Treatment For Endocrine Disorders

Question 1

Medical/surgical treatment for hyperthyroidism?

Answer 1

Drug therapy:
•Inderal
•Tapazole- signs of infection should be reported to physician immediately
•Lugol’s Solution- can cause discoloration of teeth and gastric upset. Dilute with milk, fruit juice, or some other beverage and sip through straw.

Question 2

Medical/Surgical treatment for hyperthyroidism continued.

Answer 2

Drug therapy:
•Radioactive Iodine- can cause thyroiditis or parotiditis.

Surgical therapy:
•Subtotal Thyroidectomy- dressing on front of neck. teach how to avoid straining neck and to support head.
Post-op; Turning and deep breathing, no coughing.

Question 3

Medical/Surgical treatment for hypothyroidism.

Answer 3

Hormone replacement therapy:
Synthroid
Cytomel

*patients may require lifelong replacement therapy. Older patients usually start off with low dose and then increase.

Question 4

Medical/Surgical treatment for hyperparathyroidism.

Answer 4

Surgical:
Removal of tumor, if any.

Drug therapy:
High fluid intake to dilute urine.
Calcium intake may be restricted.
Phosphates to reduce calcium level.
Calcitonin to stop release of calcium from bones.

Question 5

Medical/Surgical treatment for hypoparathyroidism.

Answer 5

Oral calcium salts
Vitamin D
Aluminum hydroxide (lowers serum phosphate level & increases serum calcium)

Question 6

Medical/Surgical treatment for Hyperpituitarism.

Answer 6

Radiation therapy
Hypophysectomy (Strict documentation of I&O and Assess for meningeal inflammation)
Parlodel & Sandostatin drug therapy

Question 7

Medical/Surgical treatment of hypopituitarism.

Answer 7

Thyroid hormone replacement, usually is lifelong.

GH replacement for children.

Question 8

Medical/Surgical treatment of Diabetes Insipidus.

Answer 8

Vasopressin (Pitressin)

- SQ, IM, or nasal spray

Question 9

Medical/Surgical treatment for SIADH.

Answer 9

Promote elimination of excess water
Hypertonic Saline. (Given slowly over 4-6 hr period)
Restrict fluid intake.
High sodium diet.
Lithium carbonate or demeclocycline. (Blocks effect of ADH)

Question 10

Medical/Surgical treatment for Addison’s disease.

Answer 10

Lifelong replacement therapy of Cortisol and Aldosterone.

Divided into doses: 2/3 of a daily does is taken in the morning and 1/3 in evening.

Question 11

Medical/Surgical treatment for Cushing’s syndrome.

Answer 11

Benign adrenal tumors removed, if any.
When surgery is contraindicated, drug therapy is used to interfere with ACTH production.
Bilateral surgical removal of adrenal glands (Pt is then treated for Addison’s disease)