Pituitary And Adrenocortical Hormones Flashcards
Adrenal insufficiency
Diminished adrenal gland production resulting in a deficiency in corticosteroids
Anovulatory
A menstrual cycle in which ovulation doesn’t occur
Cryptorchism
Failure of the testes to descend into the scrotum
Cushingoid
Group of symptoms (including moon face, Buffalo hump), because of the disease caused by the overproduction of endogenous glucocorticoids
Diabetes insipidus
Disease caused by failure of the pituitary gland to secrete vasopressin or by surgical removal of the pituitary
Feedback mechanism
Method used by glands to signal need for or cessation of hormonal production
Gonads
Glands responsible for sexual activity and characteristics
Hirsutism
Excess growth of facial and body hair in women
Hyperstimulation syndrome
Sudden ovarian enlargement caused by overstimulation
Vasopressin MOA
Regulate the reabsorption of water by the kidneys. Exhibits its greatest activity on the renal tubular epithelium, also has some vasopressor activity
Vasopressin use
Treating diabetes insipidus, preventing and treating abdominal distention and for dispelling gas interfering with abdominal roentgenography
Diabetes insipidus signs
Marked increase in urination, excessive thirst
Vasopressin side effects
Tremor, sweating, vertigo, nasal congestion, nausea, vomiting, abdominal cramps, water intoxication (overdose and toxicity)
Vasopressin precautions
History of seizures, migraine headaches, asthma, heart failure, vascular disease, and perioperative polyuria, pregnancy (cat C)
Desmopressin acetate precautions
Pregnancy (cat B), lactation, typically used when diabetes insipidus occurs during pregnancy
Vasopressin interactions
Decreased effect of vasopressin with norepinephrine, lithium, oral anticoagulants, and increased vasopressin effect with carbamazepine, and chlorpropamide
Symptoms of water intoxicating
Drowsiness, listlessness, confusion, headache (which can precede convulsions and coma)
Hormones of the anterior pituitary
Thyroid timulating hormone (TSH), adrenocorticotropic hormone (ACTH), luteinizing hormone (LH), follicle stimulating hormone (FSH), growth hormone (GH), and prolactin
ACTH MOA
Stimulates the adrenal cortex to secrete the corticosteroids in response to biologic stress
FSH and LH MOA
Called gonadotropins, influence the gonads
GH MOA
Aka somatropin, and contributes to the growth of the body during childhood, especially the growth of muscles and bones
Prolactin MOA
Stimulates the production of breast milk (not used medically)
Gonadotropine MOA
Extracted form the urine of postmenopausal women, or produced by a recombinant form of DNA
Gonadotropins use
Índice ovulation and pregnancy in anovulatory women
Menopur use
Stimulate multiple follicles for IVF
Human chorionic gonadotropin (HCG) use
Used in boys to treat cryptorchism, and in men to treat hypogonadotropic hypogonadism
Follitism AQ use
Induce sperm production
Clomiphene use
Cause the anterior pituitary hormone to increase secretion of FSH and LH, used to índice ovulation in anovulatory women
Ganirelix use
Cause pituitary to increase secretion of FSH and LH, and are used to induce ovulation of anovulatory women
Gonadotropins side effects
Vasomotor flushes, breast tenderness, abdominal discomfort, ovarian enlargement, hemoperitoneum, nausea, vomiting, headache, irritability, restlessness, fatigue, irritation at injection site
Gonadotropins contraindications
Pregnancy, (cat X), high gonadotropin levels, thyroid dysfunction, adrenal dysfunction, liver disease, abnormal bleeding, ovarian cysts, sex hormone dependent tumors, or people with an organic intracranial lesion
Gonadotropins precautions
Epilepsy, migraines, asthma, cardiac or renal dysfunction, and lactation
Signs of excessive ovarian enlargement
Abdominal distention, pain, ascites
Gonadotropins: discontinue if
Visual disturbances, or signs of excessive ovarian enlargement
GH use
Given to children who haven’t grown because if a growth hormone deficiency, and must be used before the closure of the child’s bone epiphyses, and are also used in adults to supplement to lack of endogenous hormone
GH is ineffective in..
people with closed epiphyses,
Serostim use
Patients with HIV to stop severe muscle wasting
GH side effects
Few, but antibodies may develop, resulting in failure to experience a response to therapy. Some may experiment hypothyroidism or insulin resistance or swelling, joint pain, and muscle pain
GH contraindications
Allergy to benzoyl alcoho,, and those with epiphyseal closure or underlying cranial lesion
GH precautions
Thyroid disease, or diabetes, and pregnancy (cat C) and lactation
GH interactions
Excessive glucocorticoids can decrease response to GH
Corticosteroids include
Glucocorticoids and mineralocorticoids
Glucocorticoids MOA
Enter target cells and bind to receptors, initiating many complex reactions (anti inflammatory, regulation of blood pressure, metabolism of carbs and protein, metabolism of fat, interference with the immune response, protection during stress, and CNS responses)
Glucocorticoids ex
Hydrocortisone, prednisone, triamcinolone
Glucocorticoids use
Adrenocortical insufficiency, allergic reactions, collagen diseases (systemic lupus erythematosus), dermatologic conditions, rheumatic disorders, shock, endocrine disorders, ophthalmic disease, respiratory diseases, hematologic disorders, neoplastic diseases, edematous diseases, GI diseases, and nervous system disorders
Glucocorticoids side effects
Many of the signs and symptoms seen with Cushing syndrome, which include, buffalo hump, moon face, oily skin, acne, osteoporosis, purple striae on the abdomen and hips, skin pigmentation and weight gain, also include fluid and electrolyte disturbances, musculoskeletal disturbances, cardiovascular disturbances, GI disturbances, neurological disturbances, and endocrine disturbances, ophthalmic disturbances, metabolic disorders
Glucocorticoids contraindications
Serious infections, (TB, and fungal and antibiotic resistant infections), live virus vaccines will increase any side effects to the vaccine
Glucocorticoids precautions
Renal or hepatic disease, hypothyroidism, ulcerative colitis, diverticulitis, peptic ulcer disease, inflammatory bowel disease, hypertension, osteoporosis, convulsive disorders, and diabetes, and pregnancy (cat
C) and lactation
Hydorcortisone interactions
Cholestyramine will decrease hydrocortisone effects
Corticosteroids interactions
Oral contraceptives, estrogens, and ketoconazole increase effects of corticosteroids, and hydantoins and rifampin decrease effects of corticosteroids, anticholinesterwse effects may be antagonized in myasthenia gravis, anticoagulant doses may have to be reduced, and action will be decreased, increased risk of digoxin toxicity associated with hypokalemia, decreased isoniazid serum levels, hypokalemia with potassium sparing diuretics, reduced effectiveness and reduces serum levels of salicylates, and alterations in the activity of theophylline
Mineralocorticoids use
Controlling salt and water balance,
Mineralocorticoids ex
fludrocortisone (Drug)
Fludrocortisone use
Replacement therapy for primary and adrenocortical deficiency
Fludrocortisone side effects
Edema, hypertension, HF, hear enlargement, increased sweating, allergic skin rash, hypokalemia, muscular weakness, headache, allergic reactions. Reactions can occur of dose is too high, too prolonged, or if withdrawal is too fast
Fludrocortisone contraindications
Systemic fungal infections
Fludrocortisone precautions
Addison disease, during pregnancy (cat C), lactation
Fludrocortisone interactions
Decreased effects of hydantoins and rifampin, decrease in serum levels of salicylates
Corticosteroids elderly considerations
Administered with caution, because they se more likely to have ore existing conditions (HF, hypertension, osteoporosis, arthritis) that can be worsened by drugs
Glucocorticoids discontinuation considerations
Always taper off, (over 7-10 days)
Posterior pituitary hormones ex
Desmopressin, vasopressin
Gonadotropins: ovarian stimulants ex
Choriogonadotropin, gonadotropin
Gonadotropin releasing hormones/synthetics ex
Nafarelin
Gonadotropin releasing hormone antagonists
Cetrorelix, ganirelix
Nonsteroidal ovarian stimulant ex
Clomiphene
Growth hormone and hormone inhibitors ex
Somatropin, octreotide
Adrenocorticotropic hormone ex
Adrenocorticotropic hormone, cosyntropin
Glucocorticoids ex
Betamethasone, budesonide, cortisone, dexamethasone, hydrocortisone, methylprednisolone, prednisolone, prednisone, triamcinolone
Misc hormones and hormone inhibitors ex
Bromocriptine and cabergoline
