Ex 3 Thyroid disorders/adrenal Flashcards
Function of thyroid hormones
regulates metabolic rate of all cells
regulates body heat poduction
maintains growth hormone secretion and skeletal maturation
affects CNS development
maintains cardiac rate,force,output
maintains secretion of GI tract
affects respiratory tae and oxygen use
affects RBC producton
causes of hypothyroidism
gland malfunction, pituitary tumor, removal of gland, iodine deficinecy
s/sx of hypothyroidism
sluggish, tired, poor memory, dry skin, birttle hair and nails, bradycardia, constipation, heavy menses, cold intolerant, weight gain
levothyroxine (synthroid) MOA
synthetic T4 converted to T3 to hypothyroidism
levothyroxine (synthroid) Pharmacokinetics
oral or IV (mcg)
food interferes with absorption esp. calcium
very highly protein bound = long T1/2
safe in pregnancy
levothyroxine (synthroid) adv side effects
overdose is thyrotoxic crisis
levothyroxine (synthroid) pt. education
take early AM on empty stomach
generic/brand consistency
regular lab monitoring
report thyrotoxic symptoms
Hyperthyroidism causes:
graves disease, toxic nodular goiter
hyperthyroidism s/sx
revved up, anxious, poor concentration, hungry, tachycardia, chest pain, hyper defecation, irregular to no menses, heat intolerance, weight loss
methimazole & propylthiouracil (PTU) MOA:
treats hyperthyroidism
- thionamides
- inhibit thyroid hormone synthesis
PTU also suppresses conversion of T4to T3 in the body
short or long term use
methimazole & propylthiouracil (PTU) pharmacokinetics
PO
slow onset of fects
methimazole has longer T1/2
PTU preferred in pregnancy
methimazole & propylthiouracil (PTU) adv. effects
methimazole is teratogenic
too much can cause hypothyroidism
methimazole & propylthiouracil (PTU) pt education
frequent lab monitoring required
adrenal cortex function
maintain glucose availability (glucocorticoids)
- cortisol
corticosteroids protoypes
hydrocortisone or prednisone
hydrocortisone or prednisone administration
Oral, IV,IM, rectal, topical
hydrocortisone or prednisone absorption
well-absorbed orally
hydrocortisone or prednisone metabolism
liver
hydrocortisone or prednisone excretion
urine
Glucocorticoids physiological levels risk of adverse effects
minimmal:
- glucose for the brain
- protein metabolism
- fat metabolism
- keeps BP in check
- maintains blood cells
Glucocorticoids pharmalogical levels risk of adverse effects
higher risk
treats:
allergic rxns
lung conditions
inflammation
dermatologic conditions
Addison’s disease aka Adrenal insufficinecy
not enough hormone
chronic adrenocorticoid insufficiency
requires lifelong supplementation with glucocorticoid
needs extra steroid dose during times of physical stress
Glucocorticoids pharmacological levels adverse effects
- at higher and longer doses
hyperglycemia
muslce atrophy
fat redistribution
fluid retention
adrenal suppression
osteoperosis
growth retardation
peptic ulcers
Managing adverse effects of glucocorticoids: hyperglycemia
focus on diet and exercise