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Pharm Final > Thyroid / Calcium > Flashcards

Thyroid / Calcium Flashcards

1
Q

What are the different types of Antihypercalcemia agents?

A

Biophosphonates (end in -onate)

Calcitonin (calcitonin salmon)

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2
Q

How to Antihypercalcemia agents work?

A

They decrease the Ca++ in the blood

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3
Q

What are the Indications for Antihypercalcemia’s?

A

Osteoporosis
Paget’s Disease

  • Biophosphonates: used for hypercalcemia R/T cancer
  • Calcitonins: used for emergency treatment of hypercalcemia
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4
Q

What are the Indications for Biophosphonates?

A

They’re used for hypercalcemia R/T cancer

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5
Q

What are the Indications for Calcitonins?

A

They’re used for emergency treatment of hypercalcemia

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6
Q

What are the Contraindications/Cautions for: Calcitonins?

A
  • Pregnancy
  • Renal Dysfunction
  • Pernicious Anemia
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7
Q

What are the Contraindications/Cautions for: Biophosphonates?

A
  • Hypocalcemia
  • Pregnancy & Lactation
  • GI disease
  • Renal dysfunction
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8
Q

What are the Adverse Effects of: Calcitonins?

A
  • Skin flushing (face and hands)
  • Rash
  • N/V
  • Injection site inflammation
  • Urinary Frequency
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9
Q

What are the Adverse Effects of: Biophosphonates?

A
  • HA
  • N/D
  • Bonepain
  • Paget’s Disease
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10
Q

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

A
  • Antacids
  • Ca++ products
  • Iron
  • Multivitamins
  • Aspirin

Decrease absorption of Biophosphonate.

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11
Q

What are the D/D’s for: Calcitonins?

A

No known Allergies

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12
Q

What are our Nursing Considerations for Antihypercalcemia agents?

A
  • 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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13
Q

What are the actions of: Biophosphonates?

A

They act on serum levels to inhibit bone reabsorption

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14
Q

What are the actions of: Calcitonins?

A

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

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15
Q

what are the indications for biophosphonates and calcitonins?

A

osteoporosis
pagets disease

  • biophosphonates can be used for hypercalcemia R/T cancer
  • calcitonins are emergency tx for hypercalcemia
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16
Q

what are the contra/cautions of biophosphonates?

A

hypocalcemia
pregnancy and lact
GI disease
renal dysfunction

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17
Q

what are the contra/cautions of calcitonins

A

pregnancy
renal dysfunction
pernicious anemia

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18
Q

what are the adverse effects of biophosphonates?

A

HA
N/V
bone pain
Pagets disease

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19
Q

what are the adverse effects for calcitonins

A 
skin flushing of the face/hands
rash
N/V
urinary frequency
injection site inflammation
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20
Q

what are the drug-drugs for biophosphonates

A

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

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21
Q

what are the drug-drug for calcitonins

A

NKA

22
Q

what are the nursing considerations for biophosphonates and calcitonins?

A

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

23
Q

what are the antihypocalcemic agents?

A

teriparatide
calcitriol (vit d)
parathyroid hormon

24
Q

how do antihypocalcemic’s work

A

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

25
Q

what are the indications of antihypocalcemic

A

low calcium in the blood R/T chronic renal dialysis

hypoparathyroidism

26
Q

what are contra/cautions for antihypocalcemic

A

allergy
hypercalcemia
vitamin d toxicity
HX renal stones

27
Q

what are the adverse effects of antihypocalcemic

A

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

28
Q

what are the drug-drug for antihypocalcemic’s

A

magnesium antacids: increase magnesium

digoxin: with hypercalcemia can increase digoxin toxicity

29
Q

what are the nursing considerations for antihypocalcemic?

A

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

30
Q

what are our iodine solutions

A

sodium iodid i131

strong iodine solution
potassium iodide

31
Q

how does sodium iodide i131 work

A

enters and destroys thyroid cells with radiation

32
Q

how do strong iodine solution and potassium iodide work?

A

saturate thyroid cells to decrease hormone

33
Q

what are the indications for sodium iodide i131

A

hyperthyroidism

radiation emergencies

34
Q

what are the indications for strong iodide solutions and potassium chloride

A

hyperthyroidism
radition emergencies
suppression of gland before surgery
acute thyrotoxicosis

35
Q

what are the contraindications of iodine solutions?

A

allergy

36
Q

what are the adverse effects of iodine solutions

A

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

37
Q

what are the drug-drug for iodine solutions

A

PO anticoagulants
theophylline
beta blockers
digoxin

38
Q

what are the nursing considerations for iodine solutions

A
  • 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
39
Q

what are our thioamides

A

propythiouracil (PTU)

methimazole

40
Q

how do thioamides work

A

prevent the formation of thyroid hormone

slows all functions

41
Q

what are the indications for thioamides

A

hyperthyroidism

42
Q

what are the contra/cautions for thioamides

A

allergy

PTU: liver impairment

43
Q

what are the adverse effects of thioamides

A

hypothyroidism
methimazole: bone marrow suppression
PTU: severe liver toxicity

44
Q

what are the drug-drug for thioamides

A

PO anticoagulants
theophylline
beta blockers
digoxin

45
Q

what are our nursing considerations for thioamides

A

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

46
Q

what are the drugs used for hypothyroidism

A

levothyroxine
liothyronine
liotrix
thyroid desiccated (pork product)

47
Q

how do hypothyroidism medications work

A

they increase the metabolic rate in all areas of the body

48
Q

what are the indications for hypothyroidism meds

A

hypothyroidism

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

49
Q

what are the contra/cautions for hypothyroidism meds

A

allergy
acute MI
thyrotoxicosis
hypo adrenal conditions (addisons)

50
Q

what are the adverse effects of hypothyroidism meds

A

none with long term/proper use

@ first, can have skin reactions, symptoms of hyperthyroidism, cardiac stimulation, CNS effects (anxiety/HA), hairloss (common in kids)

51
Q

what are the drug-drug for hypothyroidism meds

A

PO anticoagulants: increases bleeding

digoxin: decreases digoxin
theophylline: decreases clearance of thyophylline

52
Q

what are the nursing considerations for hypothyroidism meds

A 
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

Pharm Final (15 decks)

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