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Pharm Drug Names > Thyroid and Parathyroid Agents > Flashcards

Thyroid and Parathyroid Agents Flashcards

1
Q

Drug Names of thyroid hormones

A

Levothyroxine
Liothyronine
Liotrix
Thyroid Desiccated

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2
Q

Action of thyroid hormones?

A

increase cellular metabolism in all areas of the body

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3
Q

Indication?

why would you use a thyroid hormone?

A

Hypothyroidism

Myxedema coma

Pituitary TSH suppression in tx of euthyroid goiters

Management of thyroid cancer

Thyrotoxicosis (hyperthyroidism w s/sx) in conjunction with other therapy

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4
Q

Adverse Effects of thyroid hormones?

A

*NONE if taking the correct dose

skin reaction

sx of hyperthyroidism

cardiac stimulation

CNS effects

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5
Q

Contraindications for thyroid hormones

A

Known allergy

acute MI

thyrotoxicosis

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6
Q

Caution for thyroid Hormones

A

Hypo-adrenal conditions (Addisons disease- body would not be able to handle drug effects)

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7
Q

drug/ drug interactions for thyroid hormones?

A

oral anticoagulants
digoxin
theophylline

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8
Q

Nursing Diagnosis for thyroid hormones

A

Decreased CO- tachycardia

imbalanced nutrition: less than body req.- increased metabolism

ineffective tissue perfusion- decreased CO

deficient knowledge

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9
Q

Assessment for thyroid hormones?

A

cautions/contraindications
family hx
skin, vitals, CNS, ECG before and during therapy

Labs: thyroid fx test

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10
Q

Implementation for thyroid hormones

A

Single daily dose before breakfast w/ full glass of water
monitor cardiac response
periodic blood testing

Can take 6 weeks to take effect

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11
Q

Evaluation

A

Is the metabolism returning to normal?

are we preventing/ reducing goiter?

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12
Q

Drug Names of ANTI thyroid hormones

A

thiomides-
propylthiouracil PTU
Methimazole

iodine solutions-
strong iodine solution
sodium iodine 131
potassium iodine

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13
Q

Action of ANTI thyroid hormones

A

Thiomides-
prevent formation of thyroid hormone within thyroid cells
(lowers serum levels)

sodium iodine 131-
enters thyroid cell and destroys by giving off radiation

strong iodine and potassium iodine-
increased doses saturate thyroid cells preventing thyroid hormone formation

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14
Q

Indication?

why would you use ANTI thyroid hormones?

A

thiomides-
hyperthyroidism

sodium iodine 131-
hyperthyroidism, radiation emergencies

strong iodine solution & potassium iodine-
hyperthyroidism, radiation emergencies, suppression of thyroid gland before surgery, acute thyrotoxicosis

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15
Q

Adverse Effects of ANTI thyroid hormones

A

All: hypothyroidism
Methimazole: Bone Marrow Suppression
PTU: severe liver toxicity
iodine solutions: iodism (iodine toxicity)

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16
Q

Contraindications of ANTI thyroid hormones

A

known allergy

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17
Q

cautions of ANTI thyroid hormones

A

PTU: liver impairment

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18
Q

drug/ drug interactions for ANTI thyroid hormones

A

oral anticoagulants
theophylline
beta blockers
digoxin

19
Q

nursing diagnosis for ANTI thyroid hormones

A

decreased Cardiac output r/t slowing everything down

imbalanced nutrition: more than body req. r/t changes in metabolism

risk for injury r/t bone marrow suppression

deficient knowledge

20
Q

Assessment for ANTI thyroid hormones

A

cautions
skin, vitals, CNS, ECG

Labs:
Methimazole: CBC- BMS
thyroid fx test
PTU: pregnancy test, liver fx

21
Q

Implementation for ANTI thyroid hormones

A 
PTU: 3x a day around the clock
Give iodine solution with a straw
tablets should be taken whole or crushed
periodic blood test
assess for iodism
pt teaching: metalic taste
22
Q

evaluation for ANTI thyroid hormones

A

decreased thyroid hormone levels?

improvements of sx: increased HR coming down

23
Q

Drug names for ANTI hypocalcemic agents

A

Teriparatide

Calcitrol (Vitamin D)

Parathyroid Hormone
*limited access - need to show need to get it

24
Q

Action for ANTI hypocalcemic agents

A

stimulate osteoclast to release calcium from bone into the blood stream

increase intestinal absorption of calcium

increase calcium resorption from the kidneys

stimulation of cells in kidney to produce calcitrol (vitamin D)

25
Q

indication?

why would you use ANTI hypocalcemic agents?

A

low calcium in the blood - raised calcium

management of hypocalcemia in pt undergoing chronic renal dialysis

tx of hypoparathyroidism

26
Q

Adverse effects of ANTI hypocalcemic agents

A

GI (metallic taste, N/V/C)

CNS (weakness, HA, somnolence, irritability)

27
Q

Contraindications for ANTI hypocalcemic agents

A

allergy

vitamin D toxicity

hypercalcemia

28
Q

Caution for ANTI hypocalcemic agents

A

hx of renal stones

29
Q

drug/ drug interactions for ANTI hypocalcemic agents

A

magnesium containing antacids

digoxin toxicity w/ hypercalcemia

monitor calcium and digoxin levels (0.5-2)

30
Q

nursing diagnosis for ANTI hypocalcemic agents

A

Acute pain r/t GI and CNS

imbalanced nutrition: less than body req. r/t GI

deficient knowledge

31
Q

Assessment for ANTI hypocalcemic agents

A

cautions and contraindications
assess skin, CNS

labs:
serum calcium
magnesium
LFTs 
alkaline phosphate levels
xray bones
32
Q

Implementation for ANTI hypocalcemic agents

A

monitor calcium serum levels
supportive measures for ADE
nutritional consult if GI ADE

Labs:
calcium levels

33
Q

evaluation for ANTI hypocalcemic agents

A

serum calcium level is normal

4.5-5.8 or 8.5-10.5

34
Q

Drug names for ANTI hypercalcemic Agents

A 
Biophosphonates
"onate"
Etidronate
Ibandronate
Pamidronate
Risedronate
Alendronate

Calcitonins
Calcitonin Salmon

35
Q

Action for ANTI hypercalcemic Agents

A

Both inhibit bone resorption

Biophosphonates:
act on serum levels of calcium not directly on parathyroid gland or PTH

Calcitonins:
hormone secreted by thyroid gland to balance effects of PTH

36
Q

Indication?

why would we use ANTI hypercalcemic Agents ?

A

osteoporosis
pagets disease

Biophosphonates:
hypercalcemia in cancer

Calcitonins:
emergency tx of hypercalcemia

37
Q

Adverse Effects for ANTI hypercalcemic agents

A

Biophosphonates:
HA, N/D
Bone pain w/ pagets disease

Calcitonin:
flushing of face/hands
skin rash, N/V
urinary frequency 
local inflammation @ injection site
38
Q

Contraindications for ANTI hypercalcemic agents

A 
Biophosphonates:
Hypocalcemia
P/L 
Renal dysfunction
Gi disease

Calcitonins:
pregnancy
renal dysfunction
pernicious anemia

39
Q

drug/drug interactions for ANTI hypercalcemic agents

A 
Biophosphonates:
antacids 
calcium products
iron or multiple vitamins
asprin

Calcitonin:
none known

40
Q

Nursing diagnosis for ANTI hypercalcemic agents

A

acute pain
imbalance nutrition: less than body req.
anxiety
deficient knowledge

41
Q

Assessment for ANTI hypercalcemic agents

A

contraindications
assess skin for lesions, CNS
Abdominal examination

labs:
calcium phosphorus
magnesium levels renal function

42
Q

implementation for ANTI hypercalcemic agents

A 
ensure adequate hydration
arrange vit D, calcium supplements, and hormone replacement therapy 
monitor injection site for inflammation
monitor calcium serum regularly
blood test for renal fx periodically
43
Q

evaluation for ANTI hypercalcemic agents

A

Pharm Drug Names (7 decks)

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