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Endocrine Meds Flashcards

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1
Q

What is the purpose of the Endocrine System?

A
  1. Maintain homeostasis
  2. Communicate body’s responses to external environment
  3. Regulates growth, reproduction, energy use & electrolyte balance
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2
Q

What body functions does the hypothalamus regulate?

A

thirst, hunger, water, BP, respiration, emotions

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3
Q

What hormones are produced/secreted by hypothalamus?

A
  1. GHRH
  2. TRH
  3. CRH
  4. PRH
  5. Somatostain (GH inhibiting factor)
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4
Q

What is the thyroid mechanism of action?

A
  1. Regulate activity of genes to change the amount of protein synthesis and enzyme activity
  2. Stimulate mitochondrial oxidation
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5
Q

What does iodine deficiency cause?

A

Hypothyroidism

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6
Q

If a patient had a goiter, what would be your major concerns?

A
  1. Is there airway compromised?
  2. Can the swallow?
  3. Are the nodules cancerous?
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7
Q

What are the causes of hyperthyroidism?

A

too much T3 & T4

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8
Q

What autoimmune disorder causes hyperthyroidism?

A

Grave’s Disease

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9
Q

What are the clinical manifestations of hyperthyroidism?

A
  1. Inc metabolism (which leads to weight loss)
  2. Tachycardia
  3. Increased body temperature (leads to heat intolerance)
  4. Anxiety
  5. Insomnia
  6. Shaky hands
  7. Exophthalmos (protruding eyes)
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10
Q

What is a late sign of hyperthyroidism?

A

Exophthalmos

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11
Q

Propylthiouracil and Methimazole are in what drug class?

A

Thionamides

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12
Q

What is the mechanism of action for thionamides (propylthioruacil & methimazole)?

A
  1. Block production of thyroid hormone (TH)

2. Block conversion of T4 to T3

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13
Q

What are the therapeutic uses for Propylthioruacil & Methimazole?

A
  1. Treats Grave’s Disease
  2. Attain a euthyroid state
  3. Treats Thyroid storm
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14
Q

How long does it take to reach euthyroid state when taking thionamides (propylthioruacil/methimazole)?

A

May take up to 3-12 weeks

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15
Q

What are some adverse effects of propylthioruacil/methimazole?

A
  1. Agranulocytosis
  2. Overmedication may cause hypothyroidism
  3. Liver damage (more common with PTU)
  4. Causes change in taste, N/V, rash, arthalgias
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16
Q

Nursing Interventions for Propylthioruacil/Methimazole

A
  1. Monitor weight/VS/I&Os
  2. Watch for S/S of hypothyroidism
  3. Monitor AST & ALT, jaundice, dark urine
  4. Monitor CBC for agranulocytosis/fever/sore throat
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17
Q

Patient Education for Propylthioruacil/Methimazole

A
  1. Take at same time each day

2. Do not stop medication abruptly

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18
Q

Why would a HCP prescribe Propanolol in conjunction with thianomides?

A

To decrease tremors and tachycardia

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19
Q

Why is Methimazole preferred over propylthiouracil?

A
  1. Revereses hyperthyroidism quickly
  2. Fewer side effects
  3. Given with radioactive iodine treatment
  4. Can be taken once a day
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20
Q

How often must propylthiouracil be taken?

A

2-3 days

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21
Q

What effect does thionamides have on anticoagulants?

A

Increases the effect of anticoagulants

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22
Q

What effect does thionamides have on antidiabtics?

A

Decreases the effect of antidiabetics

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23
Q

Explain the interaction between antithyroid drugs and digoxin/lithium?

A

Digoxin/Lithium increases action of thyroid medications

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24
Q

What effect does phenytoin have on T3 levels?

A

Phenytoin increases T3 levels, so must monitor closely

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25
What patient teaching should the nurse provide if administer propranolol with thionamides?
Advise against strenuous activities/exercise to prevent HR increase until hyperthyroidism is regulated
26
How can Grave's Disease be treated? What is the most common treatment?
1. Surgical removal 2. Radioactive treatment Radioactive treatment most common.
27
What is the mechanism of action of radioactive iodine?
Destroys thyroid producing gland
28
What are the adverse effects of radioactive iodine?
1. Radiation sickness 2. Bone Marrow Suppression 3. Hypothyroidism (may need long term Synthroid/levothyroxine 4. Pregnancy Cat X
29
Nursing Interventions for Radioactive Iodine
1. Monitor CBC 2. Monitor for signs of hypothyroidism 3. Do not administer with other antithyroid meds 4. Dispose of body waste per protocol 5. Limit client contact
30
Patient Education for Radioactive Iodine Treatment
1. Increase fluid intake 2. Stop treatment if there's severe N/V 3. Increase fluid intake
31
Clinical Manifestations of Thyroid Storm
1. Extremely High Fever (T>105) 2. Severe Tachycardia 3. Agitiation 4. Tremors 5. Coma 6. Hypotension 7. HF
32
What causes severe thyrotoxicosis (Thyroid Storm)?
1. Surgery | 2. Development of concurrent illness
33
Nursing Interventions for patients with Thyroid Storm
Isolate for 2 weeks
34
What causes Myxedema?
Prolonged hypothyroidism with no treatment
35
What is Cretinism? What causes it?
1. Congenital Hypothyroidism | 2. Mother iodine deficiency during pregnancy
36
Clinical Manifestations of Cretinism
1. Large protruding tongue 2. Pot Belly 3. Dwarfish Stature
37
Common S/S of Hypothyroidism
1. Dry Skin 2. Weight Gain 3. Constipaiton 4. Hair Loss 5. Short stature (in kids)
38
Purpose of Levothyroxine
Synthetic salt form of T4
39
What is Levothyroxine used for?
1. Hypothyroidism treatment | 2. Emergency treatment of Myxedema Coma
40
Adverse Effects of Levothyroxine
1. Overmedication --> Hyperthyroidism 2. Increases effect of Warfarin 3. Dont give with Sucralfate (reduces effect) 4. Use cautiously with cardiac patients
41
Nursing Interventions for Levothyroxine
1. Monitor VS and weight 2. Administer before breakfast w/ water 3. Check labels before using OTC 4. Advise pt to report signs of hyperthyroidsim
42
Patient Education for Levothyroxine
1. Take missed dose as soon as you remember | 2. Report signs of hyperthyroidism
43
Purpose of Parathyroid Glands
1. Secrete PTH | 2. Regulate Calcium, Vit D, & Phosphate levels
44
What is Hyperparathyroidism?
Excessive production of PTH
45
What does an excessive production of PTH lead to?
Hypercalcemia
46
What causes hyperparathyroidism?
1. Osteroporosis 2. Paget disease 3. Renal failure 4. Malignancies
47
Clinical manifestations of Hyperparathyroidism
1. Hypercalcemia symptoms (BACKME) 2. Lethargy 3. AV Block 4. Hypertension 4, Muscle weakness 5. Osteoporosis 6. Kidney Stones 7. Excessive Urination
48
Purpose of Calcitonin Salmon
1. Balance effects of PTH 2. Inhibits bone resorption 3. Lowers calcium levels 4. Increases Ca excretion
49
Purpose of Alendronate
Slows/blocks bone resorption to lower Ca levels
50
What drug class is alendronate in?
Biphosphonates
51
What is the therapeutic use for Calcitonins & Biphosphonates?
Treat osteoporosis, Paget's disease, hypercalcemia, and multiple myeloma
52
What are the adverse effects of Calcitonins?
1. Flushed face/hands 2. N/V 3. Urinary frequency 4. Inflammation at injection site
53
Nursing Interventions for Calcitonins
1. Increase fluid intake 2. Rotate injection sites 3. Monitor serum calcium levels 4. Treat bone pain with acetominophen 5. Monitor Kidney fx 6. Do not administer if fish/salmon allergy
54
Adverse effects of Biphosphonates
1. Headache 2. N/D 3. Initial bone pain 4. Esophogeal erosion 5. Femoral fractures (long term use)
55
Nursing Interventions for Biphosphonates
1. Contraindicated with hypocalcemia | 2. Dont use if pregnant/breastfeeding
56
Patient Education for Biphosphonate
1. Take 30 min before breakfast with full glass of water 2. Stay upright for 30 min after taking 3. Only take for 3-5 years 5. Avoid aspirin/antacids/Ca products/iron
57
What causes hypoparathyroidism?
1. Absent parathyroid from birth | 2. Accidental removal upon thyroid removal
58
S/S of Hypoparathyroidism
1. Hypocalcemia (CATS) 2. Sensitive nerves 3. Uncontrollable spasms 4. Hyperactive reflexes 5. Positive Chvostek&Trousseau 6. Hypotension 7. Abdominal cramps
59
How do you treat hypoparathyroidism?
Daily calcium and Vitamin D
60
What is the purpose of calcitriol?
1. Regulate Ca and Phosphate absorption from small intestine 2. Mineral resorption in bones 3. Phosphate reabsorption in renal tubules
61
Therapeutic Uses of Calcitriol
1. Hypocalcemia management 2. Hypoparathyroidism 3. Chronic renal dialysis
62
Adverse effects of Calcitrol
1. GI Effects 2. CNS Effects (weakness, headache, irritability) 3. Hypermagnesemia (if taken with Mg antacids) 4. Muscle pain, bone pain
63
What is calcitrol?
Vitamin D Compound
64
Nursing Interventions for Calcitrol
1. Monitor serum calcium levels 2. Administer acetominophen for bone pain 3. Caution use with history of kidney stones 4. Educate on weight bearing exercises and smoking/drinking cessation
65
What hormones are secreted by anterior pituitary gland?
1. GH 2. ACTH 3. FSH 4. LH 5. PRL 6. TSH
66
What hormones are secreted by posterior pituitary gland?
1. ADH | 2. Oxytocin
67
Somatropin Mechanism of Action
1. replaces human growth hormone (GH) | 2. stimulates skeletal anf internal organ growth
68
What are the therapeutic uses of Somatropin?
1. Long term use for children with growth failure (Turner syndrome) 2. AIDs wasting 3. GH Deficiency (Hypopituitarism)
69
What is somatropin?
Recombinant growth hormone
70
Adverse Effects of Somatropin
1. Slipped Capital Femoral Epiphysis (SCFE) 2. Hypothyroidism (rare) 3. Insulin Resistance 4. Increased intracranial pressure (treat with lumbar puncture) 5. May cause scoliosis to be more prominent
71
What type of diabetes does somatropin cause?
Type 2 Diabetees
72
Nursing Interventions for Somatropin?
1. Administer IM or SQ 2. Rotate injection sites 3. Store meds in fridge 4. Monitor for headache 5. Monitor for hip pain
73
What causes Diabetes Insupidus?
low ADH due to disease/injury of pituitary gland
74
Clinical Manifestations of Diabetes Insipidus
1. Large amounts of dilute urine 2. Concentrated blood (due to dehydration 3. Polyuria, polydipsia 4. Normal glucose levels
75
How do you treat diabetes insipidous?
Replace ADH and fluids
76
What is demopressin?
recombinant ADH
77
What is desmopressin mechanism of action?
1. Produce antidiuretic effects 2. Increase water reabsorption 3. Decrease urine formation
78
Therapeutic Uses or desmopressin
treats diabetes insipidus
79
Adverse Effects of Desmopressin
1. Water intoxication (drowsiness, vision changes, dizziness) 2. Tremors 3. Sweating 4. Vertigo 5. N/V 6. Abdominal cramps
80
Nursing Interventions for desmopressin
1. Use cautiously in patients with epilepsy, asthma, hyponatremia 2. No pregnant ppl 3. Monitor daily weight and I&Os 4. Monitor for "hangover" symptoms 5. Advise to stop during acute illness

Pathopharmacology (6 decks)

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