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Pharmacology Exam #3 > Endocrine System > Flashcards

Endocrine System Flashcards

1
Q

levothyroxine (Synthroid): Class

A

hydrothyroid treatment: Thyroid replacement

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2
Q

levothyroxine (Synthroid): other medication

A

liothyronine (Cytomel), liotrix (Thyroloar)

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3
Q

levothyroxine (Synthroid): Use

A

Hypothyroidism. Lifelong treatment

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4
Q

levothyroxine (Synthroid): EPA

A

synthetic T4 = increased metabolic rate

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5
Q

levothyroxine (Synthroid): ADR

A

s/sx hyperthyroidism, thyrotoxicosis

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6
Q

levothyroxine (Synthroid): RN interventions

A
  • Monitor T3, T4, TSH levels
  • Measure baseline VS & weight – then periodically
  • Monitor for and educate pt on s/sx of hyperthyroidism
  • take on am empty stomach, 30 minutes before a meal
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7
Q

What are the signs and symptoms of hyperthyroidism?

A

Rapid heart rate, palpitations, chest pain
Nervousness
Tremors
Decreased appetite
Heat intolerance, fever, sweating
Weight loss

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8
Q

levothyroxine (Synthroid): contraindication

A
  • thyrotoxicosis or recent MI.
    -MANY drug interactions.
    -Food decreases absorption
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9
Q

propylthiouracil (PTU): classification

A

antithyroid drugs: thioamides

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10
Q

propylthiouracil (PTU): other medication

A

methimazole (Tapazole)

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11
Q

propylthiouracil (PTU): Use

A

Grave’s disease, thyrotoxicosis, suppression of thyroid hormone production prior to thyroidectomy

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12
Q

propylthiouracil (PTU): EPA

A

blocks iodine from integrating into tyrosine = blocks conversion of T4 into T3

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13
Q

propylthiouracil (PTU): administration

A
  • PO at regular intervals. Q.8hrs. Do not discontinue abruptly.
  • 3-12 weeks = euthyroid state, up to 12 months for stable hormone production.
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14
Q

propylthiouracil (PTU): ADR

A

s/sx of hypothyroidism. Agranulocytosis (PTU), aplastic anemia, hepatotoxicity. Rash. N/V. Arthralgia, HA, dizziness

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15
Q

propylthiouracil (PTU): RN Interventions

A
  • Monitor T3, T4, TSH
  • Baseline VS & weight – monitor periodically
  • Monitor for & educate client on s/sx hypothyroidism
  • Monitor CBC – baseline & periodically (Would see decreased leukocytes/neutrophils)
  • Client should report fever, sore throat.
  • Monitor for rash, joint/muscle pain
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16
Q

What are the signs and symptoms of hypothyroidism?

A

Fatigue, weakness
Weight gain
Cold intolerance

17
Q

propylthiouracil (PTU): Contraindications

A

teratogenic. Caution in pt’s w/ immunosuppression/infections, liver dysfunction

18
Q

desmopressin (DDAVP): class

A

posterior pituitary hormone drug

19
Q

desmopressin (DDAVP): other medications

A

vasopressin (IV- short term)

20
Q

desmopressin (DDAVP): use

A

diabetes insipidus

21
Q

desmopressin (DDAVP): EPA

A

synthetic ADH (vasopressin)

22
Q

desmopressin (DDAVP): ADRs

A

Think fluid retention - hyponatremia, edema. Seizures

23
Q

desmopressin (DDAVP): RN Interventions

A
  • Monitor for s/sx of H2O intoxication = HA, AMS/confusion, etc. -> educate pt on s/sx
  • Decrease PO H20 intake
  • Strict intake and output measuring
  • Monitor serum Na+ levels
24
Q

desmopressin (DDAVP): contraindication

A

renal failure, nephrogenic DI, electrolyte imbalances

25
Q

hydrocortisone (cortef, Solu-Cortef): classification

A

glucocorticoids

26
Q

hydrocortisone (cortef, Solu-Cortef): other medications

A

prednisone, dexamethasone

27
Q

hydrocortisone (cortef, Solu-Cortef): Use

A

Addison’s disease/adrenal insufficiency. Autoimmune, inflammatory disorders, asthma.

28
Q

hydrocortisone (cortef, Solu-Cortef): EPA

A

synthetic cortisol

29
Q

hydrocortisone (cortef, Solu-Cortef): Administration

A

PO w/ meals to decrease GI upset. Ideally take full dose in AM - if PM fatigue give in divided doses, IV - in acute/emergent setting

30
Q

hydrocortisone (cortef, Solu-Cortef): ADRs

A

at low, replacement levels – minimal ADRs.
High levels = many ADRs

31
Q

hydrocortisone (cortef, Solu-Cortef): RN Interventions

A
  • Monitor labs @ baseline & periodically (CBC, Electrolytes, Glucose, Glucocorticoid levels)
  • May need supplemental doses in times of physiological or emotional stress
  • Client needs to wear a medical alert bracelet and carry supply of glucocorticoids
  • Instruct client to call provider if signs of infection & prior to vaccines
32
Q

hydrocortisone (cortef, Solu-Cortef): contraindications

A

small doses = no contraindications, W/ larger doses interactions = oral contraceptives, phenytoin, phenobarbital, rifampin

33
Q

fludrocortisone: class

A

Mineralocorticoids

34
Q

What is fludrocortisone usually given with?

A

hydrocortisone

35
Q

fludrocortisone: Use

A

Addison’s disease/adrenal insufficiency, primary hypoaldosteronism, congenital adrenal hyperplasia.

36
Q

fludrocortisone: EPA

A

Synthetic aldosterone = Na+ and H20 retention

37
Q

fludrocortisone: ADR

A

at low, replacement levels – minimal ADRs.
High levels = fluid & electrolyte imbalances
-> HTN, edema, HF, hypokalemia

38
Q

fludrocortisone: RN interventions

A
  • Monitor for adverse effects related to fluid retention – daily weight
  • Monitor BP
  • Monitor K+ levels, watch for s/sx of hypokalemia
  • Monitor for s/sx of inadequate dosage: weight loss, poor appetite, fatigue, muscle weakness, hypotension

Pharmacology Exam #3 (10 decks)

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