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pharmacology > pharm 2 > Flashcards

pharm 2 Flashcards

1
Q

Anterior Pituitary =

A

adenohypophysis

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2
Q

Posterior Pituitary =

A

neurohypophysis

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3
Q

“Master Gland” regulates _____

A

numerous vital processes.

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4
Q

Hormones regulate:

A
  • Growth, metabolism
  • Reproductive cycle
  • Electrolyte balance
  • Water retention or loss
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5
Q

posterior pituitary regulates

A

ADH

Oxytocin

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6
Q

example of ADH

A

vasopressin (Pitressin synthetic)

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7
Q

ADH function

A

Regulates reabsorption of water by the kidneys

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8
Q

ADH is secreted by pituitary when body ____

A

fluids must be conserved.

  • -Water reabsorbed into the blood
  • -Urine becomes concentrated
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9
Q

ADH treats-

A

Diabetes insipidus (failure to secrete vasopressin)

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10
Q

Vasopressin adverse reactions

A
  • Tremors, sweating
  • Nasal congestion
  • Nausea, vomiting, abdominal cramps
  • Water intoxication (toxicity, med. overdose)
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11
Q

vasopressin:

Use cautiously in individuals with

A

history of: asthma, seizures, migraines, heart failure or vascular disease.

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12
Q

Anterior pituitary regulates which hormones?

A
  • Prolactin
  • Lutenizing Hormone (LH)
  • Follicle-Stimulating Hormone (FSH)
  • Thyroid-Stimulating Hormone (TSH)
  • Adrenocorticotropic Hormone (ACTH, corticotropin)
  • Growth Hormone (GH)
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13
Q

Influence the gonads (reproductive organs)

A

Gonadotropins (LH and FSH)

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14
Q

Contributes to the growth of the body during childhood, mainly the muscles and bones

A

Growth Hormone (GH), also called Somatotropin

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15
Q

Stimulates the adrenal cortex to produce and secrete adrenocortical hormones, especially the glucocorticoids

A

Adrenocorticotropic Hormone (ACTH)

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16
Q

Stimulates the production of breast milk in the postpartum patient

A

Prolactin

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17
Q

(ACTH) Corticotropin used to test —

A

adrenocortical function.

  • Reactions may be multisystem (Display 43.2)
  • Report symptoms of infection
  • Monitor blood sugar
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18
Q

In response to ACTH, the adrenal cortex secretes:

A
  • Glucocorticoids (sugar)
  • Mineralcorticoids (salt)
  • Sex hormones (androgens)
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19
Q

the adrenal glands are located:

A

on top of each kidney. (outer cortex, inner medulla)

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20
Q

Glucocorticoids: Most prominent hormones

A

Hydrocortisone and cortisone

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21
Q

Glucocorticoid functions

A
  • Immune response
  • Regulation of glucose, fat, protein metabolism
  • Anti-inflammatory action
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22
Q

glucocorticoid examples

A

Prednisone, cortisone, hydrocortisone

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23
Q

glucocorticoid actions

A
  • Enter target cells and bind to receptor sites

- –Some outcomes are desirable and some are not which lead to the adverse reactions

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24
Q

glucocorticoids used to treat:

A
  • Adrenocortical insufficiency (replacement therapy)
  • Allergic reactions
  • Systematic lupus erythematosus
  • Dermatologic disorders
  • Rheumatic disorders
  • Shock
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25
Q

GLUCOCORTICOID ADVERSE REACTIONS: Fluid and electrolyte disturbances:

A

fluid and sodium retention, potassium loss, hypertension, hypocalcemia, shock

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26
Q

GLUCOCORTICOID ADVERSE REACTIONS: Musculoskeletal

A

muscle weakness, osteoporosis, fractures

27
Q

GLUCOCORTICOID ADVERSE REACTIONS:

Cardiovascular

A

thromboembolism, arrhythmias, CHF

28
Q

GLUCOCORTICOID ADVERSE REACTIONS: GI

A

abdominal distention, nausea/vomiting, increased appetite and weight gain

29
Q

GLUCOCORTICOID ADVERSE REACTIONS: Dermatologic

A

impaired wound healing, thin –fragile skin, bruising, increased sweating, itching

30
Q

GLUCOCORTICOID ADVERSE REACTIONS: Neurological

A

convulsions, headache, vertigo, paresthesias, insomnia

31
Q

GLUCOCORTICOID ADVERSE REACTIONS: Endocrine

A

amenorrhea, development of Cushings syndrome, increased s/s of diabetes

32
Q

Mineralocorticoids

A

Aldosterone and Deoxycorticosterone

33
Q
  • Conserves sodium and increases excretion of potassium
  • Controls salt and water balance
  • Aldosterone most potent
  • Deficiencies = loss of salt and water, and retention of potassium
A

Mineralocorticoids: Aldosterone and Deoxycorticosterone

34
Q

Mineralocorticoids adverse reactions most often occurs when —-

A

the dose is too high, prolonged use, and d/c too rapidly.

35
Q
  • Edema, hypertension, heart failure, enlargement of the heart
  • Increased sweating, allergic skin rash
  • Hypokalemia, muscular weakness, headache, hypersensitivity
A

Mineralocorticoids adverse reactions

36
Q

Admin of glucocorticoids (5-10) days can result in:

A

shutting off the pituitary’s release of ACTH (because of high levels in blood)

37
Q

acute adrenal insufficiency

A

can result in circulation collapse

38
Q

Abrupt discontinuation=

A

acute adrenal insufficiency

39
Q
  • Located in neck in front of trachea
  • Secretes two hormones:
  • -T4 (Thyroxine)
  • -T3 (Triiodothyronine)
A

Thyroid Gland

40
Q

____ is essential for manufacture of both T3 and T4

A

Iodine

41
Q

TSH (Thyroid Stimulating Hormone) regulates the

A

manufacture of T3 & T4 by the thyroid gland

42
Q

When the level of T3 and T4 in the blood is low,

A

the anterior pituitary gland secretes TSH which activates the cells of the thyroid to release stored T3 and T4

43
Q

-Decrease in the amount of thyroid hormones manufactured and secreted
Ex = Myxedema (severe)

A

Hypothyroidism

44
Q

-Increase in the amount of hormones manufactured and secreted
Ex = Grave’s disease, Tumors of thyroid

A

Hyperthyroidism

45
Q

Rx with thyroid Hormones

A

Hypothyroidism

46
Q
  • Rx with Antithyroid drugs and radioactive iodine

- Rx with thyroidectomy

A

Hyperthyroidism

47
Q

S&S Hypothyroidism

A
  • Decreased Metabolism
  • Intolerance to cold, low body temp.
  • Bradycardia, mod hypotension
  • Lethargy
  • Pale, cool dry skin, nails thick and hard
  • Heavy menses, low sperm count
48
Q

S&S Hyperthyroidism

A
  • Increased metabolism, increased appetite, elevated temp,
  • Weight loss despite increased appetite
  • Tachycardia, mod hypertension
  • Anxiety, nervousness
  • Flushed warm moist skin
  • Irregular or scant menses
49
Q
  • Influence every organ and tissue of body
  • Contains both natural and synthetic hormones
  • Primary goal: increase metabolic rate of tissues
  • Used as replacement therapy when patient is hypothyroid : attempt at creating a “Euthyroid” state
A

thyroid hormones

50
Q

Medication for Hypothyroidism

A

Levothyroxine (Synthroid) is the drug of choice

  • -Inexpensive
  • -Once a day dosage
  • -Uniform potency
51
Q

Thyroid hormone signs of therapeutic response:

A
  • Weight loss
  • Mild diuresis
  • Increased appetite
  • Sense of well being
  • Increase in mental activity
  • Decreased puffiness
52
Q
  • Vital Signs
  • Weigh patient
  • Observe for signs of therapeutic response
  • Monitor for hyperglycemia in the diabetic patient
  • Meds given once a day, early in morning before breakfast
  • Dose adjusted based on blood levels (thyroid function tests)
  • Monitor for signs of drug-induced hyperthyroidism
A

Nursing Process for Hypothyroidism

53
Q

Replacement therapy is for:

A

life

54
Q

take hypothyroid med ___

A

before breakfast in AM

55
Q

Treated by:

  • Anithyroid drugs
  • Iodine solutions
  • Thyroidectomy (partial or total)
A

Hyperthyroidism

56
Q

Does not affect existing thyroid hormones

  • Effect of meds may not be observed for 3-4 weeks
  • Tapazole and PTU (propylthiouracil)
  • May need surgery anyway
  • Meds will reduce vascularity of thyroid gland decreasing risk of intra and post up bleeding
A

antithyroid medication

57
Q

used because the thyroid gland has an affinity for iodine. Destroys hyperactive tissue without damaging cells outside thyroid gland

A

Radioactive Iodine –

58
Q

decrease the vascularity of the thyroid gland by rapidly inhibiting the release of the thyroid hormones

A

Iodine solution –

59
Q

decrease in the number of WBC’s (Neutrophils, basophils and eosinophils) = agranulocytosis

A

adverse reactions of tapazole and PTU

60
Q

Metallic taste in mouth, swelling of parotid gland, burning of mouth

A

adverse reactions of strong iodine solution

61
Q

sore throat, N,V, bone marrow depression

A

adverse reactions of radioactive iodine

62
Q

antithyroid meds nursing process

A
  • Obtain history of symptoms of hyperthyroidism
  • -Vital signs
  • -Weight
  • -Symptoms
  • If taking Iodine preparation, is patient allergic to iodine or seafood?
  • Fever, sore throat, easy bruising, signs of infections (relationship to decreased blood cells)
  • Assess for s/s of thyroid storm (thyrotoxicosis)
  • -High fever
  • -Extreme tachycardia
  • -Altered mental state
  • Monitor for difficulty swallowing large tablet
  • Iodine drops added to juice to disguise taste (drink through straw to prevent teeth staining
  • Observe for signs of hyperthyroidism
  • Help develop time schedule for q 8 hour doses.
63
Q

pt teaching for antithyroid meds

A
  • Take meds as directed
  • Notify provider of symptoms (sore throat, fever, bruising etc)
  • Record weight twice a week; notify MD for sudden weight gain or loss
  • Dilute iodine solution with juice

pharmacology (26 decks)

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