • Pituitary
  • Pancreas
  • Thyroid
  • Gonads
  • Parathyroid
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3
Q

Glands:

A

Gland - group of cells that produce and secrete chemicals in response to a stimulus
Exocrine gland - releases secretions in the skin or inside the mouth vid ducts. e.g. sweat and salivary glands
Endocrine gland - releases more than 20 major hormones directly into the bloodstream, where they can be transported to cells in other parts of the body. e.g. Pituitary, Thyroid, Pancreas

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4
Q

Endocrine medications include:

A
  • Anti-diabetic agents - hypoglycemics
  • Thyroid and anti-thyroid agents
  • Calcium regulating agents
  • Hormone therapy
  • Contraceptives
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5
Q

Diabetes Mellitus Mx:

A
  • Multi-system disease
  • caused by absence deficiency or inactivity of insulin
    Signs and symptoms include:
  • elevated BGL
  • glycosuria
  • polyuria and loss of minerals
  • thirst and polydipsia
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6
Q

Glucose metabolism:

A
  • regulated by pancreas
  • BGL rises - following food
  • insulin released by the pancreas
  • insulin stimulated cells to take in glucose from the bloodstream
  • glucose is converted to glycogen/fat for storage and used for energy
  • this results in a normal BGL
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7
Q

Types of diabetes:

A

Type 1 Diabetes Mellitus: T1DM
- insulin dependent
- autoimmune disorder
- no insulin production
Type 2 Diabetes Mellitus: T2DM
- 30% become insulin dependent
Gestational Diabetes Mellitus: GDM
- during pregnancy

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8
Q

Insulin deficiency:

A
  • insulin reduces blood glucose levels by facilitating glucose uptake by muscle and connective tissues
  • influences protein and fat metabolism
  • diabetes mellitus affects how the body metabolises carbohydrates, proteins and fats
  • insulin deficiency is characterised by an imbalance between required and available amounts of insulin
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9
Q

Treatment of T2DM:

A

Oral Hypoglycaemic Agents (OHAs)
- Sulphonylureas
- Biguanides (Metformin)
- Thiazolidinediones (Gitazones)
- Post-prandial glucose regulators

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10
Q

Adverse effects of OHAs:

A
  • weight gain
  • oedema
  • nausea
  • hypoglycaemia
  • GIT upset
  • allergic skin reaction
  • bone marrow depression
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11
Q

Hypoglycaemia:

A
  • not eating enough at meals, skipping meals
  • insulin excess
  • stress or anxiety
  • drugs - alcohol, beta blockers, high dose aspirin
  • CNS - dizziness, faintness, tremors, sweating, agitation, convulsion, coma
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12
Q

Managment of Hypoglycaemia:

A

immediate treatment is required as patients can lose consciousness quickly.
- glycose, complex carbohydrates
- slow IV glucose
- IM, S/C, IV glucagon if severe

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13
Q

Nursing considerations of OHAs:

A
  • regular BGL monitoring
  • consider drugs that can interact with oral hypoglycaemics
  • administer with food to minimise hypoglycaemia
  • long-acting agents should be avoided
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14
Q

Hyperthyroidism:

A

signs and symptoms:
- tachycardia
- hyperactivity
- anxiety
- moist skin
- weight loss
- increased appetite
- pyrexia

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15
Q

Hypothyroidism:

A

signs and symptoms:
- bradycardia
-hypopyrexia
- hypoactivity
- fatigue
- hair loss
- dry skin
- weight gain
- poor memory

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16
Q

Anti-thyroid medications:

A

Carbimazole (Neo-Mercazole)
- blocks production of thyroid hormone
- high dose first then decreased for maintenance
Sodium iodide:
- reduces the production of thyroid hormone by destroying thyroid cells
- short term use in patients who have high surgical risk

17
Q

Thyroid medications:

A
  • treatment relies on replacement of the missing hormone.
    Thyroxine - slow onset but long acting
  • adverse effects - tremor, headache, tachycardia, GIT disturbance, weight loss, insomnia
18
Q

Thyroxine (Oroxine, Eutroxsig) nursing considerations:

A
  • monitor heart rate and rhythm
  • therapy is life-long
  • takes 3-4 weeks of therapeutic effect
  • reduce effect of digoxin
19
Q

Hormone replacement therapy (HRT):

A
  • oral, injectable or topical (transdermal, intranasal, or vaginal)
  • avoid first pass effect permitting lower dose
    Adverse effects:
  • breast tenderness
  • fluid retention
  • headaches
  • GIT disturbances
  • break-through bleeding
  • risk of breath and uterine cancer
    Nursing considerations:
  • apply skin patches to clean, dry skin
  • rotate skin to reduce irritation
20
Q

Osteoporosis:

A
  • reduction in bone mass that occurs with aging, especially in post-menopausal women
  • risk reduced by diet, adequate calcium intake, HRT, physical activity
  • drug use is to prevent fractures and associated morbidity in people with low bone density or history of fracture
21
Q

Corticosteroid indications:

A
  • replacement therapy in corticosteroid deficiency (Addison’s disease)
  • anti-inflammatory in asthma, rheumatoid arthritis, cerebral oedema, allergies
  • immunosuppressant in organ transplant and neoplastic disease
22
Q

Corticosteroid actions:

A
  • increase gluconeogenesis (generation of glucose)
  • depress inflammatory and allergic response
  • delayed healing
  • increase fat storage in face, shoulders, abdomen
  • retains sodium
  • causes euphoria
23
Q

Adverse effects for corticosteroids:

A
  • sodium/fluid retention
  • hypertension
  • muscle wasting, weakness, osteoporosis, tendon rupture
  • hiccups, nausea, vomiting, anorexia, indigestion
  • depression, psychosis, mood swings, nervousness, insomnia
  • delayed wound healing, increased bruising, acne
24
Q

Corticosteroids nursing considerations:

A

monitor for:
- mood changes
- hyperglycaemia
- hypertension
- signs of infection
- weight changes indicative of fluid retention

25
Q

Patient education about corticosteroids:

A
  • patient should not drink alcohol, NSAIDs and aspirin
  • low sodium diet
  • good intake of protein to avoid muscle wasting
  • antacid to reduce GIT upsets
  • don’t stop taking medication without medical advice

Oral Medications (13 decks)

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