Endocrine System Flashcards
Endocrine System
Collection of glands that secrete hormones to regulate the functions of cell tissues and organs
Hormones
Chemical messages released in response to a change in the body’s internal environment to maintain body hemostasis
Negative Feedback
One hormone controls secretion of another hormone and the last hormone in the pathway provides feedback to turn off secretion of the first hormone
replacement therapy
Insufficient quantities of endogenous hormone a are produced
Ex: insulin in diabetes, or Synthroid in hypothyroidism
Cancer treatment
To shrink the size of hormone-sensitive tumors
EX: tamoxifen
Exaggerated response
Normal action of a hormone but exaggerated
EX: hydrocortisone to suppress inflammation
Anti-hormones
Block actions of endogenous hormones
EX: prpylthiouracli (PTU) in hyperthyroidism,
ADH
(Anti diuretic hormone)
ADD MORE
Causes the retention of fluid
DI is when you have too little AHD - lot of urine output
Too much ADH - very decreased and concentrated output (SIADH)
DDAVP
Desmopressin
Thera: Hormone
PharmL: ADH
Indications: diabetes insipidus, von Willebrands disease, bed wetting
MOA; acts on kidneys to rehab robs water, controls bleeding in certain clotting disorders
Adverse: Drowsiness, headache, symptoms of water intoxication (edema/weight gain, HTN, hyponatremia)
Indications: monitor i&o, fluid volume statues, specific gravity. Use with caution in clients with renal disease, hyponatremia. Available PO, intranasal, SC and IV piggyback
Thyroid Hormones
Thyroid affects basal metabolic rate- growth and development in kiddos
Triiodothyronine (T3) - more effective
Tetraiodothyronine (T4) - more produced
Hypothyroidism
Subnormal temp Bradycardia Weight gain Thickened skin Cardiac complication Extreme fatigue
Hyperthyroidism
Hot Weight loss Tachycardia Flushing Bulging eyes Tremors Diarrhea Localized edema
Levothyroxine (Synthroid)
Thera: Thyroid hormone replacement
Pharm: Thyroid hormone
Indications: Hypothyroidism
MOOA: Synthetic T4 increases metabolic rate of body tissues
Adverse: Symptoms of hyPERthyoidism (tachy, hot, anxiety, weight loss, etc)
Indications: Given on on empty stomach (30-60 before brekkie to prevent insomnia), narrow therapeutic range but long half life, given once per day and peaks 6-8 weeks. Many drug interactions. Use with caution in elderly with heart disease. Education patients that this is a life long therapy (does not cure). Monitor TSH levels
If hypo low T4 levels and high TSH levels
Methimazole (Tapazole)
Hyperthyroidism
Often used prior to thyroidectomy to radioactive iodine therap
Interfered with synthesis of T3 and T4
Adverse effect include symptoms of hyPOthyroidism, hepatotoxicity, bone marrow suppression
*Second line drug for hyPER is propylthiouracil
Adrenal Hormones
Glucocorticoids (cortisol) - sugar
Mineralocorticoids (aldosterone) - salt
Androgens/gonadocorticoids (testosterone) - sex
Glucocorticoids
ADD INSULIN SECTION
Ex: hydrocortisone, methylprednisolone, cortisone, prednisone, dexamethasone
Can be used to manage adrenal insufficiency (due to Addison’s disease, sudden withdrawal of corticosteroids or insufficient amounts in the critically ill)
Regular Insulin (Humulin R and Novolin R)
Thera: hormone drug for diabetes
Pharm: hypoglycemic
Indications: treatment of hyperglycemia, treatment of acute ketoacidosis, treatment of hyperkalemia (off-label)
MOA: short acting insulin to promote entry of glucose into cells
Adverse: hypoglycemia (tachy, confusion, sweating; coma/death if severe goes untreated), hypokalemia
Implications: Sc or IV. Only use insulin syringe, admin 30 min before meal
Metformin (glucophage)
Thera: antidiabetic
Pharm: biguanide
Indications: Type II diabetes (first line)
MOA: decreases hepatic production of glucose and reduces insulin resistance(benefit is that it does not cause hypoglycemia; also lowers triglyceride, LDL levels and promotes weight loss)
Adverse: N/V, diarrhea, abdominal bleeding, metallic taste
BLACK BOX: increased risk of lactic acidosis (may be fatal) with liver/renal disease, excess alcohol intake or serious infection
Implications: contraindicated with impaired renal function, heart failure, liver failure, serious infection. Must be held 2 before and 2 days after receiving IV contrast
Diabetes
Deficiency in insulin secretion or a decreased sensitivity of insulin receptors leading to elevated blood glucose levels (hyperglycemia)
Glucose
Major source of energy for the body
Insulin
Allows glucose to enter cells in order to be used for energy.
If insulin is not available to facilitate the entry of glucose into the cells, the body then metabolizes lipids as a source of energy leaving to a state of acidosis ~
HYPERglycemia
Blood glucose ~ 180
Thirst, hunger, frequent urination
HYPOglycemia
BG < 70mg/dL
Usually sudden onset
decreased LOC
Types of diabetes
Type I: Pancreas cannot secrete insulin. Patients are insulin dependent
Type II: Pancreas can secrete insulin but usually in small amounts; insulin receptors in target tissues are unreceptive
Gestational: Unknown but possible due to increased hormones from placenta blocking insulin.
