Ch 50 Pituitary, Thyroid, Parathyroid

Question 0

What disease results from hyperthyroidism

Answer 0

Graves’ disease

Question 1

If a persons PSH level is increased what type of disorder do you have

Answer 1

You have a thyroid problem

Question 2

What are manifestations of hypothyroidism

Answer 2

Decreased BP
decreased HR
Decreased metabolism, resulting in wt. gain
Lethargy
Heat intolerance 
..........levers thing slows down

Question 3

What are manifestations of hyperthyroidism

Answer 3

Increased BP
increased HR
wt. loss
Bulging eyes
Cold intolerance
Thinking slows down
Insomnia

Question 4

What are signs and symptoms of thyrotoxicosis ( thyroid crisis)

Answer 4

Tachycardia
Fever
Dysrhythmias 
HF
flushed skin
....can lead to coma

Question 5

What is true of hyperthyroidism

Answer 5

When you have hyperthyroidism some or all of the gland may have to be removed…supplemental hormones will be given for the duration of life

Question 6

What is anterior pituitary gland dysfunction

Answer 6

Includes growth hormone deficiency and excess

Question 7

What is posterior pituitary glad dysfunction

Answer 7

Major disorders are diabetes insipidus and syndrome of inappropriate ANTIDIURETIC hormone ( SIADH)

Question 8

What is thyroid gland dysfunction

Answer 8

Hyper functioning or hypo functioning gland, misfunctions that may either be caused by a congenital defect or by a problem that occurs later in life

Question 9

Parathyroid gland dysfunction

Answer 9

Hormone is a major regulator of serum calcium and phosphate
A decrease in serum calcium concentration is the dominant regulator of PTH, with a response rate of just a few seconds
A decrease in phosphate causes an indirect effect on PTH by combining with calcium and decreasing serum calcium concentrations

Question 10

What are growth hormones prototype drug

Answer 10

Somatropin

Question 11

What is true of GH deficiency

Answer 11

Growth hormone deficiency, leading to short stature, was initially treated with growth hormone injections extracted from the pituitary gland of cadavers.
Presently synthetic human GH ( rhGH), produced from recombinant DNA is available
rhGH is very expensive

Question 12

What is Somatropin used for

Answer 12

It is used as long term replacement of inadequate endogenous GH secretion

Question 13

How is Somatropin administered

Answer 13

SC, IM

Excreted in liver and kidneys

Question 14

What is the pharmacodynamics of Somatropin

Answer 14

It stimulates cell growth and cellular mitosis, facilitates cellular uptake of amino acids for protein synthesis, and promotes use of fatty acids for energy

Question 15

What are contraindications of Somatropin

Answer 15

Growth hormone in children with closed epiphyses

Question 16

What are adverse effects of Somatropin

Answer 16

Headache 
HTN
joint and back pain
Peripheral edema
Muscle aches
Rhinitis

Question 17

What are drug interactions of Somatropin

Answer 17

Anabolic steroids

Androgens, estrogens, or thyroid hormones may accelerate epiphyseal maturation

Question 18

What can hypothyroidism develop from

Answer 18

Hypothyroidism may develop during Somatropin therapy

Question 19

For patients who require chronic cycling peritoneal dialysis, when should they receive there doses of Somatropin

Answer 19

In the morning after there dialysis is completed

Question 20

What may Somatropin therapy induce

Answer 20

It may induce insulin resistance

Be alert for the development of hip or knee pain and inform provider

Question 21

What is an ongoing assessment of a person with Somatropin therapy

Answer 21

Evaluate thyroid function at regular intervals because hypothyroidism compromises rGH drug effects

Question 22

Patients taking Somatropin should have what lab values monitored on a routine basis due to adverse effects of drug therapy

Answer 22

TSH
GLUCOSE LEVEL
Because Somatropin can cause hypothyroidism and glucose intolerance.

Question 23

What two hormones does the posterior pituitary gland store

Answer 23

Vassopressin and oxytocin
They are produced in the hypothalamus. They are synthetic analogues of the naturally occurring posterior pituitary gland hormone.
Prototype: desmopressin

Question 24

What does the posterior pituitary gland hormone desmopressin do

Answer 24

It manages central DI and nocturnal enuresis and maintains homeostasis in hemophilia A.

Question 25

How is desmopressin administered

Answer 25

Intranasally Orally Parenterally IV or SC

Question 26

What are adverse effects of desmopressin

Answer 26

``` Abdominal pain Transient headache Nasal congestion Nausea Rhinitis Facial flushing ```

Question 27

What are drug interactions of desmopressin

Answer 27

Carbamazepine, chlorpromazine, and NSAIDS

Question 28

How can maximize the therapeutic effects of desmopressin

Answer 28

Establish baseline values for wt., BP, electrolytes and urine specific gravity Protect ADH solutions from agitation and temperature extremes

Question 29

What can alter the therapeutic response of desmopressin

Answer 29

Alcohol

Question 30

What are the Pharmacotherapeutics of levothyroxine, Synthroid

Answer 30

These drugs are used as a replacement therapy in hypothyroidism It acts a replacement for natural thyroid hormone in hypothyroidism

Question 31

What should a person be cautious of when taking Synthroid or levothyroxine

Answer 31

Be cautious of ppl on anticoagulants and ppl with diarrhea, it can exacerbate it. Hold if HR is tachycardic because this med increases HR GIVE 30 min before meals or 2 hr after, because food decreases absorption

Question 32

If a person is tachycardic and has hyperthyroidism what med will you expect to give

Answer 32

Beta blockers

Question 33

What can long term hormone treatment result in

Answer 33

Osteoporosis

Question 34

What is Somatropin

Answer 34

A growth hormone

Question 35

What is desmopressin

Answer 35

A posterior pituitary hormone regulator

Question 36

What are anti thyroid compounds

Answer 36

They treat hyperthyroidism

Question 37

What is the prototype anti thyroid hormone

Answer 37

Methimazole (MMI) Propythiouracil Iodine radioactive sodium iodine ( I-131)

Question 38

What is needed for synthesis of thyroid hormones

Answer 38

Low doses of iodine is needed for thyroid hormone synthesis

Question 39

What is MMI methimazole

Answer 39

Palliative treatments of hyperthyroidism/ inhibits the synthesis of thyroid hormone. Administered orally, excreted in the kidneys, metabolized in the liver

Question 40

What are adverse effects of methimazole

Answer 40

Hives, itching, fever, arthralgia, joint swelling, vertigo, drowsiness,nausea, vomiting, altered taste sensation.

Question 41

What are drug interactions of methimazole

Answer 41

Beta blockers Theophylline Warfarin

Question 42

What is Lugol

Answer 42

Presurgical solution of iodine prior to surgery

Question 43

How can one minimize adverse effects of MMI therapy

Answer 43

Arrange for periodic blood tests to monitor hematologic and thyroid functions Monitor bone marrow function

Question 44

How many parathyroid glands do we have

Answer 44

4 parathyroid glands

Question 45

What is the regulation of calcium do strictly to

Answer 45

The regulatio. Of calcium is due strictly to parathyroid glands

Question 46

Paget's disease

Answer 46

Softening of bones | Overactive bone formation

Question 47

What are antihypercalcemic drugs

Answer 47

Antihypercalcemic drugs do not directly affect the parathyroid gland or PTH but rather inhibit bone reabsorption of calcium Theses drugs are frequently used in Paget's disease Individuals with symptomatic disease experience bone pain and deformity, fractures, spinal cord compression, or cranial and spinal cord entrapment.

Question 48

What is the prototype antihypercalcemic drug

Answer 48

``` Calcitonin Alendronate Etidronate Pamidronate Risedronate Tiludronate ```

Question 49

Any time you see the suffix -nate, what does it mean

Answer 49

Parathyroid supplement

Question 50

What is calcitonin used for

Answer 50

Treatment of symptomatic Paget's disease

Question 51

What are contraindications of calcitonin

Answer 51

Allergies to salmon

Question 52

What are adverse effects of calcitonin

Answer 52

GI disturbances Skin rash Flushing of the face and hands Nasal irritation or rhinitis if using nasal spray alternate nostrils

Question 53

What are drug interactions of calcitonin

Answer 53

Calcium supplements Antacids Vitamin D Theophylline

Question 54

For Paget's disease, how should calcitonin be administered

Answer 54

INJECTION

Question 55

What does hypocalcemia lead to

Answer 55

Muscle tetany (severe Charlie horse)

Question 56

What is an ongoing assessment of the administration of calcitonin

Answer 56

Calcitonin can cause the serum calcium level to drop, resulting in tetany and cardiac arrhythmias

Question 57

If calcitonin salmon is given with calcium supplements, antacids, or vitamin D, What will happen

Answer 57

There is risk of HYPERCALCEMIA and therapeutic effect is decreased

Question 58

What are antihypercalcemic drugs

Answer 58

Calcitonin (1,25- dihydroxyvitwmin D3, rocaltrol [ capsules, solution]) Calcijex ( parenteral)

Question 59

Tell me what you know about vitamin D

Answer 59

Vitamin D Compounds regulate absorption of calcium and phosphate Vitamin D is considered a hormone, although it is not a natural human hormone. Vitamin D Metabolites control intestinal absorption of dietary calcium, tubular reabsorption of calcium from the kidney, and mobilization of calcium from the skeleton in conjunction with PTH vitamin D is also involved in MG metabolism Vitamin D works together with PTH and calcitonin to regulate calcium homeostasis .

Question 60

What is calcitrol used for

Answer 60

Management of hypocalcemia | It is a fat soluble vitamin derived fro natural sources ( fish, liver oils) or from conversion of provitamins

Question 61

What are contraindications of calcitriol

Answer 61

Given carefully to patients at risk for hypercalcemia or hypercalcuria

Question 62

What are adverse effects of calcitriol

Answer 62

Weakness headache nausea vomiting | Dry mouth constipation bone pain

Question 63

What are drug interactions of calcitriol

Answer 63

Thiazide diuretics

Question 64

What should chronic dialysis patients avoid while on calcitriol therapy

Answer 64

Avoid magnesium containing antacids