pituitary Flashcards
what makes up the neuroendocrine sysyem
the hypothalamus and pituitary system
(govern all body systems)
what is the main goal of the endocrine system
maintenance of physiologoc stability
every cell and organ in the body comes into contact with what system
endocrine system (communicates with nearly 50 million target cells in the body)
how does the endocrine system communicate with target cells in the body
with hormones
____: large groups of natural substances that cause highly specific physiologic effects in the cells of their target tissues
hormones
the _____ controls the pituitary gland
CNS/hypothalamus
(function together but primary direction comes from the hypothalamus)
the CNS and hypothalamus are both signaling systems that operate in a ___ pattern
stimulus-response
hormones secreted by the anterior lobe of the pituitary gland
- growth hormone
- TSH
- adrenocorticotropic hormone (ACTH)
- prolactin
- gonadotropic hormones (FSH, LH)
hormones secreted by the posterior lobe of the pituitary gland
- vasopressin (antidiuretic hormone, ADH)
- oxytocin
ACTH
targets adrenal gland (adrenal cortex); mediates adaptation to physical and emotional stress and starvation; redistributes body nutrients, promotes synthesis of adrenocortical hormones; involved in skin pigmentation
FSH (follicle-stimulating hormone)
stimulates oogenesis and follicular growth in females and spermatogenesis in males
(testis and ovary)
GH (growth hormone)
regulates anabolic processes related to growth and adaptation to stressors; promotes skeletal and muscle growth; increases protein synthesis; increases liver glycogenolysis; increases fat mobilization
(protein synthesis in all cells)
LH (luteinizing hormone)
stimulates ovulation and estrogen release by ovaries in females; stimulates interstitial cells in males to promote spermatogenesis and testosterone secretion
prolactin
targets mammary glands; stimulates lactogenesis and breast growth in females
TSH
stimulates secretion of thyroid hormones T3 and T4 by the thyroid gland
ADH
increases water reabsorption in distal tubules and collecting ducts of nephron; concentrates urine; causes potent vasoconstriction
oxytocin
targets mammary glands; stimulates ejection of milk and contraction of uterine smooth muscle
name three anterior pituitary drugs
cosyntropin, somatropin, octreotide
____: used in the diagnosis of adrenocortical insufficiency
cosyntropin
_____: human GH produced by recombinant technology
somatropin
somatropin is used for wasting associated with what
HIV
somatropin is effective in ______ in patients with inadequate secretion of normal endogenous GH
(treatment of growth failure resulting from inadequate endogenous GH secretion)
stimulating skeletal growth
what routes can somatropin be given
SQ or IM
(important NOT to shake product)
______is useful in alleviating certain symptoms of carcinoid tumors stemming from the secretion of VIP
octreotide
name symptoms of carcinoid tumors that octreotide can alleviate
severe diarrhea, flushing, potentially life-threatening hypotension associated with carcinoid crisis
octreotide can be used for the treatment of what
esophageal varices
octreotide may affect glucose regulation and cause what
severe hypoglycemia in patients with type I diabetes or hyperglycemia in patients with type II diabetes or patients without diabetes
octreotide can enhance toxic effects of what drugs
drugs that prolong the OT interval
what routes can octreotide be given
IV, IM, SQ
name two posterior pituitary drugs
vasopressin and desmopressin
both vasopressin and desmopressin can be used to prevent or control what
POLYDIPSIA (excessive thirst), polyuria, dehydration in pts with DI caused by a deficiency in ADH
______: used to control various types of bleeding (GI hemorrhage) and in pulseless arrest and vasodilatory shock
vasopressin
vasopressin should be used with caution in patients with what disorders
seizure disorder, asthma, cardiovascular disease, renal disease
IV infiltration of vasopressin can lead to what
vasoconstriction and localized tissue necrosis
what routes can vasopressin be given
nasal, IM, IV
when being used for septic shock how must vasopressin be given
continuous IV infusion
how must vasopressin be taken nasally
applied topically to nasal membranes and must NOT be inhaled
______: used for the treatment of hemophilia A and type I von willebrand disease (because of effects on various blood-clotting factors)
desmopressin
desmopressin is available as ____ and had an antidiuretic effect that is about one-tenth that of an equivalent dose given intravenously
DDAVP Rhinal tube
what should be assessed and documented prior to giving any pituitary drug
height, weight, vital signs
what tests may be ordered before the use of octreotide
- ECG (bc of possible adverse effect of conduction abnormalities)
- baseline glucose levels, liver and kidney function tests
what health histories should be watched for with the use of desmopressin
seizures, asthma, cardiovascular disease
what should be monitored with the use of desmopressin
neurologic status, vital signs, breath sounds, heart sounds
what must be monitored with the use of vasopressin for shock
- monitor in and ICU setting with and ECG, vital signs, invasive monitoring (art lines, central lines, arterial blood gases)
what should be obtained and monitored while using GHs
baseline thyroid, glucose, calcium levels
potential side effects of GHs
hyperglycemia, hypothyroidism, hypercalciuria
the use of somatropin requires attention to what of a pediatric patient
growth, motor skills, height, weight
how should desmopressin be mixed
mix injectable solution by gently swirling the liquid using only clear solutions
name some adverse effects of vasopressin
elevated blood pressure, fever, nausea, abdominal cramping
therapeutic response of octreotide
improved symptoms related to carcinoid tumors, VIPoma, or esophageal varices
therapeutic effects of vasopressin
improvement in DI, esophageal varices, vasodilatory shock
therapeutic effects of somatropin
increased growth
adverse effects of somatropin
headache, hyperglycemia, hypothyroidism, hypercalciuria, flulike syndrome
adverse effects of desmopressin and vasopressin
increased blood pressure, fever, headache, abdominal cramps, nausea
