Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Pharmacology > Chapter 30: Pituitary Drugs > Flashcards

Chapter 30: Pituitary Drugs Flashcards

1
Q

Hypothalamus

A

Consists of the anterior pituitary gland (adenohypophysis) and posterior pituitary gland (neurohypophysis)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Endocrine system

A

Can be considered similarly to the CNS for signaling; each operates in a stimulus-and-response manner. Together, they function to maintain the physiologic stability of the endocrine system

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

These are stored in the posterior pituitary gland and is secreted by the hypothalamus

A

The hormones vasopressin and oxytocin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

The hypothalamus secretes several

A

Hormone releasing factors that stimulate the anterior pituitary gland to secrete a variety of hormones that control many bodily functions

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Water soluble hormones

A

Protein based substances such as the catecholamines norepinephrine and epinephrine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Lipid soluble hormones

A

Consist of the steroid and thyroid hormones

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Anterior pituitary gland (adenohypophysis) hormones

A 
Adrenocorticotropic hormone (ACTH) 
Follicle-stimulating hormone (FSH)
Growth hormone (GH) 
Luteinizing hormone (LH) 
Prolactin (PH) 
Thyroid-stimulating hormone (TSH)

Drugs include: cosyntropin, somatropin, and octreotide

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Posterior pituitary gland (neurohypophysis)

A 
Antidiuretic hormone (ADH) 
Oxytocin

Drugs include: vasopressin, desmopressin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Negative feedback loop

A

A system where the production of one hormone is controlled by the levels of a second hormone that reduces the output of the first hormone.

Ex: when gland X releases hormone X, this stimulates target cells to release hormone Y. When there is an excess of hormone Y, gland X senses this excess and decreases its release of hormone X.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Pituitary drugs

A

Used as replacement therapy for hormone deficiency or as a diagnostic aid to determine the status of the patients hormonal functions.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Exogenous corticotropin

A

IV is no longer manufactured
IV was replaced by cosyntropin
IM or SubQ injections are available
H.P. Actuary Gel is also available

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Cosyntropin MOA

A

Travels to the adrenal cortex (located just above the kidney) and stimulates the secretion of cortisol which has many anti inflammatory effects (e.g., reduce leukocyte inflammatory functions and scar tissue formation) and promotes renal retention of sodium, which can result in edema and hypertension

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Drugs that mimic the GH (MOA)

A

Somatropin and Somatrem promote growth by stimulating various anabolic (tissue building) processes, liver glycogenolysis (to raise blood sugar), lipid mobilization from body fat stores, and retention of sodium, potassium, and phosphorus. Promoting growth in children lacking endogenous hormone

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Drug that antagonizes the effects natural GH by inhibiting GH release (MOA)

A

Octreotide is similar to GH release-inhibiting factor (somatostatin) and reduces conc.s of vasoactive intestinal polypeptide (VIP)- a protein secreted by a type of tumor known as VIPoma causing profuse watery diarrhea

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Vasopressin mimics the ADH (posterior pituitary effector) (MOA)

A

Concentrated urine, reduces water by up to 90%; potent vasoconstrictor used in certain hypotension emergencies (e.g., vasodilator/septic shock), ACLS of pulseless cardiac arrest, and stop bleeding of esophageal varies

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Desmopressin mimics the ADH (posterior pituitary effector) (MOA)

A

Concentrated the urine, reducing water excretion by up to 90%; causes a dose-dependent increase in plasma levels of factor VIII (antihemophilic), von Willebrand factor, and tissue plasminogen activator making it useful in treating certain blood disorders; also is used to manage nocturnal enuresis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Oxytocin (MOA)

A

Mimics the endogenous hormone, promoting uterine contractions

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Cosyntropin indication

A

Used in the diagnosis of adrenocortical insufficiency

Drug treatment involves replacement therapy using forms of the deficient corticosteroid hormones

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Somatropin and somatrem indication

A

Effective in stimulating skeletal growth in patients with an inadequate secretion of normal endogenous GH, such as those with hypo pituitary dwarfism, and are also used for wasting associated with HIV infection

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Octreotide indication

A

Alleviating certain symptoms of carcinoid tumors stemming from VIP secretion, including severe diarrhea, flushing, and potentially life-threatening hypotension associated with carcinoid crisis; also used to treat esophageal varices

21
Q

Vasopressin and Desmopressin indications

A

Prevent or control polydipsia (thirst), polyuria, and dehydration in patients with diabetes insipidus caused by a deficiency of endogenous ADH.

Due to vasoconstrictive properties, are used to treat bleeding esp in particular GI hemorrhage

Desmopressin is useful in the treatment of hemophilia A and type I von Willebrand Disease because of its effects on various blood clotting factors

22
Q

Pituitary “contraindications”

A

Simply special caution in patients with acute or chronic illnesses such as migraine headaches, epilepsy, and asthma

23
Q

Octreotide adverse effects

A 
Fatigue, malaise, HA
Increase or decrease in glucose
Diarrhea, N/V
Dyspnea
Arthralgia
Conduction abnormalities
24
Q

Desmopressin and vasopressin adverse effects

A 
Increased blood pressure
Fever, vertigo, HA
N, heartburn, cramps
Uterine cramping
Nasal irritation & congestion, tremor, sweating
25
Q

Growth hormone analogues adverse effects

A

HA
Hyperglycemia, hypothyroidism
Hypercalciuria

Rash, urticaria, development of antibodies to GH, inflammation at injection site, flulike syndrome

26
Q

Desmopressin interactions

A

Carbamazepine, result in enhanced desmopressin effects; lithium, alcohol, demeclocycline result in reduced desmopressin effects

27
Q

Octreotide interactions

A

Cyclosporine- Care report of transplant rejection; thioridazine and ciprofloxacin prolong QT interval

28
Q

Somatropin interaction

A

Glucocorticoids reduce growth effects

29
Q

Vasopressin interactions

A

Carbamazepine and fludrocortisone enhance the antidiuretic effect

Demeclocycline, norepinephrine, and lithium reduce the antidiuretic effect

30
Q

Octreotide drug profile

A

Contraindicated in allergy; caution in patients with renal impairment (may impair gallbladder function)

May affect glucose: can cause severe hypoglycemia in patients with type 1 diabetes and hyperglycemia in patients with type 2 diabetes or patients without diabetes

May enhance toxic effects of drugs that prolong the QT interval- like Ciprofloxacin

Can be given IV, IM, or SubQ

Pregnancy category B

31
Q

Somatropin drug profile

A

Indicated to treat growth failure due to inadequate GH secretion. Used for patients with HIV infection with wasting or cachexia in conjunction with antiviral therapy.

Pregnancy category B or C (manufacturer-dependent)
Contraindicated in allergy, in children with closed growth plates, patients with tumors, and patients with acute illnesses.

ADRs: HA, injection site reactions, muscle pain, hypoglycemia, or hyperglycemia

DO NOT SHAKE

Usually given SubQ; some products are given IM

32
Q

Vasopressin drug profile

A

Used to control various types of bleeding (in particular GI hemorrhage) and in pulseless arrest and vasodilatory shock (continuous IV)

Contraindicated in allergy, pregnancy (category C), caution in patients with seizure disorder, asthma, CV disease, renal disease

Watch IV for infiltration (May lead to severe vasoconstriction and localized tissue necrosis) and use a central venous line access device when possible

Nasal spray- a topical applied to the nasal membranes and must NOT be inhaled, IM, or IV use

33
Q

Desmopressin drug profile

A

Used to treat hemophilia A and Type I von Willebrand desease because of its effects in various blood clotting factors.

Available as DDAVP Rhinal Tube and has an antidiuretic effect that is about one tenth that of an equivalent dose given IV.

34
Q

Octreotide acetate assessment

A

Prescriber May order an electrocardiogram because of possible conduction abnormalities

Baseline glucose, liver and kidney functions completed as prescribed

35
Q

Desmopressin assessment

A

Assess VS, Hx of seizures, asthma, or CV disease which require cautious use with neurological status, VS, breath sounds, and heart sounds

36
Q

Vasopressin assessment

A

If being treated for shock:

Close monitoring with ECG, VS, and invasive monitoring methods like arterial lines, central venous pressure lines, and/or arterial blood gas

37
Q

GH assessment

A

Obtain baseline thyroid, glucose, and calcium levels (as prescribed) due to the potential side effects of hyperglycemia, hypothyroidism, and hypercalciuria

38
Q

Somatropin assessment

A

Monitor growth, motor skills, height, and weight of the pediatric patient

39
Q

Octreotide implementations

A

Take care not to confuse the injection form with the injectable depot suspension dosage form

Only clear solutions; check for complications

Report abd. distress, diarrhea, N/V that’s unimaginable

Stress the importance of follow ups for lab tests

40
Q

Desmopressin implementations

A

Per prescribers orders because dose and route vary with indication

Can be given oral, IV, intranasal, and SubQ

Rotate SubQ/ IM injections (somatropin)

Mix injectable solutions by swirling the liquid; ONLY CLEAR SOLS.

Intranasal can lead to changes in nasal mucosa with unpredictable drug absorption

For patients with diabetes insipidus, fluid intake may be adjusted according to the predicted risk for water intoxication and sodium deficit.

41
Q

Vasopressin implementations

A

Available as a nasal spray, IM, or IV

Check clarity of sols. Before administration; discard if there are any visible particles or fluid discoloration

Notify I’d ADRs of elevated blood pressure, fever, nausea, or abd. Cramping worsen

Given topically when given nasally- NOT TO BE INHALED

42
Q

Octreotide evaluation

A

Therapeutic effects include improved S/S related to carcinoid tumors, VIPoma, or esophageal varies

43
Q

Vasopressin evaluation

A

Improvement in diabetes insipidus, esophageal varices, or vasodilatory shock

44
Q

Somatropin evaluation

A

Increased growth is expected for whom it is indicated

Evaluate for ADRs: HA, muscle pain, and altered blood glucose levels

45
Q

Desmopressin and vasopressin evaluation

A

ADRS: increased blood pressure, fever, HA, abd. Cramps, and nausea

46
Q

GH evaluation

A

May lead to HA, hyperglycemia hypothyroidism, hypercalciuria, and flu-like syndrome

47
Q

Intranasal dosages

A

Nasal passages must be cleared before admin

Prime drug by pressing down 4 times

Pump will stay primed for 1 week then reprime

Store nasal spray at room temp
Store DDAVP Rhinal Tube in Fridge

48
Q

Children with endocrine disorders

A

May have increased risk for bone problems

If limping= need to be evaluated by prescribers

Pharmacology (4 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions