Endocrine pharm - E3

Question 1

what class is Aminoglutethimide

Answer 1

Adrenal corticosteroid inhibitor

Question 2

Adrenal corticosteroid inhibitor MOA

Answer 2

Blocks synthesis of all adrenal steroids

Question 3

Aminoglutethimide indications

Answer 3

Temporary therapy to decrease cortisol production

Question 4

Aminoglutethimide SE

Answer 4

Drowsiness
Nausea
Anorexia
Rash

Question 5

Aminoglutethimide nursing considerations

Answer 5

Usually do not use longer than 3 months -> does not treat anything just manages

Question 6

what class is ketoconazole

Answer 6

anti fungal

Question 7

anti fungal MOA

Answer 7

Antifungal that also inhibits glucocorticoid synthesis

Question 8

ketoconazole indication

Answer 8

Adjunct therapy to surgery or radiation for cushing syndrome

Question 9

ketoconazole nursing consideration

Answer 9

Can become very toxic to the liver-> do not drink

Cannot take during pregnancy bc can cause fetal thyroid damage

Question 10

ketoconazole SE

Answer 10

severe liver damage

Question 11

what class is Phenoxybenzamine HCL

Answer 11

alpha blockers

Question 12

alpha blockers MOA

Answer 12

Long lasting, irreversible blockage of alpha adrenergic receptors

Question 13

Phenoxybenzamine HCL indication

Answer 13

Pheochromocytoma

Question 14

Phenoxybenzamine HCL SE

Answer 14

Lowers BP
Orthostatic hypotension
Reflex tachycardia
Nasal congestion
Sexual side effects in men

Question 15

Phenoxybenzamine HCL nursing considerations

Answer 15

smooth muscle relaxer so lower BP

Question 16

what class is Demeclocycline

Answer 16

Tetracycline broad spectrum antibiotic

Question 17

Tetracycline broad spectrum abx MOA

Answer 17

Interferes w/ renal response to ADH

Question 18

Demeclocycline indications

Answer 18

Treatment of chronic SIADH

Question 19

Demeclocycline SE

Answer 19

Photosensitivity
Teeth staining
Nephrotoxic

Question 20

Demeclocycline nursing considerations

Answer 20

Not first line treatment, try to restrict fluids firsts
can also give loop diuretics but only if Na is >125

Question 21

what class is Desmopressin [DDAVP]

Answer 21

Antidiuretic hormone

Question 22

Antidiuretic hormone MOA

Answer 22

Synthetic ADH replacement -> gives anti diuretic effects

Question 23

Desmopressin [DDAVP] indications

Answer 23

Treatment for neurogenic DI

Question 24

Desmopressin [DDAVP] SE

Answer 24

Small dose: none
Nasal spray: nasal irritation
Large doses: hyponatremia, water intoxication

Question 25

Desmopressin [DDAVP] nursing considerations

Answer 25

Cannot be used for nephrogenic DI bc ADH doesn’t have an effect on the kidneys

Question 26

what class is Levothyroxine

Answer 26

T4 synthetic thyroid hormone

Question 27

T4 synthetic thyroid hormone MOA

Answer 27

Converts to T3 in the body

Question 28

Levothyroxine indication

Answer 28

Treatment for hypothyroidism

Question 29

Levothyroxine SE

Answer 29

If dose too high: hyperthyroid symptom If dose too low: hypothyroid symptom

Question 30

Levothyroxine nursing considerations

Answer 30

long half life -> stay steady between doses but **takes a month for effects to kick in** take on an empty stomach **increases risk of bleeding if pt is on warfarin** taken for life

Question 31

drug therapy for Addison's Disease

Answer 31

life long corticosteroid replacement -all get glucocorticoid (drug of choice is **hydrocortisone** bc has min + glu but could be prednisone or dexamethasone paired w/ fludrocortisone) **give as small of dose as possible**

Question 32

when should a person w/ Addison's take their steroids

Answer 32

take all at bedtime because that is when our body naturally produces cortisol (but some dr divide the dose to 2/3 in the morning & 1/3 at night)

Question 33

when a person w/ Addison's disease is in a stressed state, what do they need to do with their medications

Answer 33

**must** increase glucocorticoid dose -> failure to do so can be fatal bc a healthy body naturally increases glucocorticoid in response to stress so these people need to do the same (ex: illness or surgery) **3x3 rule**

Question 34

to avoid an addisonian crisis, what should you never do

Answer 34

never abruptly stop drug therapy

Question 35

main teaching point for people with Addison's disease

Answer 35

must carry extra meds on them at all times and they have to have an injectable preparation plus an oral preparation & they should wear a medical bracelet