Thyroid / Calcium Flashcards by Ashley Arellano

What are the different types of Antihypercalcemia agents?

Biophosphonates (end in -onate)

Calcitonin (calcitonin salmon)

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How to Antihypercalcemia agents work?

They decrease the Ca++ in the blood

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What are the Indications for Antihypercalcemia’s?

Osteoporosis
Paget’s Disease

Biophosphonates: used for hypercalcemia R/T cancer
Calcitonins: used for emergency treatment of hypercalcemia

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What are the Indications for Biophosphonates?

They’re used for hypercalcemia R/T cancer

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What are the Indications for Calcitonins?

They’re used for emergency treatment of hypercalcemia

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What are the Contraindications/Cautions for: Calcitonins?

Pregnancy
Renal Dysfunction
Pernicious Anemia

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What are the Contraindications/Cautions for: Biophosphonates?

Hypocalcemia
Pregnancy & Lactation
GI disease
Renal dysfunction

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What are the Adverse Effects of: Calcitonins?

Skin flushing (face and hands)
Rash
N/V
Injection site inflammation
Urinary Frequency

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What are the Adverse Effects of: Biophosphonates?

HA
N/D
Bonepain
Paget’s Disease

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What are the D/D’s for: Biophosphonates?

Antacids
Ca++ products
Iron
Multivitamins
Aspirin

Decrease absorption of Biophosphonate.

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What are the D/D’s for: Calcitonins?

No known Allergies

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What are our Nursing Considerations for Antihypercalcemia agents?

Will complete an abdominal exam
Will do labs for: Ca++, phosphorous, magnesium, and renal functioning

Education:

Take with fluid and must sit upright for 30-60mins after
Ensure adequate hydration

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What are the actions of: Biophosphonates?

They act on serum levels to inhibit bone reabsorption

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What are the actions of: Calcitonins?

These are hormones secreted by the thyroid to balance and inhibit bone reabsorption

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what are the indications for biophosphonates and calcitonins?

osteoporosis
pagets disease

biophosphonates can be used for hypercalcemia R/T cancer
calcitonins are emergency tx for hypercalcemia

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what are the contra/cautions of biophosphonates?

hypocalcemia
pregnancy and lact
GI disease
renal dysfunction

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what are the contra/cautions of calcitonins

pregnancy
renal dysfunction
pernicious anemia

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what are the adverse effects of biophosphonates?

HA
N/V
bone pain
Pagets disease

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what are the adverse effects for calcitonins

skin flushing of the face/hands
rash
N/V
urinary frequency
injection site inflammation

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what are the drug-drugs for biophosphonates

antacids, calcium products, iron, multivitamins, apririn: decrease bio absorption

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what are the drug-drug for calcitonins

NKA

what are the nursing considerations for biophosphonates and calcitonins?

abdominal exams
labs: calcium, phosphorous, magnesium, renal function
ensure adequate hydration
take biophosphonates with water and SIT UP RIGHT FOR 30-60 MINS AFTER ADMIN

what are the antihypocalcemic agents?

teriparatide
calcitriol (vit d)
parathyroid hormon

how do antihypocalcemic’s work

they stimulate osteoclasts to release calcium
increase absorption of calcium in the small intestine
increase ca reabsorption in kidneys and produce calcitrol

what are the indications of antihypocalcemic

low calcium in the blood R/T chronic renal dialysis hypoparathyroidism

what are contra/cautions for antihypocalcemic

allergy hypercalcemia vitamin d toxicity HX renal stones

what are the adverse effects of antihypocalcemic

GI: N//V, metallic taste, constipation CNS: weakness, increased sleeping, HA, irritability

what are the drug-drug for antihypocalcemic's

magnesium antacids: increase magnesium digoxin: with hypercalcemia can increase digoxin toxicity

what are the nursing considerations for antihypocalcemic?

labs: calcium serum, magnesium, alkaline phosphate, and LFTs want x-rays for possible breaks want to ensure good calcium serum levels increase risk for injury with falls

what are our iodine solutions

sodium iodid i131 strong iodine solution potassium iodide

how does sodium iodide i131 work

enters and destroys thyroid cells with radiation

how do strong iodine solution and potassium iodide work?

saturate thyroid cells to decrease hormone

what are the indications for sodium iodide i131

hyperthyroidism | radiation emergencies

what are the indications for strong iodide solutions and potassium chloride

hyperthyroidism radition emergencies suppression of gland before surgery acute thyrotoxicosis

what are the contraindications of iodine solutions?

allergy

what are the adverse effects of iodine solutions

hypothyroidism iodism (iodine toxicity) - sore mouth/teeth, burning mouth, metallic taste, excessive salivation, HA/confusion

what are the drug-drug for iodine solutions

PO anticoagulants theophylline beta blockers digoxin

what are the nursing considerations for iodine solutions

* sodium iodide i131: only for infertile women and older adults who cannot go through surgery ``` want ECG and vitals with baselines labs: thyroid levels pregnancy tests if crushing PO, use straw to avoid staining on teeth educate of S/S for iodine toxicity ```

what are our thioamides

propythiouracil (PTU) | methimazole

how do thioamides work

prevent the formation of thyroid hormone slows all functions

what are the indications for thioamides

hyperthyroidism

what are the contra/cautions for thioamides

allergy | PTU: liver impairment

what are the adverse effects of thioamides

hypothyroidism methimazole: bone marrow suppression PTU: severe liver toxicity

what are the drug-drug for thioamides

PO anticoagulants theophylline beta blockers digoxin

what are our nursing considerations for thioamides

obtain ECG and vitals for baselines labs: thyroid levels, CBC (methimazole), liver (PTU) pregnancy test PTU admin is 3 times a day

what are the drugs used for hypothyroidism

levothyroxine liothyronine liotrix thyroid desiccated (pork product)

how do hypothyroidism medications work

they increase the metabolic rate in all areas of the body

what are the indications for hypothyroidism meds

hypothyroidism myxedema coma (extreme hypothyroidism/emergency) euthyroid goiter: used to suppress the thyroid gland thyrotoxicosis (used as adjunct therapy)

what are the contra/cautions for hypothyroidism meds

allergy acute MI thyrotoxicosis hypo adrenal conditions (addisons)

what are the adverse effects of hypothyroidism meds

none with long term/proper use @ first, can have skin reactions, symptoms of hyperthyroidism, cardiac stimulation, CNS effects (anxiety/HA), hairloss (common in kids)

what are the drug-drug for hypothyroidism meds

PO anticoagulants: increases bleeding digoxin: decreases digoxin theophylline: decreases clearance of thyophylline

what are the nursing considerations for hypothyroidism meds

``` dont use thyroid desiccated for religious/vegan patients are they in a hypoadrenal state? hypothyroidism more common in women obtain vitals/EKG and thyroid labs monitor for CO issues ADMIN BEFORE BREAKFAST AT SAME TIME DAILY WITH WATER takes 6weeks to reach therapeutic levels S/S hypo/hyperthyroidism ```