Endocrine Medications Flashcards
(25 cards)
Endocrine system:
- consists of ductless glands
- produces hormones that regulate and control metabolic activities maintaining homeostasis
- digestion
- growth and development
- electrolyte and water metabolism
- reproductive functions
Major endocrine glands:
- Pineal
- Adrenal
- Hypothalamus
- Thymus
- Pituitary
- Pancreas
- Thyroid
- Gonads
- Parathyroid
Glands:
Gland - group of cells that produce and secrete chemicals in response to a stimulus
Exocrine gland - releases secretions in the skin or inside the mouth vid ducts. e.g. sweat and salivary glands
Endocrine gland - releases more than 20 major hormones directly into the bloodstream, where they can be transported to cells in other parts of the body. e.g. Pituitary, Thyroid, Pancreas
Endocrine medications include:
- Anti-diabetic agents - hypoglycemics
- Thyroid and anti-thyroid agents
- Calcium regulating agents
- Hormone therapy
- Contraceptives
Diabetes Mellitus Mx:
- Multi-system disease
- caused by absence deficiency or inactivity of insulin
Signs and symptoms include: - elevated BGL
- glycosuria
- polyuria and loss of minerals
- thirst and polydipsia
Glucose metabolism:
- regulated by pancreas
- BGL rises - following food
- insulin released by the pancreas
- insulin stimulated cells to take in glucose from the bloodstream
- glucose is converted to glycogen/fat for storage and used for energy
- this results in a normal BGL
Types of diabetes:
Type 1 Diabetes Mellitus: T1DM
- insulin dependent
- autoimmune disorder
- no insulin production
Type 2 Diabetes Mellitus: T2DM
- 30% become insulin dependent
Gestational Diabetes Mellitus: GDM
- during pregnancy
Insulin deficiency:
- insulin reduces blood glucose levels by facilitating glucose uptake by muscle and connective tissues
- influences protein and fat metabolism
- diabetes mellitus affects how the body metabolises carbohydrates, proteins and fats
- insulin deficiency is characterised by an imbalance between required and available amounts of insulin
Treatment of T2DM:
Oral Hypoglycaemic Agents (OHAs)
- Sulphonylureas
- Biguanides (Metformin)
- Thiazolidinediones (Gitazones)
- Post-prandial glucose regulators
Adverse effects of OHAs:
- weight gain
- oedema
- nausea
- hypoglycaemia
- GIT upset
- allergic skin reaction
- bone marrow depression
Hypoglycaemia:
- not eating enough at meals, skipping meals
- insulin excess
- stress or anxiety
- drugs - alcohol, beta blockers, high dose aspirin
- CNS - dizziness, faintness, tremors, sweating, agitation, convulsion, coma
Managment of Hypoglycaemia:
immediate treatment is required as patients can lose consciousness quickly.
- glycose, complex carbohydrates
- slow IV glucose
- IM, S/C, IV glucagon if severe
Nursing considerations of OHAs:
- regular BGL monitoring
- consider drugs that can interact with oral hypoglycaemics
- administer with food to minimise hypoglycaemia
- long-acting agents should be avoided
Hyperthyroidism:
signs and symptoms:
- tachycardia
- hyperactivity
- anxiety
- moist skin
- weight loss
- increased appetite
- pyrexia
Hypothyroidism:
signs and symptoms:
- bradycardia
-hypopyrexia
- hypoactivity
- fatigue
- hair loss
- dry skin
- weight gain
- poor memory
Anti-thyroid medications:
Carbimazole (Neo-Mercazole)
- blocks production of thyroid hormone
- high dose first then decreased for maintenance
Sodium iodide:
- reduces the production of thyroid hormone by destroying thyroid cells
- short term use in patients who have high surgical risk
Thyroid medications:
- treatment relies on replacement of the missing hormone.
Thyroxine - slow onset but long acting - adverse effects - tremor, headache, tachycardia, GIT disturbance, weight loss, insomnia
Thyroxine (Oroxine, Eutroxsig) nursing considerations:
- monitor heart rate and rhythm
- therapy is life-long
- takes 3-4 weeks of therapeutic effect
- reduce effect of digoxin
Hormone replacement therapy (HRT):
- oral, injectable or topical (transdermal, intranasal, or vaginal)
- avoid first pass effect permitting lower dose
Adverse effects: - breast tenderness
- fluid retention
- headaches
- GIT disturbances
- break-through bleeding
- risk of breath and uterine cancer
Nursing considerations: - apply skin patches to clean, dry skin
- rotate skin to reduce irritation
Osteoporosis:
- reduction in bone mass that occurs with aging, especially in post-menopausal women
- risk reduced by diet, adequate calcium intake, HRT, physical activity
- drug use is to prevent fractures and associated morbidity in people with low bone density or history of fracture
Corticosteroid indications:
- replacement therapy in corticosteroid deficiency (Addison’s disease)
- anti-inflammatory in asthma, rheumatoid arthritis, cerebral oedema, allergies
- immunosuppressant in organ transplant and neoplastic disease
Corticosteroid actions:
- increase gluconeogenesis (generation of glucose)
- depress inflammatory and allergic response
- delayed healing
- increase fat storage in face, shoulders, abdomen
- retains sodium
- causes euphoria
Adverse effects for corticosteroids:
- sodium/fluid retention
- hypertension
- muscle wasting, weakness, osteoporosis, tendon rupture
- hiccups, nausea, vomiting, anorexia, indigestion
- depression, psychosis, mood swings, nervousness, insomnia
- delayed wound healing, increased bruising, acne
Corticosteroids nursing considerations:
monitor for:
- mood changes
- hyperglycaemia
- hypertension
- signs of infection
- weight changes indicative of fluid retention
