Insulins, Thyroids, Pituitary/Adrenal Flashcards
Rapid Acting Insulins
Aspart (Novolog)
Lispro (Humalog)
Glulisine (Apidra)
Intermediate Acting Insulins
Neutral Protamine Hagedorn (NPH)
Long Acting Insulins
Glargine (Lantus)
Detemir (Levemir)
Toujeo
Degludec (Tresiba)
Insulin Side Effects
Hypoglycemia
Weight Gain
Lipohypertrophy
Lipoatrophy
Insulin Injection Sites
Upper arms
Anterior/lateral aspects of the thigh
Buttocks
Abdomen (except 2 inch radius around navel)
Conditions that raise serum T4, T3 and TBG
Pregnancy
Infectious/chronic active hepatitis
HIV infection
Conditions that lower serum T3, T4 and TBG
Genetic factors
Acute and chronic illness
Glucocorticoids
Medications that affect thyroid function
Lithium
Iodine
Radiographic contract agents
Hypothyroid Drugs
Levothyroxine
Liothyronine
Thyroid USP (Armour Thyroid)
Drug Interactions with levothyroxine
Estrogens Ca, Mg, Fe Rifampin Amiodarone Iodine Coudamin Digoxin
Hypothyroid Drug ADRs
Palpitations
Insomnia
Nervousness
Hyperthyroid Drugs
Methimazole
Propylthiouracil
Beta blockers (propranolo, atenolol, metoprolol, nadolol)
Hyperthyroid Drugs ADRs
Rash
GI Upset
Arthalgias
HA
Treatment of Thyroid Storm
In order of effectiveness:
Propylthiouracil
Methimazole
Propranolol
Dopamine Agonists
Tx of Hyperprolactinemia
Cabergoline (Dostinex)
Bromocriptine (Parlodel)
Dopamine Agonists ADRs
Dizziness, HA, nausea
Acromegaly Treatment
Dopamine Agonists
Somatostatin analogues
GH receptor antagonists
Somatostatin Analogues
Acromegaly Tx Octreotide (Sandostatin) Lanreotide autogel (Somatuline)
Somatostatin Analogues ADRs
Diarrhea
Abd. cramps
Flatulence
GH Receptor Antagonist
Acromegaly Tx
Pegvisomant (Somatuline)
Pegvisomant ADRs
N/D, injection site pain
GH Deficiency Tx
Somatropin
Somatropin ADRs
Intracranial tumors, intracranial hypertension, diabetic retinopathy
ADH Deficiency (Diabetes Insipidus) Tx and ADRs
DDAVP (desmopressin)
ADRs: Nausea, HA, abd. cramps
Pheochromocytoma Tx and ADRs
Phenoxybenzamine (use while awaiting surgery)
ADRs: hypotensioin, tachycardia, erectile dysfunction
Adrenal Insufficiency Tx
Cortisol
Hypoparathyroidism Tx
Calcium Gluconate (IV) Vitamin D (Rocaltrol) Oral Calcium Calcitriol Thiazide diuretics Natpara
Calcium Gluconate ADRs
Hypoparathyroid (hypocalcemia) tx
Tingling, heat sensation, chalky taste
Calcitriol ADRs
Hypoparathyroid (hypocalcemia) tx
Hypercalcemia, hypercalciuria, vitamin D intoxication
Natpara ADRs
Hypoparathyroid (hypocalcemia) tx
N/V/D