pharm: GH + ADH Flashcards
Thyroid Function
Acts like a car accelerator, increasing metabolism.
Hormone Regulation
Negative feedback mechanism prevents excessive hormone production.
Growth Hormone (GH) - Somatropin
Produced by the anterior pituitary, targets bone & skeletal muscle, promotes growth & protein synthesis, reduces glucose utilization (raises plasma glucose).
GH Deficiency - Effects
Childhood: Short stature. Adulthood: Reduced muscle mass.
GH Excess - Effects
Childhood: Gigantism (growth plates open, excessive height). Adulthood: Acromegaly (growth plates closed, abnormal tissue growth).
Conditions Treated with GH Therapy
Non-GH short stature, Turner’s syndrome, Prader-Willi syndrome, chronic renal insufficiency, cachexia, short-bowel syndrome, AIDS wasting syndrome.
Treatment for Excess GH
Gigantism: Pituitary gland removal. Acromegaly: Management strategies (e.g., surgery, medications).
Adverse Effects of Somatropin
Hyperglycemia (monitor in diabetics), neutralizing antibodies (can inactivate the drug).
Contraindications & Precautions for GH
Pregnancy/lactation (risk vs. benefit), obesity/severe respiratory impairment (esp. in Prader-Willi), diabetes, hypothyroidism (can worsen function), glucocorticoid use (suppresses growth).
Administration Guidelines for GH
IM or Sub-Q, reconstitute med gently (do not shake), check for particles/discoloration, give after 5 PM, rotate injection sites (abdomen & thighs).
Monitoring Requirements for GH
Baseline height & weight, growth patterns, glucose levels (esp. in diabetics), thyroid function, protein levels (for muscle growth).
Growth Hormone Antagonists (Octreotide, Lanreotide, Pegvisomant)
Suppress GH release, used when surgery/radiation is not possible.
Adverse Effects (General)
GI issues (nausea, diarrhea), injection site reactions, metabolic disturbances (hypo/hyperglycemia, liver injury).
What are the adverse effects of Octreotide?
GI (gallstones, nausea, cramps, diarrhea, flatulence, ileus), hypo-/hyperglycemia.
How is Octreotide administered?
IM, SQ, IV. Give without food or at bedtime (reduces nausea).
What are the drug interactions of Octreotide?
Antidysrhythmics, insulin.
What are the adverse effects of Lanreotide?
GI (gallstones, diarrhea), injection site reactions.
How is Lanreotide administered?
SQ.
What are the drug interactions of Lanreotide?
Bradycardia risk.
What are the adverse effects of Pegvisomant?
GI (nausea, diarrhea), liver injury, chest pain, flu-like symptoms.
How is Pegvisomant administered?
SQ.
What are the drug interactions of Pegvisomant?
Opioids.
Desmopressin (DDAVP) Administration
Oral, intranasal (for hemophilia nosebleeds), SQ, IV.
Nursing considerations with fluids for DDAVP
Reduce fluid intake to prevent water retention.
Cautions for ADH Use
CAD, decreased peripheral circulation, chronic nephritis/renal impairment (risk of excessive vasoconstriction).
ADH Interactions
Increased effect: Carbamazepine, TCAs. Decreased effect: EtOH, heparin, lithium, phenytoin.
Monitoring for ADH Therapy
BP, HR, daily weight, I&O, lung sounds (crackles = fluid overload), edema.
Labs to Monitor for ADH
Potassium, sodium, BUN, creatinine, specific gravity, osmolality.
AEs of DDAVP
Water intoxication
Sleepiness, pounding HA -> convulsions -> terminal coma
MI: Angina diaphoresis
Uses of ADH
DI, Nocturnal Enuresis (bed wetting), Hemophilia (release clotting factors)
In CPR used in high doses for more vasoconstriction
Simulate ADH
Promote reabsorption of water in the kidneys
How does ADH work
Maintains fluid homeostasis, increased osmolality of blood - more solutes than water -> release ADH so water reabsorb back into body -> osmolality decrease
