Endocrine System Flashcards
Aka hypophysis
Pituitary Gland
Location of pituitary gland
Base of brain next to hypothalamus
Anterior and posterior
Hormones that are secreted by the Anterior Pituitary Gland
GH, TSH, & ACTH
Deficit of GH
Dwarfism
Excess of GH
Gigantism (before maturation) or acromegaly (after maturation)
What disease can a child develop by taking GH
Diabetes
What route are GH drugs given?
Not PO
Excess of TSH
Hyperthyroidism
Deficit of TSH
Hypothyroidism
What organs are affected by excess/deficit of TSH?
All organs and tissues; changes are at a cellular level.
What hormone causes the release of corticoids by the adrenal gland?
Adrenocorticotropic Hormone (ACTH)
Excess or deficit of ACTH causes what?
Steroid excess or deficiency
What drug is used to determine whether a excess or deficit of corticoids release is a pituitary or an adrenal problem?
Corticotropin : Cortrosyn
The anterior pituitary gland is controlled by what?
Hypothalamus through releasing factors
Adjacent to the hypothalamus
Post. Pituitary
What acts as a storage reservoir for hormones from the hypothalamus?
Post. Pituitary
Hormones that are stored in the post. Pituitary?
ADH & Oxytocin
Deficit in ADH
Diabetes insipidus
Oxytocin does what?
Stimulates the uterine contraction
Drug therapy for post pituitary
Desmopressin, Lypressin, Vasopressin
What should you monitor for pts with post pituitary drug therapy?
Edema, weight gain, UOP, electrolytes and glucose.
What hormones are produced by the Thyroid Gland?
T3 and T4
What is required to produce thyroid hormone?
Iodine
Calcitonin is produced by the ___, and maintains ___ in the ___.
Thyroid, calcium, blood.
What hormone regulates the release of TSH, thyroid stimulating hormone?
TRH, thyrotropin releasing hormone
Which thyroid hormone is produced more?
T4
Which thyroid hormone has a very short half-life?
T4
T/F: T3 is 4x more active than T4
True
- Control the rate of cellular metabolism
- Influence the function of every cell in the body
- Control body temp, CO, blood volume, enzyme system activity, and growth and development.
Thyroid hormones
What can cause hypothyroidism?
Absence of thyroid gland, lack of iodine, tumor or autoimmune disease of thyroid, lack of TSH or TRH.
Hypothyroidism in children
Cretinism
Hypothyroidism in adults
Myxedema
Goiters are caused by?
Gland enlargement due to iodine deficiency.
T4 thyroid drugs
Levothyroxine (Synthroid)
Drug of choice for long-term tx.
T3 thyroid drugs
Cytomel: short duration, should not be given to cardiac pts.
T3 & T4 thyroid drugs
Euthroid, Thyrolar, Armour Thyroid
Do not give thyroid replacement drugs to pts with the following…
Narcotic Analgesia, Acute MI or cardiac problems, Lactation, on anticoagulants, digitalis, or theophylline.
When should Synthroid be taken?
First thing of the morning, on an empty stomach.
S/S of excess Synthroid include.
Tremors, tachycardia, nervousness, chest pain, excessive sweating
How long til Synthroid effects are felt?
1-3 wks
Pt teaching for thyroid replacement
Avoid OTC, take at the same time each day, med-alert bracelet.
Forms of hyperthyroidism
Graves’s disease, thyrotoxicosis
Antithyroid drugs that block production
Propylthiouracil (PTU) & Tapazole
Antithyroid drugs that destroy cells
Radioactive iodine (I 131)
I 131 is contraindicated with what?
Pregnancy
Antithyroid drugs that block function
High dose iodine solutions
Antithyroid drugs can cause what?
Agranulocytosis and goiter
Pt on antithyroid drugs will need to be on ___ for the rest of their life.
Thyroid replacement therapy
Parathyroid produces
PTH and calcium
Parathyroid dysfunction can cause what disease?
Paget’s Disease
PTH deficiency can cause…
Hypocalcemia, muscular irritability (spasms, dysrhythmias, convulsions, tetany)
To increase serum calcium
Increase calcium intake and absorption, decrease calcium excretion. (effect of corticosteroids)
Increase bone calcium
Vitamin D and Ca supplements, biphosphonates (prevent Ca release from bone)
Decrease serum Ca
Biphosphonates, calcitonin (blocks PTH effects), increase excretion (lasix), IV saline, corticosteroids.
Two glands above the kidneys
Adrenal glands
Cortex of adrenal glands produces
Corticosteroids
Medulla of adrenal glands produce
Epinephrine and norepinephrine
Corticosteroids promote ___ retention and ___ excretion.
Na, K
Excess of corticosteroids
Cushing’s syndrome
Deficiency of corticosteroids
Addison’s disease
What affects metabolism, sodium absorption, anti-inflammatory reactions, and anti-stress reactions?
Glucocorticoids
Often called cortisone drugs?
Glucocorticoids
Glucocorticoid short term tx for…
Inflammatory and allergic reactions
Glucocorticoid long-term tx for…
Organ transplant
Large doses of hydrocortisone (glucocorticoid) can mask the s/s of ___.
Infection
Serious side effects of glucocorticoids are?
Weight gain of fat around the face and trunk, peptic ulcers, decreased wound healing, capillary fragility, and mask signs of infection.
Mineralocorticoid (aldosterone) enhances Na ___ and K ____.
Retention, excretion
Relative or absolute lack of insulin
Diabetes mellitus
What are some serious s/s of diabetes mellitus?
Hyperglycemia, polyuria, polydipsia, polyphagia, hemoconcentration, hypervolemia, hyperviscosity, hypoperfusion, hypoxia, acidosis
Chronic complications of diabetes
CV disease, cerebrovascular disease, retinopathy, neuropathy, nephropathy, erectile dysfunction
Types of diabetes
Type 1 and 2, gestational, genetic defect of beta cells, disease of pancreas, chemically induced, infections.
Type 1 DM
Insulin-dependent DM
Beta cells of pancreas do not produce insulin.
Type 2 DM
Non-insulin-dependent DM
Not enough insulin produced, peripheral tissues become resistant to insulin
Which type of insulin is the only one that can be administered IV
Short-acting Regular
What factors affect absorption. Of insulin?
SQ site and depth
Too much insulin, too little food, or too much exercise can cause what?
Hypoglycemia
What is given to hypoglycemic pts who cannot take PO CHO, and why?
Glucagon, it stimulates the liver to break break glycogen into glucose.
Sulfonylureas are split up into how many generations?
First short-, intermediate-, and long-acting, and Second generations
Which generation of sulfonylureas are cheaper and have less side effects?
Second generation
What are the nonsulfonylureas?
Biguanides, Alpha-Glucosidase Inhibitors, TZDs/”Glitazones”, Meglitinides, Incretin Modifiers, Amylun Analog
Which nonsulfonylurea ⬇ liver glucose production, ⬆ muscle uptake, and ⬇ blood glucose. Hypoglycemia very rare
Biguanide (Metformin)
Nonsulfonylurea that blocks an enzyme in the small intestine causing a slower absorption of CHO, resulting in a less rise in blood glucose and insulin after eating?
Alpha-Glucosidase Inhibitors (Precose, Glyset)
Most expensive nonsulfonylurea. Under FDA review, takes 4-6 wks for effects.
TZDs “Glitazones” (Avandia, Actos)
Nonsulfonylurea that acts like sulfonylureas. Short-acting, cannot be used if pt has liver problems. Causes hypoglycemia and weight gain. (usually taken with Metformin)
Meglitinides (Prandin, Starlix)
Injectable-not an insulin. Signals pancreas to produce right amount of insulin after meals. Helps stop liver from producing too much sugar when not needed. Slows down rate at which sugar enters the bloodstream. Causes weight loss.
Incretin Modifiers, (Byetta, Victoza)
Nonsulfonylurea that decreases glucagon secretion and gastric emptying, decreases appetite.
Amylin Analog
Amylin Analog is given SQ but cannot be given in the ___. Why?
Arm, requires fatty tissue to distribute.
Most diabetics pts should also be taking _____.
Baby ASA, ACE inhibitors, and possibly statins.
What percentage of all medication errors in hospital settings involve insulins?
11%
Normal range for FBS?
70-110
What are some nursing interventions for diabetes pts?
Insulin admin-timing, oral hypoglycemic admin-timing, food intake, med-alert bracelet, check blood sugar before exercising, teaching drug interactions.
