Endocrine System Flashcards
levothyroxine (Synthroid): Class
hydrothyroid treatment: Thyroid replacement
levothyroxine (Synthroid): other medication
liothyronine (Cytomel), liotrix (Thyroloar)
levothyroxine (Synthroid): Use
Hypothyroidism. Lifelong treatment
levothyroxine (Synthroid): EPA
synthetic T4 = increased metabolic rate
levothyroxine (Synthroid): ADR
s/sx hyperthyroidism, thyrotoxicosis
levothyroxine (Synthroid): RN interventions
- 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
What are the signs and symptoms of hyperthyroidism?
Rapid heart rate, palpitations, chest pain
Nervousness
Tremors
Decreased appetite
Heat intolerance, fever, sweating
Weight loss
levothyroxine (Synthroid): contraindication
- thyrotoxicosis or recent MI.
-MANY drug interactions.
-Food decreases absorption
propylthiouracil (PTU): classification
antithyroid drugs: thioamides
propylthiouracil (PTU): other medication
methimazole (Tapazole)
propylthiouracil (PTU): Use
Grave’s disease, thyrotoxicosis, suppression of thyroid hormone production prior to thyroidectomy
propylthiouracil (PTU): EPA
blocks iodine from integrating into tyrosine = blocks conversion of T4 into T3
propylthiouracil (PTU): administration
- PO at regular intervals. Q.8hrs. Do not discontinue abruptly.
- 3-12 weeks = euthyroid state, up to 12 months for stable hormone production.
propylthiouracil (PTU): ADR
s/sx of hypothyroidism. Agranulocytosis (PTU), aplastic anemia, hepatotoxicity. Rash. N/V. Arthralgia, HA, dizziness
propylthiouracil (PTU): RN Interventions
- 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
What are the signs and symptoms of hypothyroidism?
Fatigue, weakness
Weight gain
Cold intolerance
propylthiouracil (PTU): Contraindications
teratogenic. Caution in pt’s w/ immunosuppression/infections, liver dysfunction
desmopressin (DDAVP): class
posterior pituitary hormone drug
desmopressin (DDAVP): other medications
vasopressin (IV- short term)
desmopressin (DDAVP): use
diabetes insipidus
desmopressin (DDAVP): EPA
synthetic ADH (vasopressin)
desmopressin (DDAVP): ADRs
Think fluid retention - hyponatremia, edema. Seizures
desmopressin (DDAVP): RN Interventions
- 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
desmopressin (DDAVP): contraindication
renal failure, nephrogenic DI, electrolyte imbalances
hydrocortisone (cortef, Solu-Cortef): classification
glucocorticoids
hydrocortisone (cortef, Solu-Cortef): other medications
prednisone, dexamethasone
hydrocortisone (cortef, Solu-Cortef): Use
Addison’s disease/adrenal insufficiency. Autoimmune, inflammatory disorders, asthma.
hydrocortisone (cortef, Solu-Cortef): EPA
synthetic cortisol
hydrocortisone (cortef, Solu-Cortef): Administration
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
hydrocortisone (cortef, Solu-Cortef): ADRs
at low, replacement levels – minimal ADRs.
High levels = many ADRs
hydrocortisone (cortef, Solu-Cortef): RN Interventions
- 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
hydrocortisone (cortef, Solu-Cortef): contraindications
small doses = no contraindications, W/ larger doses interactions = oral contraceptives, phenytoin, phenobarbital, rifampin
fludrocortisone: class
Mineralocorticoids
What is fludrocortisone usually given with?
hydrocortisone
fludrocortisone: Use
Addison’s disease/adrenal insufficiency, primary hypoaldosteronism, congenital adrenal hyperplasia.
fludrocortisone: EPA
Synthetic aldosterone = Na+ and H20 retention
fludrocortisone: ADR
at low, replacement levels – minimal ADRs.
High levels = fluid & electrolyte imbalances
-> HTN, edema, HF, hypokalemia
fludrocortisone: RN interventions
- 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
