Endocrine Flashcards
(20 cards)
Hypothyroidism
Cretinism - neonate unable to produce T3/T4
Myxedema - slowing of metabolism, mucous accumulation in connective tissue
Hashimoto’s - autoimmune attacking thyroid gland
Hyperthyroidism
Graves’ disease - autoimmune disorder where thyroid is over stimulated
Hypothyroid Medications
Thyroid hormone replacement therapy
Levothyroxine
Usually required for life
Hyperthyroid Medications
Radioactive iodine - taken up in gland, radiation kills cells (may eventually require replacement therapy)
Antithyroid drugs - propylthiouracil, methimazole (reduce T3/T4 production, reduce conversion of T4 to T3)
Adrenal Gland
Mineralocorticoids
Glucocorticoids
Gonadocorticoids
Mineral/gluco are collectively called corticosteroids
Corticosteroid Pharmacology
Over 20 types
All are well absorbed, transported attached to plasma proteins, widely distributed, metabolized by liver, excreted by kidneys
Classified by duration of action
Corticosteroid Adverse Effects
Immune suppression Peptic ulcers (if taken with NSAIDS) Osteoporosis Muscle wasting Glaucoma risk Metabolic changes Most significant effect of long term use - CUSHINGS SYNDROME
Corticosteroid Nursing Intervention
Use lowest dose possible to reduce risk of adverse effects
Apply topically and locally if possible
Alternate day doses to minimize adrenal atrophy
Adrenocortical Insufficiency
Addison’s disease
Lack of glucocorticoids and mineralocorticoids
Corticosteroid replacement therapy
Corticosteroids for Inflammation
Usually requires much larger dose
Regimen is essential to minimize adverse effects
Ex: arthritis, IBD, asthma, allergies, transplant rejection prophylaxis, dermatological conditions, neoplasms, edema
Cushing’s Syndrome Medication
Ketoconazole- inhibits synthesis of adrenal steroids
Bolus Insulin
Rapid acting
Short acting
Rapid Acting Insulin
15 min before meals
Peak 1-2 hours
Duration 3-5 hours
Short Acting Insulin
Humulin R
30 minutes before meals
Peak 2-3 hours
Duration 6.5 hours
Basal Insulins
Intermediate acting
Long acting
Intermediate acting Insulin
Humulin N Given once or twice daily Onset 1-3 hours Peak 5-8 hours Duration up to 18 hours
Long Acting Insulin
Usually given once at bedtime
Onset 90 minutes
Duration 16-24 hours depending on specific medication
Premixed Insulins
Mix of long and short acting insulins
Type 2 DM
Usually controlled with diet/lifestyle changes and oral antihyperglycemic drugs
Oral Antihyperglycemic Medications
Alpha- glucosidase inhibitors Biguanides Incretin enhancers Meglitinides Sulfonylureas Thiazolidinediones
