Endocrine - Pituitary + Adrenal Disorders Flashcards
Types of Pituitary Disorders
1 Growth Hormone [GH] Deficiency
2 Diabetes Insipidus [DI]
3 Adrenal Insufficiency
Growth Hormone[GH]
- released by ANT.pituitary gland
- stim growth of bones + tissues
GH Deficiency
s/s
aka dwarfism, or pituitary dwarfism
-short stature w normal body proportions
GH Deficiency
Tx
somatropin
soma=body
tropin=growth
somatropin
MOA
replacement hormone
somatropin
CI
- severely obese
- sleep apnea
somatropin
indications
- deficiency
- AIDS wasting
- cachexia (dramatic loss of skeletal muscle)
*somatropin
A/E
- HYPERglycemia incr blood sugar
- renal calculi/kidney stones/nephrolatisis
- —decr UO w norm BUN/Cr - check stones or BPH
somatropin
interactions
concurrent corticosteroids can inactivate
*somatropin
admin
- IM or subQ
- reconstitute (roll to mix)
*somatropin
RN/teaching
- adjust insulin
- monitor flank pain
- drink plenty of fluid
- rotate injection sites
Diabetes Insipidus [DI]
-excessive urination due to ADH deficiency
Diabetes Insipidus [DI]
Tx
vasopressin or desmopressin
vasopressin + desmopressin
MOA
hormone replacement
*vasopressin + desmopressin
CI
- CAD
- MI
- Angina
- -monitor EKG
vasopressin + desmopressin
indication
- DI
- low BP
- nocturnal enuresis
- CPR
vasopressin + desmopressin
A/E
- constricts coronary arteries
- water intoxication
- decr periph circulation
*vasopressin + desmopressin
interactions
***lithium
vasopressin + desmopressin
admin
- subQ + IM
- intranasal
- starts w bedtime doses
vasopressin + desmopressin
RN/teaching
monitor:
- serum Na
- I+O
- urine SG
- EKG + BP
Adrenal insufficiency
aka Addison’s Disease
-adrenal cortex doesn’t make enough cortisol (helps respond to stress)
Cortisol
- incr blood glucose
- regulates metab
- salt water balance
- memory formation
Adrenal insufficiency
aka Addison’s Disease
Tx
glucocorticoid (steroid hormones)
glucocorticoids
drug names
1 hydrocortisone
2 dexamethasone
3 prednisone
glucocorticoids
[hydrocortisone, dexamethasone, prednisone]
MOA
replacement
glucocorticoids
[hydrocortisone, dexamethasone, prednisone]
CI
active infections
steroids decr immune system
glucocorticoids
[hydrocortisone, dexamethasone, prednisone]
indications
- Addison’s disease
- tons of inflammatory disorders
- **allergies (v common)
**glucocorticoids
[hydrocortisone, dexamethasone, prednisone]
A/E
- HYPERglycemia
- decr immune
- wt gain
- hypo-K
- osteoporosis
- adrenal suppression
- HTN
- edema
- infection
- Cushing syndrome (too much cortisol)
glucocorticoids
[hydrocortisone, dexamethasone, prednisone]
interactions
vaccines, diuretics, NSAIDs, APAP, ETOH>GI bleed
**glucocorticoids
[hydrocortisone, dexamethasone, prednisone]
admin
- must adjust insulin
- taper off/don’t stop abruptly
- prevent infection (stay away fr sick ppl, report cough)
- take Ca, vit D, wt bearing exercise (4 osteoperosis)
- monitor for weakness + low BP
- monitor for tarry stools
med is PO in AM
glucocorticoids
[hydrocortisone, dexamethasone, prednisone]
RN/teaching
- times of stress, incr dose
- must adjust insulin
- taper off/don’t stop abruptly
- prevent infection (stay away fr sick ppl, report cough)
- take Ca, vit D, wt beating exercise (for osteoporosis)
- monitor for weakness + low BP
- monitor for tarry stools
