T Flashcards
What is the endocrine system composed of?
Ductless glands that secrete hormones into the bloodstream.
What are hormones?
Chemical substances synthesized from amino acids and cholesterol that act on body tissues and organs.
How are hormones categorized?
Into two categories: proteins or small peptides and steroids.
Which glands are included in the endocrine system?
Pituitary (hypophysis)
Thyroid
Parathyroid
Adrenal
Gonads
Pancreas
What is the role of hypothalamic hormones?
They are found in minute quantities and are used for diagnostic purposes or as antineoplastic agents.
What is the pharmacokinetics of hypothalamic agents?
Most are absorbed slowly when given intramuscularly, subcutaneously, or in depot form.
Fill in the blank: Most hypothalamic hormones can cross the _______.
Placenta.
What are common adverse effects of hypothalamic agents?
Increased release of sex hormones
Loss of energy
Decreased sperm count and activity
Fluid retention
What types of drugs affect the anterior pituitary hormones?
Adrenocorticotropics
Somatropin
Gonadotropics
Thyrotropics
What are the indications for growth hormone agonists?
Treatment of children with growth failure due to lack of growth hormones or chronic renal failure.
True or False: Anterior pituitary drugs can be given orally.
False.
What is hyperpituitarism?
GH hypersecretion usually caused by pituitary tumors.
What is acromegaly?
The excessive GH secretion that occurs after puberty and epiphyseal plate closure.
What are contraindications for growth hormone therapy?
Closed epiphyses
Cranial lesions
Acute illness
Pregnancy and lactation
What are some adverse effects of growth hormone therapy?
Development of antibodies to GH
Autoimmune-type reactions
Endocrine reactions of hyperthyroidism
What is the mechanism of action for glucocorticoids?
They reduce inflammation and suppress the immune system.
Fill in the blank: Glucocorticoids are effective at _______.
Reducing inflammation.
What is a common indication for Beclomethasone?
Blocking inflammation in the respiratory tract.
What are the common routes of administration for anterior pituitary drugs?
Most require injection; some can be administered topically.
What should be monitored in patients taking growth hormone therapy?
Height, weight, thyroid function tests, glucose tolerance tests, and GH levels.
What role do glucocorticoids play in inflammation?
They help control the inflammation process, reducing potential tissue damage.
What happens when the usual control mechanisms that turn off inflammation are not functioning properly?
Tissues can become damaged.
This refers to the uncontrolled inflammation process.
What are glucocorticoids?
A class of steroid hormones that regulate inflammation and immune responses.
What is the indication for Beclomethasone (Beclovent)?
Blocking inflammation in the respiratory tract.
What is the indication for Betamethasone (Celetone)?
Management of allergic intra-articular and topical inflammatory disorders.
What is cortisone used for?
Replacement therapy in adrenal insufficiency, treatment of allergic and inflammatory disorders.
What are the indications for Dexamethasone (Decadron)?
Management of allergic and topical inflammatory disorders, adrenal hypofunction.
What is the purpose of Flunisolide (Nasalide, AeroBid, Aerospan)?
Control of bronchial asthma, relief of symptoms of seasonal and allergic rhinitis.
What is Hydrocortisone (Cortef) used for?
Replacement therapy, treatment of allergic and inflammatory disorders.
What are the indications for Methylprednisolone (Medrol)?
Treatment of allergic and inflammatory disorders.
What is the primary use for Prednisolone (Delta-Cortef)?
Treatment of allergic and inflammatory disorders.
What is the primary indication for Prednisone (Deltasone)?
Replacement therapy for adrenal insufficiency, treatment of allergic and inflammatory disorders.
What is Triamcinolone (Aristocort) used to treat?
Treatment of allergic and inflammatory disorders, management of asthma.
What are the pharmacokinetics of glucocorticoids?
Metabolized by natural systems, absorbed well, excreted in urine, can cross the placenta and enter breast milk.
In which cases should glucocorticoids be used during pregnancy?
Only if benefits to the mother clearly outweigh potential risks to the fetus or neonate.
What forms are Beclomethasone and Flunisolide available in?
Respiratory inhalant and nasal spray.
What is Budesonide used for?
Intranasal use as a relatively new steroid.
What is the effect duration of Dexamethasone and Triamcinolone?
Effects can last for 2 days.
What is the main concern with the use of Hydrocortisone?
It has largely been replaced by other steroid hormones with less mineralocorticoid effect.
What are the contraindications for glucocorticoids?
Known allergy to any steroid preparation, acute infections, diabetes, peptic ulcers, other endocrine disorders, pregnancy.
What adverse effects are associated with glucocorticoids?
Local inflammation, infections, burning, stinging, growth retardation in children.
What drug interactions can occur with glucocorticoids?
Increased toxicity with erythromycin, ketoconazole; decreased effectiveness with salicylates, barbiturates.
What is the role of Mineralocorticoids?
Influence salt and water balances (electrolyte and fluid balance).
What is the indication for Fludrocortisone (Florinef)?
Replacement therapy and treatment of salt-losing adrenogenital syndrome.
What are the pharmacokinetics of mineralocorticoids?
Absorbed slowly, undergo hepatic metabolism, cross the placenta and breast milk.
What are common adverse effects of mineralocorticoids?
Increased fluid volume, edema, hypertension, headache, arrhythmias, weakness.
What should be assessed before beginning therapy with mineralocorticoids?
History of allergy, heart failure, hypertension, infections, blood pressure, pulse.
What are thyroid agents used for?
To replace thyroid hormone when thyroid function is low or to suppress overproduction when it is high.
What are the types of thyroid agents?
Thyroid hormones and antithyroid drugs, including thioamides and iodine solutions.
What are the main thyroid hormones for treating hypothyroidism?
Levothyroxine, Liothyronine, Liotrix, Thyroid dessicated.
What are the primary thyroid hormones used in replacement therapy for hypothyroidism?
Levothyroxine, Liothyronine, Liotrix, Thyroid dessicated
Examples include Synthroid, Cytomel, and Armour Thyroid.
What is the main indication for thyroid hormone replacement therapy?
Hypothyroidism, suppression of TSH release, treatment of myxedema coma, treatment of thyrotoxicosis
True or False: Thyroid hormone can cross the placenta.
False
What should be monitored during thyroid replacement therapy?
Thyroid function tests, pulse, blood pressure, and ECG
What are the contraindications for using thyroid hormones?
Cardiac problems, anxiety problems, and known allergies to thyroid hormone
What are some common adverse effects of thyroid hormone replacement therapy?
Skin reactions, loss of hair, symptoms of hyperthyroidism, arrhythmias, hypertension
Fill in the blank: Thyroid hormones should not be used in patients with _______.
hypoadrenal conditions such as Addison’s disease
What are the two main types of antithyroid agents?
Thioamides, Iodine solutions
List the thioamide drugs used to treat hyperthyroidism.
- Methimazole (Tapazole)
- Propylthiouracil (PTU)
What is a common indication for antithyroid agents?
Treatment of hyperthyroidism, thyroid blocking in a radiation emergency
How do iodine solutions work in the body?
Rapidly absorbed from the GI tract and distributed throughout body fluids
What are the contraindications for using antithyroid agents?
- Allergy to any component of the drug
- Pregnancy
- Lactation
- Pulmonary edema or tuberculosis
What are some adverse effects associated with thioamides?
- Drowsiness
- Lethargy
- Bradycardia
- Nausea
- Skin rash
Fill in the blank: The drug of choice for pregnant women with hyperthyroidism is _______.
PTU (Propylthiouracil)
What should be monitored during the use of iodine solutions?
Signs of iodism and any adverse effects
What are the key nursing considerations when administering thyroid hormones?
- Monitor patient response
- Arrange for periodic blood tests
- Provide patient teaching
What is the role of Vitamin D in managing hypoparathyroidism?
Stimulates calcium absorption from the intestine and restores normal serum calcium levels
List the antihypocalcemic agents used in treatment.
- Calcitriol (Rocaltrol)
- Teriparatide (Forteo)
- Dihydrotachysterol (Hytakerol)
What condition is primarily treated with antihypocalcemic agents?
Hypocalcemia
What is the significance of monitoring digitalis levels during thyroid hormone therapy?
To prevent increased digitalis levels when combined with thyroid hormones
True or False: The effectiveness of oral anticoagulants is decreased when combined with thyroid hormone.
False
What should be done if cholestyramine is used with thyroid hormones?
Take the drugs 2 hours apart
What is the primary treatment for hypocalcemia?
Vitamin D and, if necessary, dietary supplements of calcium
Name an antihypocalcemic agent used for managing hypocalcemia.
Calcitriol (Rocaltrol)
What is the indication for Teriparatide?
Postmenopausal osteoporosis and hypogonadal osteoporosis
What is the half-life of Calcitriol?
Approximately 5-8 hours
What are the adverse effects of antihypocalcemic agents?
GI effects, CNS effects, and increased levels in patients with liver or renal dysfunction
True or False: Calcitriol is associated with hypercalcemia in nursing mothers.
True
Which patient population is Teriparatide limited to?
Postmenopausal women at high risk of fractures and men with primary hypogonadal osteoporosis
Fill in the blank: An adverse effect of Calcitonins is _______.
Flushing of the face and hands
What should be avoided when taking antihypercalcemic agents?
Magnesium-containing antacids
What is the recommended action if bisphosphonates are taken with antacids?
Separate by at least 30 minutes
What are the key nursing considerations for monitoring patients on these drugs?
Monitor serum calcium concentration, renal function, and provide patient teaching
What are the common GI effects associated with antihypocalcemic agents?
Metallic taste, nausea, vomiting, and constipation
Which drugs are classified as antihypercalcemic agents?
Bisphosphonates and calcitonin salmon
What is a contraindication for the use of bisphosphonates?
History of allergy to bisphosphonates
What is the duration of effect for salmon calcitonin?
8 to 24 hours
What is the onset of action for bisphosphonates?
Slow onset of action
List the types of insulin available.
- Lispro (Humalog) * Insulin aspart (NovoLog) * Glargine (Lantus) * Glulisine (Apidra) * Detemir (Levemir) * Regular insulin (Humulin R) * NPH insulin (Humulin N)
What is the primary use of insulin?
To treat type 1 diabetes and type 2 diabetes in patients who cannot control their diabetes by diet or other agents
What should be assessed before starting therapy with antihypocalcemic agents?
History of allergy, hypercalcemia, vitamin D toxicity, renal stones, and pregnancy or lactation
True or False: Calcitonins have no clinically important drug-drug interactions.
True
What are the adverse effects of bisphosphonates?
Headache, nausea, diarrhea, bone pain, and esophageal erosion
What should be done to enhance patient compliance with drug therapy?
Provide thorough patient teaching about the drug and its side effects
What is NPH insulin used for?
Treatment of type 1 diabetes mellitus, type 2 diabetes mellitus, severe ketoacidosis, hyperkalemia, and short courses during stress periods.
NPH insulin (Humulin N) is effective in managing various diabetic conditions.
What are the key pharmacokinetic properties of insulin?
Insulin is available in various preparations with different peaks and durations of action, administered subcutaneously, intramuscularly, or intravenously in emergencies.
The choice of insulin preparation affects the management of blood glucose levels.
What should be monitored when administering insulin during pregnancy?
Glucose levels should be monitored closely and insulin doses adjusted accordingly.
Insulin does not cross the placenta but enters breast milk.
What are common adverse effects of insulin?
Hypoglycemia, allergic reactions, local reactions at injection sites, and decline in pulmonary function with inhaled insulin.
Adverse effects can vary based on individual responses and administration routes.
True or False: Insulin glargine and insulin detemir can be mixed with other insulins.
False
These insulins cannot be mixed with any other drug, including other insulins.
What are the first-generation sulfonylureas?
Chlorpropamide, tolazamide, tolbutamide.
These drugs are used to stimulate insulin release in patients with type 2 diabetes.
List the advantages of second-generation sulfonylureas over first-generation.
- Excreted in urine and bile, safer for renal dysfunction
- Fewer interactions with protein-bound drugs
- Longer duration of action, increasing compliance
- Generally less expensive
These advantages make second-generation sulfonylureas more favorable for many patients.
What is the primary action of sulfonylureas?
Stimulate insulin release from beta cells in the pancreas and improve insulin receptor binding.
They are indicated as adjuncts to diet and exercise for lowering blood glucose levels in type 2 diabetes.
What are the contraindications for sulfonylureas?
Known allergy to sulfonylureas, diabetes with severe infection or trauma, severe renal or hepatic disease, pregnancy, and lactation.
These conditions require tighter glucose control, often necessitating insulin use.
What are common adverse effects of sulfonylureas?
CNS effects (drowsiness, fatigue), GI distress (nausea, heartburn), hypoglycemia, and skin reactions (pruritus, urticaria).
Monitoring for these effects is important during therapy.
Fill in the blank: Insulin does not cross the ______ during pregnancy.
placenta
This makes insulin a safe choice for managing diabetes during pregnancy.
What should patients on sulfonylureas be cautious about?
Interactions with drugs that acidify urine, beta-blockers, alcohol, and various herbal therapies.
These interactions can alter blood glucose levels and mask hypoglycemia symptoms.
What is the mechanism of action for sulfonylureas?
They stimulate insulin release and improve insulin receptor binding in the body.
This action is particularly effective for patients with functioning beta cells.
What caution must be used with drugs that alter blood glucose levels?
Caution must also be used with many drugs that could alter blood glucose levels.
What are some contraindications for antidiabetic agents?
- Allergy to sulfonylureas
- Diabetes mellitus with complications
- Type 1 diabetes mellitus
- Serious hepatic or renal impairment
- Uremia
- Thyroid or endocrine impairment
- Glycosuria
- Hyperglycemia associated with primary renal disease
- Pregnancy
What should be assessed in a physical examination for diabetes?
- Skin color and lesions
- Orientation and reflexes
- Peripheral sensation
- Adventitious sounds
- Liver evaluation
- Bowel sounds
- Urinalysis
- BUN
- Blood glucose
- CBC
What are some other antidiabetic agents available?
- Alpha-glucosidase inhibitors (e.g., acarbose, miglitol)
- Biguanide (e.g., metformin)
- Meglitinides (e.g., repaglinide, nateglinide)
- Thiazolidinediones (e.g., pioglitazone, rosiglitazone)
- Incretin mimetics (e.g., exenatide, liraglutide)
- Human amylin (e.g., pramlintide)
- DDP-4 inhibitors (e.g., linagliptin, saxagliptin, sitagliptin)
True or False: The safety and efficacy of other antidiabetic agents have been established for use in children.
False
What assessments should be performed for patients taking other antidiabetic agents?
- Assess for contraindications or cautions
- History of allergy to any agents
- Severe renal or hepatic dysfunction
- Status of pregnancy or lactation
- Complete physical assessment to establish baseline status
What are glucose-elevating agents indicated for?
- Treatment of hypoglycemic reactions related to insulin or oral antidiabetic agents
- Treatment of hypoglycemia related to pancreatic or other cancers
- Short-term treatment of acute hypoglycemia related to anterior pituitary dysfunction
Fill in the blank: Diazoxide is given _______ only.
[parenterally]
What are the pharmacokinetics of glucagon and diazoxide?
- Diazoxide is rapidly absorbed and widely distributed
- Glucagon is administered orally
- Both are excreted in the urine
What are some adverse effects associated with glucagon?
- GI upset
- Nausea
- Vomiting
- Hypotension
- Headache
- Vascular ischemia
What is the contraindication for diazoxide?
Known allergies to sulfonamides or thiazides
What nursing considerations should be taken for patients taking glucose-elevating agents?
- Assess for contraindications and cautions
- Perform a complete physical assessment
- Monitor blood glucose levels
- Monitor laboratory tests for glucosuria, serum glucose, renal and liver function
Define hypercalcemia.
Excessive calcium levels in the blood.
What is the role of glucocorticoids?
Increase blood glucose levels, fat deposits, and protein breakdown for energy.
What is diabetes mellitus?
A metabolic disorder characterized by high blood glucose levels and altered metabolism of proteins and fats.
What is the effect of thiazolidinediones?
They lower blood glucose levels.
What hormone does calcitonin counteract?
Parathyroid hormone
What is the definition of hypothyroidism?
Lack of sufficient thyroid hormone to maintain metabolism.
What are corticosteroids?
Steroid hormones produced by the adrenal cortex, including androgens, glucocorticoids, and mineralocorticoids.
What is diabetes mellitus?
A metabolic disorder characterized by high blood glucose levels and altered metabolism of proteins and fats
Diabetes mellitus is associated with thickening of the basement membrane, leading to numerous complications.
What are the primary characteristics of diabetes mellitus?
High blood glucose levels and altered metabolism of proteins and fats
It can lead to various complications due to changes in the basement membrane.
What complications are associated with diabetes mellitus?
Numerous complications due to thickening of the basement membrane
The thickening affects various bodily functions and can lead to serious health issues.
What is the significance of potassium excretion in diabetes management?
Potassium excretion is important for maintaining electrolyte balance and preventing complications
Retention and excretion of potassium can be affected by diabetes.
Which reference is cited for drug information related to the endocrine system?
Saunder’s Nursing Drug Handbook, 2016
This handbook is a resource for nurses regarding various medications and their effects.
Who is the author of ‘Focus on Nursing Pharmacology’ 6th Edition?
Karch, A.M.
This text provides insights into pharmacology relevant to nursing.
What is the publication year of Karch’s nursing drug guide?
2011
It is published by Wolters Kluwer Health/Lippincott Williams & Wilkins.
