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Pharmacology Exam 3 Review > Thyroid & Anti-thyroid, Antidiabetic, & Adrenal Drugs > Flashcards

Thyroid & Anti-thyroid, Antidiabetic, & Adrenal Drugs Flashcards

1
Q

Thyroid Replacement Thyroid Drug

A

Levothyroxine

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2
Q

Replaces thyroid hormone
- Increases T4 levels
(Indication): Hypothyroidism

A

Levothyroxine

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3
Q

Teachings for (Levothyroxine)

A
  • Taken on an empty stomach & 30 minutes before breakfast
  • Warn foods with Vitamin K (Fruits & Veggies) = Inhibits thyroid secretion
  • Therapeutic range (>1 month)
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4
Q

Implementation for (Levothroxine)

A
  • Dosed in mcg (>200mcg = error)
  • Monitor vital signs & weight (Hyperthyroidism = High BP, HR, & T, & rapid weight loss)
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5
Q

What drug causes the destruction of the thyroid gland?
- Orangish-reddish color
- Can stain teeth

A

Radioactive Iodine

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6
Q

Teachings for (Radioactive Iodine)

A
  • Drink it through a straw & avoid contact with the teeth
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7
Q
  • Propylthiouracil (PTU)
  • Methimazole
A

Antithyroid drugs (Thioamide drugs)

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8
Q

Inhibit the incorporation of iodine molecule into tyrosine (Process of making T4 & T5)
(Indications): Hyperthyroidism

A
  • Propylthiouracil (PTU)
  • Methimazole
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9
Q

What antithyroid drug can be used during the 2nd and 3rd trimester?

A

Methimazole

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10
Q

What can antithyroid drugs cause in fetus & their mother?

A

Hepatotoxicity

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11
Q
  • Bone Marrow Toxicity
  • Hepatotoxicity
  • Agranulocytosis
  • Leukemia
  • Thrombocytopenia
  • Anemia
    Sides effects of what drugs?
A

Anti-thyroid drugs
- Propylthiouracil (PTU)
- Methimazole

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12
Q

Assessments for (Antithyroid drugs)

A
  • Assess S/s of thyroid crisis (Tachycardia, dysrhythmias, fever, heart failure, confusion)
  • Assess for Hypotension & Vascular collapse
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13
Q

Teaching for (Antithyroid drugs)

A
  • If taking radioactive iodine (avoid iodized salts & shellfish)
  • Do not abrupty stop antithyroid drugs (Hyperthyroid symptoms can reoccur)
  • Report S/s of hyperthyroidism
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14
Q

Substitute for endogenous insulin
- Binds to insulin receptors of cells (Allows glucose to be actively transported into cells)

A

Insulin

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15
Q
  • Insulin aspart
  • Insulin Lispro
  • Insulin Glulisine
A

Rapid acting insulin

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16
Q
  • NPH (Basal Insulin)
A

Intermediate Insulin

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17
Q
  • Insulin Glargine
  • Insulin Determir
A

Long-acting insulin

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18
Q
  • Regular insulin
A

Fast-acting insulin

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19
Q

Rapid-acting insulin & regular insulin are considered what?

A

Meal-Time insulin

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20
Q

Insulin are dosed in what?

A

Units

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21
Q

Patient is Hangry & Sweaty
What does the patient have? And what should you give them?

A

Hypoglycemia
- Give them candy

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22
Q

Patient is experiencing polyuria, polyphagia (a lot of eating), & polydipsia (A lot of drinking) they are also hot & dry.
What does the patient have?

A

Hyperglycemia

23
Q

What are used to draw up insulin and what color is the caps?

A

Insulin syringes
- Orange caps

24
Q

What insulin can be given IV?

A
  • Rapid-Acting Insulin
  • Regular Insulin
25
Q

What insulin cannot be given IV?

A
  • Intermediate Insulin (NPH)
  • Long-acting Insulin
26
Q

Assessments for (Insulin)

A
  • Assess blood glucose & Hgb A1c
27
Q

Normal fasting blood glucose range

A

60-110

28
Q

Fasting blood glucose goal for (Diabetics)

A

80-130

29
Q

Hemoglobin A1C goal for (Diabetics)

A

<7

30
Q

Implementation for (Insulin)

A
  • Double check insulin dosage
  • Label w/ expiration date (28 days after vial was opened)
  • Inject air equal to the amount to be given into the insulin (Prior to drawing up insulin)
  • Follow steps for mixing insulin
31
Q

Steps for mixing (Rapid-acting insulin) & NPH (Intermediate insulin)

A
  • Roll NPH (DONT SHAKE) until it turns cloudy
  • Clean top of both the clear insulin (Rapid or fast-acting insulin) & Cloudly insulin (NPH)
  • Inject air equal to amount of insulin to be administered (Cloudy insulin first) then (Clear insulin)
  • Draw up correct amount of (Clear insulin)
  • Draw up correct amount of (Cloudy insulin)
32
Q

Teaching for (Insulin)

A
  • Reports of Hypoglycemia & Hyperglycemia
  • Don’t keep insulin in hot places or freezing places
  • Discard opened insulin after 28 days (Never use expired insulin)
  • Label w/ expiration date once vial is opened
  • Inspect insulin before usage (Should always be clear & never cloudy)
33
Q
  • Metformin
  • Sulfonylureas
A

Oral Antidiabetic drugs

34
Q
  • Decreases hepatic production of glucose (Stored glycogen)
  • Decreases absorption of glucose (Small Intestines)
  • Diminish increased serum levels after meal
  • Increases insulin receptors & peripheral glucose uptake (Cellular level)
A

Metformin

35
Q
  • Renal Disease
  • Hepatic Disease
  • Severe heart failure
    These are the contraindications of what drug?
A

Metformin

36
Q

What does the creatinine clearance level have to be in order to take metformin

A

> 30mL/min

37
Q

How long should metformin be held prior to surgery & after surgery?

A

48 hours

38
Q

Stimulate pancreatic beta cells to secrete more insulin

A

First-Generation Sulfonylureas

39
Q

Stimulate pancreatic beta cells to secrete more insulin & increase tissue sensitivity to insulin

A

Second-Generation Sulfonylureas

40
Q

Assessment for (Metformin)

A
  • Assess for renal & hepatic dysfunction
  • Ask about alcohol intake (Increase risk for lactic acidosis)
41
Q

Implementation for (Oral Antidiabetic drugs)

A
  • Monitor blood glucose levels
  • Monitor Hemoglobin A1C levels (every 6 months)
42
Q

Teachings for (Oral Antidiabetic drugs)

A
  • Do not drink alcohol (Causes: Hypoglycemic reactions)
  • If (hypoglycemia occurs): eat candy, orange juice, soda
43
Q

If a patient is conscious & talking to you and their blood glucose is less than 60 what should you give them?

A

Oral form of glucose
- 4oz of orange juice
- Hard candy

44
Q

If a patient is unconscious & their blood glucose is less than 60, & has access to an IV, what should you give them?

A

Dextrose 50% in water (wait 20 minutes, recheck blood sugar, Call HCP)

45
Q

If a patient is unconscious & their blood glucose is less than 60, & has no access to an IV, what should you give them?

A

Glucagon subcutaneously or intramuscularly
- Can cause pt to vomit (Turn pt on their side to prevent aspiration of their emesis)

46
Q
  • Prednisone
  • Methylprednisone
A

Glucocorticoids

47
Q

Suppresses inflammation (Steroid) “-one”

A

Glucocorticoids

48
Q
  • Fungal infections
  • Peptic ulcer disease
  • Diabetes mellitus
  • Mental health disorder
    These are contraindications of what drug?
A

Glucocorticoids
- Prednisone
- Methylprenisone

49
Q

Assessments for (Glucocorticoids)

A
  • Lab test: (Electrolytes & blood glucose levels): K can decrease & blood glucose can increase
  • Assess medical history (Glaucoma, cataracts, diabetes, peptic ulcer
50
Q

Implementation for (Glucocorticoids)

A
  • VS: increased BP related to (Increase Na & H20 retention)
  • IV Push (Give over 3-15 minutes)
  • Monitor weight (report 5lb gain)
  • Monitor S/s of hypokalemia (weakness, irregular HR, Abnormal distention, & paralytic ileus)
  • Taper dose (Assess for adrenal crisis)
51
Q

How should you administer 250mg of Glucococorticoids IV?

A

Infusion pump
- over 30-60 minutes

52
Q
  • Anorexia
  • Nausea
  • Weakness
  • Fatigue
  • Dyspnea
  • Hypotension
  • Hypoglycemia
    These are S/s of what?
A

Adrenal Crisis

53
Q

Teaching for (Glucocorticoids)

A
  • Take as prescribed (Don’t stop abruptly; leads to adrenal crisis)
  • Avoid sick people
  • Take with food
  • Increase potassium-rich food (vitamin K)

Pharmacology Exam 3 Review (3 decks)

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