Endocrine pharm - E3 Flashcards
what class is Aminoglutethimide
Adrenal corticosteroid inhibitor
Adrenal corticosteroid inhibitor MOA
Blocks synthesis of all adrenal steroids
Aminoglutethimide indications
Temporary therapy to decrease cortisol production
Aminoglutethimide SE
Drowsiness
Nausea
Anorexia
Rash
Aminoglutethimide nursing considerations
Usually do not use longer than 3 months -> does not treat anything just manages
what class is ketoconazole
anti fungal
anti fungal MOA
Antifungal that also inhibits glucocorticoid synthesis
ketoconazole indication
Adjunct therapy to surgery or radiation for cushing syndrome
ketoconazole nursing consideration
Can become very toxic to the liver-> do not drink
Cannot take during pregnancy bc can cause fetal thyroid damage
ketoconazole SE
severe liver damage
what class is Phenoxybenzamine HCL
alpha blockers
alpha blockers MOA
Long lasting, irreversible blockage of alpha adrenergic receptors
Phenoxybenzamine HCL indication
Pheochromocytoma
Phenoxybenzamine HCL SE
Lowers BP
Orthostatic hypotension
Reflex tachycardia
Nasal congestion
Sexual side effects in men
Phenoxybenzamine HCL nursing considerations
smooth muscle relaxer so lower BP
what class is Demeclocycline
Tetracycline broad spectrum antibiotic
Tetracycline broad spectrum abx MOA
Interferes w/ renal response to ADH
Demeclocycline indications
Treatment of chronic SIADH
Demeclocycline SE
Photosensitivity
Teeth staining
Nephrotoxic
Demeclocycline nursing considerations
Not first line treatment, try to restrict fluids firsts
can also give loop diuretics but only if Na is >125
what class is Desmopressin [DDAVP]
Antidiuretic hormone
Antidiuretic hormone MOA
Synthetic ADH replacement -> gives anti diuretic effects
Desmopressin [DDAVP] indications
Treatment for neurogenic DI
Desmopressin [DDAVP] SE
Small dose: none
Nasal spray: nasal irritation
Large doses: hyponatremia, water intoxication
Desmopressin [DDAVP] nursing considerations
Cannot be used for nephrogenic DI bc ADH doesn’t have an effect on the kidneys
what class is Levothyroxine
T4 synthetic thyroid hormone
T4 synthetic thyroid hormone MOA
Converts to T3 in the body
Levothyroxine indication
Treatment for hypothyroidism
Levothyroxine SE
If dose too high: hyperthyroid symptom
If dose too low: hypothyroid symptom
Levothyroxine nursing considerations
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
drug therapy for Addison’s Disease
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
when should a person w/ Addison’s take their steroids
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)
when a person w/ Addison’s disease is in a stressed state, what do they need to do with their medications
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
to avoid an addisonian crisis, what should you never do
never abruptly stop drug therapy
main teaching point for people with Addison’s disease
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
