Endocrine Medications Flashcards
1
Q
Oral hypoglycemic precautions (2)
A
- Use caution in patients with renal, cardiac, hepatic disorders
- Avoid during pregnancy and lactating
2
Q
Alpha-glucosidase inhibitor medications (2)
A
- Acarbose
- Miglitol
3
Q
Alpha-glucosidase inhibitor action
A
Slows carb absorption and digestion
4
Q
Alpha-glucosidase inhbitor precautions
A
- Not for patients with intestinal diseases due to increased gas formation
5
Q
Biguanides medications(1)
A
- Metformin
6
Q
Biguanides action
A
Reduces gluconeogenesis and makes muscle tissue more sensitive to insulin
7
Q
Biguanides precautions (2)
A
- Withhold 48 hours before/after test with contrast dye
- Not used in patients with severe infections, shock hypoxic conditions
8
Q
Gliptins medications (1)
A
- Sitagliptin
9
Q
Gliptins action
A
- Promotes release of insulin, lowers glucagon secretion, slows gastric emptying
10
Q
Gliptins precautions
A
- Caution in patients with impaired renal function
11
Q
Meglitinides medications (2)
A
- Repaglinide
- Nateglinide
12
Q
Meglitinides action
A
Stimulates beta cells to release insulin
13
Q
Meglitinides precautions (3)
A
- Short acting
- Give before each meal
- Risk of hypoglycemia
14
Q
Sulfonylureas medications (2)
A
- Glipizide
- Glyburide
15
Q
Sulfonylureas precautions (2)
A
- Very high risk of hypoglycemia in patients with renal, hepatic, adrenal disorders
- Can cause disulfiram like reaction with alcohol ingestion
16
Q
Thiazolidinediones medications (2)
A
- Rosiglitazone
- Pioglitazone
17
Q
Thiazolidinediones action
A
- Decrease cellular insulin resistance
18
Q
Thiazolidinediones precautions
A
- Can exacerbate heart failure
19
Q
Rapid acting insulin medication
A
Lispro
20
Q
Short acting insulin medication
A
Regular insulin
21
Q
Intermediate insulin
A
NPH
22
Q
Long acting insulin
A
Glargine
23
Q
Insulin precautions (4)
A
- When mixing regular with NPH, draw up regular first
- Don’t mix other insulins with lispro, glargine, combination 70/30
- Regular insulin only one given IV and only in normal saline
- Give glargine at bedtime
24
Q
Insulin side/adverse effects (2)
A
- Hypoglycemia/hyperglycemia
- Lipodystrophy
25
Insulin nursing interventions (2)
- Roll vial (except for regular) to mix
- Rotate injection sites to prevent lipodystrophy
26
Glycemic agent action
Initiates regulatory processes to promote breakdown of glycogen to glucose in the liver causing increased serum glucose levels
27
Glycemic agent medications
Glucagon
28
Therapeutic use of glycemic agents
- Emergency treatment of severe hypoglycemia
29
Precautions for glycemic agents
- Don't mix with sodium chloride or dextrose solutions
30
Side/adverse effects of glycemic agents (2)
- N/V
- Rebound hypoglycemia
31
Thyroid hormone action
Stimulates metabolism of all body systems by accelerating the rate of cellular oxygenation
32
Thyroid hormone medication
Levothyroxine/T4
33
Thyroid hormone therapeutic use (2)
- Hypothyroidism
- Emergency treatment of myxedema coma
34
Thyroid hormone precaution
Overmedicating can cause signs of hyperthyroidism
35
Side/adverse effects of thyroid hormone (7)
- Tachycardia
- Restlessness
- Diarrhea
- Weight loss
- Decreased bone density
- Heat intolerance
- Insomnia
36
Nursing interventions for thyroid hormone (4)
- Monitor cardiac system
- Start with low dose and increase as needed
- Monitor T4 and TSH levels
- Take early in the morning
37
Thyroid hormone antagonist action
Blocks synthesis of thyroid hormone
38
Thyroid hormone antagonist medication
Methimazole
39
Thyroid hormone antagonist therapeutic uses (4)
- Hyperthyroidism
- Preop thyroidectomy
- Thyrotoxic crisis
- Thyroid storm
40
Thyroid hormone antagonist precautions (3)
- Caution in patients with bone marrow depression, hepatic disease, bleeding disorders
- Stop before radioactive iodine uptake testing
- Don't take while breastfeeding
41
Thyroid hormone antagonist side/adverse effects (9)
- Skin rash, pruritus
- Abnormal hair loss
- GI upset
- paresthesias
- Periorbital edema
- Joint/muscle pain
- Jaundice
- Agranulocytosis
- Thrombocytopenia
42
Thyroid hormone antagonist nursing interventions (4)
- Give with food at same time everyday
- Increase fluids to 3L/day
- Avoid OTC containing iodine
- Taper dose if stopping
43
Anterior pituitary/growth hormones action
Increase production of insulin-like growth factor throughout the body
44
Anterior pituitary/growth hormones medication
Somatropin
45
Anterior pituitary/growth hormones therapeutic use (2)
- Treat growth hormone deficiencies
- Turner's syndrome
46
Anterior pituitary/growth hormones precautions (3)
- Not to be used in severely obese patients
- Can be discontinued before epiphyseal closure
- Don't use with glucocorticoids
47
Anterior pituitary/growth hormones side/adverse effects (2)
- Hyperglycemia
- Hypothyroidism
48
Anterior pituitary/growth hormones nursing interventions (3)
- Monitor growth patterns
- Reconstitute following manufacturers instructions
- Give subq per protocol
49
Posterior pituitary/antidiuretic hormones action
Promote reabsorption of water with the kidneys, vasoconstriction of vascular smooth muscle
50
Posterior pituitary/antidiuretic hormones medications (2)
- Desmopressin
- Vasopressin
51
Desmopressin routes (4)
- Oral
- Intranasal
- SubQ
- IV
52
Vasopressin routes (3)
- Intranasal
- SubQ
- IV
53
Posterior pituitary/antidiuretic hormones therapeutic uses (4)
- Diabetes insipidus
- Cardiac arrest
- Nocturnal enuresis
- Hemophilia (desmopressin)
54
Posterior pituitary/antidiuretic hormones precautions
- Not for patients with chronic nephritis or high risk for MI
55
Posterior pituitary/antidiuretic hormones side/adverse effects (3)
- Hyponatremia
- Seizures
- Coma
56
Posterior pituitary/antidiuretic hormones nursing interventions (3)
- Monitor urine specific gravity, bp, urinary output
- Prevent hyponatremia due to water intoxication
- Teach how to use nasal spray
57
Adrenal hormone replacement action
Anti-inflammatory, suppresses immune response
58
Adrenal hormone replacement medications (4)
- Dexamethasone
- Hydrocortisone sodium succinate
- Fludrocortisone acetate
- Prednisone
59
Adrenal hormone replacement therapeutic uses (2)
- Acute/chronic replacement for adrenocortical insufficiency (Addison'a disease)
- Inflammation, allergic reactions, cancer
60
Adrenal hormone replacement precautions (3)
- Not for patients with systemic fungal infections
- Use caution in patients with HTN, gastric ulcers, diabetes, osteoporosis
- Higher doses needed during acute illness or extreme stress
61
Adrenal hormone replacement side/adverse effects (6)
- Adrenal suppression when given for inflammation, allergic reactions
- Infection
- Hyperglycemia
- Osteoporosis
- GI bleeding
- Fluid retention
62
Adrenal hormone nursing interventions (5)
- Don't skip doses
- Monitor bp, fluid/electrolytes, weight, output, signs of bleeding, GI discomfort
- Take calcium supplements and maintain vitamin D levels
- Give with food
- Taper dose
- Provide immune protection
