Endocrine System Flashcards
Alpha-Glucosidase Inhibitors Examples
Acarbose
Miglitol
Alpha-Glucosidase Indications
Type 2 Diabetes (oral hypoglycemic)
Alpha-Glucosidase Precautions
contraindicated in clients with intestinal disease due to increased gas formation
Biguanides Examples
Metformin
Biguanides Indications
Type 2 Diabetes (oral hypoglycemic)
Biguanides Precautions
withhold 48 hr prior to and 48 hr after contrast media
contraindicated in clients with severe infection, shock, hypoxic conditions
Gliptins Examples
Sitagliptin
Gliptins Indications
Type 2 Diabetes (oral hypoglycemic)
Gliptins Precautions
use caution in impaired renal function as dose will be reduced
Oral Hypoglycemics Precautions
use caution in renal, hepatic, cardiac disorders
avoid during pregnancy/breastfeeding
Meglitinides Examples
repaglinide
nateglinide
Meglitinide Indications
Type 2 Diabetes (oral hypoglycemic)
Meglitinide Precautions
short acting
administer before each meal
risk of hypoglycemia
Sulfonylureas Examples
Glipizide
Glyburide
Sulfonylureas Indications
Type 2 Diabetes (oral hypoglycemic)
Sulfonylureas Precautions
Extreme high risk of hypoglycemia in clients with renal, hepatic, or adrenal disorders
can cause disulfiram-like reactions with alcohol ingestion
assess for sulfa allergy
Thiazolidinediones Examples
Rosiglitazone
Pioglitazone
Thiazolidinediones Indications
Type 2 Diabetes (oral hypoglycemic)
Thiazolidinediones Precautions
Exacerbation of heart failure
Oral Hypoglycemics Assessment
Teach signs and management of hypoglycemia, especially with sulfonylureas
Encourage diet and exercise
monitor HbA1C
refer to diabetic nurse educator
Rapid Acting Insulin Example
Lispro
Onset: 15-30 min
Peak: 0.5-2.5 hr
Duration: 3-6 hr
Short Acting Insulin Example
Regular Insulin
Onset: 0.5-1 hr
Peak: 1-5 hr
Duration: 6-10 hr
Intermediate Acting Insulin Example
NPH
Onset: 1-2 hr
Peak: 6-14 hr
Duration: 16-24 hr
Long Acting Insulin Example
Glargine
Onset: 1.5 hr
Peak: None
Duration: 24 hr
Insulin Indications
Type 1 diabetes
Type 2 diabetes
Gestational diabetes
Insulin Precautions
when mixing regular with NPH insulin, draw up regular insulin first
do not mix any insulin except regular or NPH
only regular insulin can be given IV
administer glargine at bedtime
Insulin Complications
hypoglycemia/hyperglycemia
Lipodystrophy
Insulin Administration
monitor serum glucose levels before meals and at bedtime
rotate injection sites to prevent lipodystrophy
teach signs and management of hypo/hyperglycemia
encourage diet and exercise
monitor HbA1C
refer to diabetic nurse educator
Levothyroxine Indications
hypothyroidism
emergency treatment of myxedema coma
Levothyroxine Precautions
overmedication can result in signs of hyperthryoidism
Levothyroxine Complications
tachycardia restlessness diarrhea weight loss decreased bone density heat intolerance insomnia
Levothyroxine Administration
Monitor cardiac system
initiate therapy with low doses, advanced to higher dosage while monitoring laboratory vitals
monitor T4 and TSH levels
take early in the morning
Methimazole Classification
Thyroid hormone antagonist
Levothyroxine Classification
Thyroid hormone
Methimazole Indications
hyperthyroidism
preoperative thyroidectomy
thyrotoxic crisis
thyroid storm
Methimazole Precautions
administer with caution to clients who have bone marrow depression, hepatic disease, bleeding disorders
discontinue prior to radioactive iodine uptake testing
contraindicated with breastfeeding
Methimazole Complications
rash, pruritus abnormal hair loss GI upset paresthesias periorbital edema joint and muscle pain jaundice agranulocytosis thrombocytopenia
Methimazole Administration
administer with food at the same time each day
increase fluids to 3L daily
avoid OTC products containing iodine
taper dose before discontinuing
monitor for therapeutic response: weight gain, decreased pulse, blood pressure, T4 levels
monitor for signs of overdose and signs of hypothyroid: periorbital edema, cold intolerance, mental depression
Somatropin Classification
Anterior Pituitary Growth Hormone
Somatropin Indications
treat growth hormone deficiencies
Turner’s syndrome
Somatropin Precautions
contraindicated in clients who are severely obese
therapy must be discontinued prior to epiphyseal closure
avoid concurrent use of glucocorticoids
Somatropin Complications
Hyperglycemia
Hypothyroidism
Somatropin Administration
monitor growth patterns
reconstitute medication per manufacturer instructions
administer subcutaneous per protocol
dose is individualized
Desmopressin Classification
posterior pituitary hormone
antidiuretic hormone
Vasopressin Classification
posterior pituitary hormone
antidiuretic hormone
Desmopressin Indications
diabetes insipidus
cardiac arrest
nocturnal enuresis
hemophilia
Vasopressin Indications
diabetes insipidus
cardiac arrest
nocturnal enuresis
Desmopressin Precautions
contraindicated with chronic nephritis or high risk for myocardial infarction
Vasopressin Precautions
contraindicated with chronic nephritis or high risk for myocardial infarction
Desmopressin Complications
hyponatremia
seizures
coma
Vasopressin Complications
hyponatremia
seizures
coma
Desmopressin Administration
monitor urine specific gravity monitor blood pressure monitor urine output prevent hyponatremia due to water intoxication education regarding use of nasal spray
Vasopressin Administration
monitor urine specific gravity monitor blood pressure monitor urine output prevent hyponatremia due to water intoxication education regarding use of nasal spray
Adrenal Hormone Examples
dexamethasone
hydrocotisone
fludrocortisone
prednisone
Adrenal Hormone Indications
acute and chronic replacement for adrenocortical insufficiency (Addison’s disease)
inflammation
allergic reactions
cancer
Adrenal Hormone Precautions
contraindicated in clients who have systemic fungal infection
caution in clients who have hypertension, gastric ulcers, diabetes, osteoporosis
requires higher doses in acute illness or extreme stress
Adrenal Hormones Complications
adrenal suppression when administered for inflammation, allergic reactions infection hyperglycemia osteoporosis GI bleeding fluid retention
Adrenal Hormones Administration
do not skip doses
monitor blood pressure
monitor fluid and electrolyte balance, weight, output
monitor for signs of bleeding and GI discomfort
take calcium supplements and maintain vitamin D levels
give with food
taper dose when discontinuing medication
provide immunoprotection