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d-nursing pharmacology > in class corticosteroids > Flashcards

in class corticosteroids Flashcards

1
Q

ENDOCRINE SYSTEM FUNCTION

works off of

A

Chemical messengers tell the glands when to release hormones

Works off a feedback loop

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2
Q

adrenal cortex hormones and effects

A

aldosterone-increases blood na level

cortisol-increases blood sugar level

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3
Q

adrenal medulla hormone and effect

A

epinephrin and norepineherin

stimulates fight or flight

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4
Q

pancreas hormone and effect

A

insulin Reduces blood glucose level

Glucagon Increases blood glucose level

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5
Q

thyroid hormone and effect

A

Thyroxine (T4) & Triiodothyronine (T3) Stimulates basal metabolic rate

Calcitonin Reduces blood Ca+ level

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6
Q

hormone pharmacotherapy is given when

A

When the body can’t produce enough

To shrink hormone-sensitive tumors

Produce an exaggerated response

Block the action of hormones

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7
Q

who runs endocrine system

A

hypothalamus

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8
Q

ADRENOCORTICOTROPIC
HORMONE (ACTH
ant pituitary gland

A

Targets the adrenal gland to release cortisol

Regulates BP, sugar, immune system & stress response

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9
Q

THYROID-STIMULATING (TSH)
ant pituitary gland

A

Targets the thyroid

Stimulates the thyroid to release T3/T4

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10
Q

PROLACTIN ant pituitary gland

A

Targets the mammary gland

Promotes milk production

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11
Q

FOLLICLE-STIMULATING
HORMONE (FSH)
ant pituitary gland

A

Targets the ovaries

Promotes ovulation

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12
Q

LEUTENIZING HORMONE (LH)
ant pituitary gland

A

Targets the ovaries (women)
Targets the testes (men)

Promotes ovulation
Produces testosteron

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13
Q

GROWTH HORMONE
ant pituitary gland

A

Targets nearly every cell in the body

Stimulates growth & metabolism

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14
Q

oxytocin
post pit gland

A

Targets the uterine smooth muscle

Promotes uterine contraction in labor

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15
Q

ANTI-DIURETIC
HORMONE (ADH
post pit gland

A

Acts on collecting ducts of the kidneys

Increases water reabsorption (deficiency can cause DI)

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16
Q

adrenal cortex
secretes
use
regulates

A

secretes steroids

LONG-TERM stress adaptation

Regulates stress response, blood pressure, blood volume, nutrient uptake & storage, fluid & electrolyte balance, inflammation

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17
Q

adrenal medulla
secretes
mediatedby

A

Secretes epinephrine & norepinephrine

SHORT-TERM stress adaptation

Mediated by the Sympathetic Nervous System (SNS)

18
Q

pancreas

A

Secretes Glucagon using glycogenolysis & gluconeogenesis, raising blood glucose levels

Secretes Insulin to promote the uptake of glucose into skeletal and adipose body cells & liver to produce glycogen, lowering blood glucose levels

19
Q

thyroid
secretes
required
sensitivity
regultes

A

Secretes calcitonin, decreasing calcium levels in blood

Required for protein synthesis and fetal/childhood development and tissue growth

Increases sensitivity to Epi/NorEpi, affecting heart

Regulates basal metabolic rate

20
Q

Type I Diabetes

A

Autoimmune disease impacting beta cells of the pancreas

Beta cells DO NOT produce insulin

Irreversible but treatable

Treat with synthetic insulin

Cannot use oral medications

21
Q

Type II Diabetes

A

Acquired

Body cells become resistant to the effects of insulin

Results from poor diet and inactivity

Reversable & preventable with weight loss, physical activity, and a healthy diet

Treat with oral medications first

May need insulin if uncontrolled or hositalized

22
Q

Hypoglycemia
s/s
risks
treatment

A

s/s: Hunger, shakiness, fatigue, sweaty, clammy/pale skin, headache & dizziness

Blood glucose < 70 or Severe <40

Risks: Use of Beta-Blockers & exercise

Treatment: 15/15 rule, Dextrose 50% IV, or Glucagon pen

23
Q

hyperglycemia

s/s
what puts you at risk
complications
treatments

A

s/s: Polyuria, polydipsia, polyphagia, weight loss, fatigue, non-healing wounds, blurred vision

Blood glucose > 130 (2 separate occasions)

Risks: Stress, infection, steroid use

Complications: Heart disease, stroke, amputations, neuropathy, nephropathy, retinopathy

Treatment: Insulin & exercise/activity

24
Q

DKA

s/s
what puts you at risk
complicaitions
treatment

A

s/s: Blurred vision, fruity breath, Kussmaul’s respirations, flushed/dry/warm skin

Risks: Glucose > 300, stress, infection, steroid use, poorly managed diabetes

Complications: Coma and death

Treatment: Hospitalization (fluids/insulin IV)

25
Q

Hypothyroidism

cause
s/s
treatment

A

Cause: Inflammation of thyroid gland

S/S: Low Metabolic Rate, weight gain, cold extremities, constipation, reduced libido, menstrual irregularities, reduced mental activity

Treatment: Levothyroxine…. FOREVER

26
Q

Hyperthyroidism
cause
s/s
treatment

A

Cause: Pituitary or thyroid tumor, Graves Disease, Enlarged thyroid (goiter)

S/S: Increased Metabolic Rate, weight loss, excessive body heat, sweating, diarrhea, tremors/nervousness, increased heart rate/palpitations, exophthalmos

Treatment: Radioactive Iodine (RAI), Thyroid Surgery, Propylthiouracil (PTU) all followed by Levothyroxine… FOREVER

27
Q

Corticosteroids
useage
causes
stop

A

Available oral, IV, topical

Used for a variety of reasons (suppress inflammation)

Comes with great effects but great risks

Can cause adrenal suppression, hyperglycemia, cardiovascular disease (weight gain), bone pain, bruising, poor wound healing and immunosuppression

Never stop abruptly (HPA suppression)

28
Q

Insulin Pen

A

individually used

Ready for administration

Can be self-administered

Increases safety with insulin administration

Less prep time required

Reduces medicine waste

Not commonly used due to cost

29
Q

Insulin Pump

A

Provides precise dose of insulin based on blood glucose

Can pair with continuous glucose monitor

Patient must count carbohydrates

Patient may need to readjust dosing with increased activity

Easier to handle sick days

30
Q

Rapid-Acting Insulin (Lispro/aspart
given
appearance
dosage
opd

A

Given 15 minutes before meals or with meals

Appears clear and colorless
Dose depends on carbohydrate intake, glucose levels or anticipated activities

May be given as a basal rate and/or sliding scale

Onset 15-30 minutes
Peak 1-3 hours
Duration 3-5 hours

31
Q

Short-Acting Insulin (Regular

A

Administered with meals

Individualized based on carb intake, premeal glucose levels, and anticipated activity

Should be given 30 minutes of eating to avoid hypoglycemia

Can be given IV – THE ONLY ONE!!!

Onset 30 min
Peak 3 hours
Duration 8 hours

32
Q

Intermediate-Acting Insulin

A

Given once or twice daily

Appears white and cloudy

Gently roll or invert to resuspend insulin

Can be mixed with short or rapid-acting insulin

Draw up cloudy-clear-clear-cloudy

Onset 1-2 hours
Peak 6 hours
Duration Up to 24 hours

33
Q

Long-Acting Insulin (Glargine)

A

Usually given once daily

Appears clear and colorless

CANNOT be mixed with other insulins

Given subcutaneous

Onset 3-4 hours
Peak None
Duration > 24 hours

34
Q

Glucagon Pen

A

Increases blood glucose concentration rapidly

Treatment for severe hypoglycemia

Available SubQ, IM, IV, or PO

Given if patient is unable to swallow

Peak: 13-20 minutes after injection

35
Q

Sulfonylurea (Glipizide)
stimulates
causes
peak
s/e

A

Stimulates the release of insulin and increases sensitivity at receptor cells

Taken at the same time each day

Can cause disulfiram-like reaction – No alcohol

Peak: 1-3 hours after 1st dose

S/E: Weight gain and hypoglycemia

36
Q

Biguanide (Metformin)
contraidicated/stop
casues
eat
s/e

A

Contraindicated in patient’s with kidney disease

Stop immediately with s/s of lactic acidosis

Hold/stop if having a radiologic study using iodine

Can cause metallic taste in the mouth

Does NOT produce hypoglycemia

Take at the same time each day

Eat a healthy diet and incorporate exercise

S/E: N/V, diarrhea, weakness, flatulence, indigestion, abdominal discomfort, headache

37
Q

DPP-IV Inhibitor (Sitagliptin)
increases
take
stop
s/e

A

Increases insulin production and decreases hepatic glucose overproduction

Take at the same time each day (with or without food)

Stop with hypersensitivity

S/E: Hypoglycemia

38
Q

Levothyroxine
what is
take w/@
monitor
s/e

A

Synthetic T4 that is taken FOREVER

Take with full glass of water and 30 min before breakfast or 4 hours before/after drugs that interfere with absorption (antacids, iron, calcium)

Take at the same time each day

Monitor serum thyroid closelyand weight

S/E: Overtreatment = hyperthyroidism, drug-to-drug interactions

39
Q

Propylthiouracil (PTU)
used
given
notify
s/e

A

Used to treat hyperthyroidism in preparation for thyroidectomy or RAI

Given every 8 hours

Notify PCP if you become pregnant

S/E: Hypothyroidism, liver failure, agranulocytosis, vasculitis, and fetal harm

40
Q

Radioactive Iodine (RAI)

A

Given in pill or liquid form to destroy the thyroid gland and thyroid cancer cells

Harmful to pregnant women and small children

Patients must sleep in separate beds

Flush toilet 2-3 times daily

Cover cough/sneeze with Kleenex

S/E: Hypothyroidism (will need Levothyroxine after treatment)

d-nursing pharmacology (14 decks)

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