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N341A Pharmacology > Pituitary, Thyroid, Parathyroid, and Adrenal Disorders > Flashcards

Pituitary, Thyroid, Parathyroid, and Adrenal Disorders Flashcards

1
Q

Review: What hormones does the anterior pituitary produce?

A 
GH 
TSH
ACTH
FSH, LH
Prolactin
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2
Q

What is Somatropin used for?

A

Growth Hormone Deficiency Replacement (

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3
Q

What are the contraindications for Somatropin?

A

Corticosteroids and patients with malignancy.

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4
Q

What are the side effects of Somatropin?

A

Arthralgias ( joint pain), myalgias ( muscle aches and pain), edema, weakness, glucose fluctuation, hypothyroidism.

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5
Q

What are the adverse reactions from Somatropin?

A

Seizures, ICP hypertension, secondary malignancy.

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6
Q

Can Somatropin be given PO?

A

No, gastric enzymes will deactivates the medication.

It has to be given IM injection.

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7
Q

When is it too late to start giving Somatropin to children?

A

When the epiphyseal plate has closed.

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8
Q

What is acromegaly?

A

Excess growth hormone production after the epiphyseal plate closes.

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9
Q

What is Gigantism?

A

Excess growth hormone production before the epiphyseal plate closes.

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10
Q

What is the most common cause of acromegaly and Gigantism?

A

Pituitary tumors.

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11
Q

Main treatment for acromegaly and Gigantism?

A

Radiation therapy

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12
Q

What does Lantreotide (somatostatin analogue) do?

A

Reduces the effects of growth hormone effects.

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13
Q

When is Lantrotide (somatostatin analogue) used?

A

For patients of Acromegaly or gigantism. It is to combat the excess growth hormone secretion.

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14
Q

What hormones does the posterior pituitary produce?

A

Antidiuretic hormone (ADH) and Oxytocin

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15
Q

What is SIADH?

A

Syndrome of Inappropriate Antidiuretic hormone.

It is caused by excess ADH and causes fluid retention.

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16
Q

What is Diabetes Insipidus?

A

A deficiency of ADH. It causes a large amounts of water to be excreted by the kidneys.

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17
Q

What are the issues of having SIADH?

A

Fluid overload, edema, electrolyte imbalance (hyponatremia)

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18
Q

What is our interventions for SIADH?

A

Fluid restriction, hypertonic saline and drug therapy

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19
Q

What effects does Diabetes Insipidus cause?

A

Severe fluid volume deficit and electrolyte imbalances.

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20
Q

What is our intervention for Diabetes Insipidus?

A

Give the patient Desmopressin acetate.

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21
Q

What is the most common cause of SIADH?

A

Small cell carcinoma

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22
Q

What are some key characteristics of Hyperthyroidism?

A

Bulging eyes, Tachycardia, localized edema, intolerance to heat, diarrhea

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23
Q

What are some key characteristics of hypothyroidism?

A

hair loss, lethargy, dry skin, muscle weakness, constipation, intolerance to cold.

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24
Q

What is Myxedema and what are some key characteristics?

A

Severe hypothyroidism in adults.

Key characteristics include periorbital puffiness, confusion, decreased RR, slow speech

it is a life threatening illness.

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25
Q

What is cretinism?

A

Congenital hypothyroidism.

If not detected early, this can result in delayed physical and mental development for the infant.

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26
Q

What is levothyroxine?

A

artificial thyroid hormone replacement.

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27
Q

What is an indication for levothyroxine?

A

Patients with primary hypothyroidism with or without goiter.

28
Q

What is the MOA of Levothyroxine?

A

Increases metabolic rate, oxygen consumption, utilization and mobilization of glycogen stores; promotes gluconeogenesis and body growth; stimulates protein synthesis.

29
Q

What are the contraindications for Levothyroxine?

A

Thyrotoxicosis (too much thyroid hormones in the body) and MI ( don’t want to increase oxygen consumption on the heart)

30
Q

What are the side effects of Levothyroxine?

A

N/V, anorexia, diarrhea, cramps, tremors, nervousness, irritability, weight loss, diaphoresis

31
Q

What are the adverse reactions to Levothyroxine?

A

Tachycardia, hypertension, osteoporosis, thyroid crisis, cardiovascular collapse.

32
Q

If you want measure thyroid hormone levels on someone on Levothyroxine, what would you measure?

A

TSH levels.

33
Q

What does Parathyroid Hormone do?

A

1) Increases Serum Calcium levels
2) increases intestinal absorption of calcium
3) Decreases renal excretion of calcium.
4) Increases resorption/release of calcium from bone.

34
Q

What medication do you give for Hypoparathyroidism?

A

Calcitriol

35
Q

What occurs because of hypoparathyroidism?

A

Dysregulation of calcium in the body

36
Q

What medication do you give for Hyperparathyroidism?

A

Bisphosphonates (alendronate)

37
Q

What occurs because of hyperparathyroidism?

A

Excess secretion of PTH sends a message to the body that it needs more circulating calcium. This causes excess calcium to be pulled from the bones and thus increasing the risk of osteoporosis.

38
Q

Indications for Calcitriol?

A

To treat parathyroid disorders (both hyper and hypoparathyroidism) and to manage hypocalcemia in chronic renal failure.

39
Q

What is the MOA of Calcitriol?

A

Calcitriol enhances calcium deposits into bones

Reabsorbs calcium by the kidneys; enhances intestinal absorption of dietary calcium; and decreases serum phosphate, bone resorption, and parathyroid hormones.

Basically it promotes calcium absorption from the GI tract and promotes secretion of calcium from bone to the bloodstream.

40
Q

Side effects of Calcitriol?

A

Early signs of Hypercalcemia which include

fatigue, weakness, drowsiness, dizziness, vertigo, metallic taste, lethargy, constipation, and xerostomia.

41
Q

Adverse effects of Calcitriol?

A

Late stage signs of hypercalcemia which include:

Anorexia, photophobia, dehydration, cardiac arrhythmias, decreased libido, hypertension, sensory disturbances, hypercalciuria, hypercalcemia, and hyperphosphatemia

42
Q

What class is the drug Alendronate?

A

Bisphosphonate.

43
Q

Indications for Alendronate?

A

Osteopenia, osteoporosis

44
Q

MOA of Alendronate?

A

Inhibits bone resorption via action on osteoclasts.

45
Q

Side effects of Alendronate?

A

bone pain, acid reflux and upset stomach.

46
Q

Adverse reactions to Alendronate?

A

Avascular necrosis of the jaw, spiral fractures of the femur, duodenal ulcers.

47
Q

What important nursing implications do we have to think about for Alendronate?

A

Alendronate must be taken alone on empty stomach with water and remain upright for 30 minutes after taking.

If the patient cannot remain upright for 30 minutes, an alternative medication will have to be considered.

Have the patient do a bone density screening every two years

Patients must tell dentist that they are taking Alendronate due to the possible avascular necrosis of the jaw effect.

48
Q

What is Addison’s Disease?

A

Adrenocortical Insufficiency

49
Q

What are some key characteristics of Addison’s Disease?

A

Weakness, Bronze Pigmentation of skin, hypoglycemia, postural hypotension, Weight loss, GI disturbances.

50
Q

What are some key characteristics of Cushing’s syndrome?

A

Hyperglycemia, Moon Face, Edema, CNS irritability, Thin skin, Purple Striae.

51
Q

What class is Prednisone under?

A

Glucocorticoid

52
Q

What are the indications for Prednisone?

A

Adrenocortical insufficiency, Addison Disease

53
Q

MOA of Prednisone?

A

Suppress inflammation, immune responses (humoral), and adrenal function; Had a mild mineralcorticoid activity

54
Q

What are the contraindications for Prednisone?

A

Untreated serious infections, hypersensitivity, varicella

55
Q

What are the side effects from Prednisone?

A

Fluid and Sodium retention, nausea, diarrhea, abdominal distention, increased appetite, immunosuppression, elevated serum glucose, purple striae, moon face, weight gain, osteoporosis.

56
Q

What are the adverse reactions from Prednisone?

A

Angioedema, cardiac arrhythmia, osteoporosis, fractures, cardiac arrest, cardiomyopathy, GI ulceration

57
Q

How should a patient be taken off prednisone?

A

Slowly, taper off the patient from Prednisone. Do not withdraw immediately because it can cause an adrenocortical crisis.

58
Q

What is Fludrocortisone classified as?

A

Mineralocorticoid

59
Q

MOA of Fludrocortisone?

A

Promotes sodium retention and potassium and hydrogen excretion in the renal tubules; maintaining fluid balance.

60
Q

Is Fludrocortisone given alone or with another medication for corticosteroid deficiency?

A

Given with a glucocorticoid.

61
Q

What are the adverse side effects of Fludrocortisone?

A

Hypokalemia, fluid imbalance, fluid overload, hypertension.

62
Q

What should you monitor when giving Fludrocortisone?

A

Serum potassium and sodium levels.

Blood pressure

Urine output

63
Q

What should you monitor when giving Prednisone?

A

Blood Glucose levels

Monitor electrolyte levels.

Monitor daily weights.

Bone density tests

64
Q

What are some nursing implications for Calcitriol?

A

Monitor serum Calcium levels.

Educate patients on calcitriol about the late signs of hypercalcemia.

65
Q

What are some nursing implications for giving Somatropin?

A

Checking Blood glucose levels in order look out for glucose fluctuation.

Monitor TSH levels to look out for Hypothyroidism

Monitoring for signs of ICP hypertension and malignancy.

66
Q

What are some nursing implications for Desmopressin?

A

Monitor serum sodium levels.

Urine output/daily weights for fluid volume

Monitor Electrolyte levels

67
Q

What are some nursing implications for Levothyroxine?

A

Monitor BP and HR for tachycardia and hypertension.

Monitor serum calcium levels for osteoporosis.

N341A Pharmacology (7 decks)

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