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Flashcards in Endocrine System Deck (25):
1

Endocrine System

Collection of glands that secrete hormones to regulate the functions of cell tissues and organs

2

Hormones

Chemical messages released in response to a change in the body's internal environment to maintain body hemostasis

3

Negative Feedback

One hormone controls secretion of another hormone and the last hormone in the pathway provides feedback to turn off secretion of the first hormone

4

replacement therapy

Insufficient quantities of endogenous hormone a are produced
Ex: insulin in diabetes, or Synthroid in hypothyroidism

5

Cancer treatment

To shrink the size of hormone-sensitive tumors
EX: tamoxifen

6

Exaggerated response

Normal action of a hormone but exaggerated
EX: hydrocortisone to suppress inflammation

7

Anti-hormones

Block actions of endogenous hormones
EX: prpylthiouracli (PTU) in hyperthyroidism,

8

ADH
(Anti diuretic hormone)
ADD MORE

Causes the retention of fluid
DI is when you have too little AHD - lot of urine output
Too much ADH - very decreased and concentrated output (SIADH)

9

DDAVP
Desmopressin

Thera: Hormone
PharmL: ADH
Indications: diabetes insipidus, von Willebrands disease, bed wetting
MOA; acts on kidneys to rehab robs water, controls bleeding in certain clotting disorders
Adverse: Drowsiness, headache, symptoms of water intoxication (edema/weight gain, HTN, hyponatremia)
Indications: monitor i&o, fluid volume statues, specific gravity. Use with caution in clients with renal disease, hyponatremia. Available PO, intranasal, SC and IV piggyback

10

Thyroid Hormones

Thyroid affects basal metabolic rate- growth and development in kiddos
Triiodothyronine (T3) - more effective
Tetraiodothyronine (T4) - more produced

11

Hypothyroidism

Subnormal temp
Bradycardia
Weight gain
Thickened skin
Cardiac complication
Extreme fatigue

12

Hyperthyroidism

Hot
Weight loss
Tachycardia
Flushing
Bulging eyes
Tremors
Diarrhea
Localized edema

13

Levothyroxine (Synthroid)

Thera: Thyroid hormone replacement
Pharm: Thyroid hormone
Indications: Hypothyroidism
MOOA: Synthetic T4 increases metabolic rate of body tissues
Adverse: Symptoms of hyPERthyoidism (tachy, hot, anxiety, weight loss, etc)
Indications: Given on on empty stomach (30-60 before brekkie to prevent insomnia), narrow therapeutic range but long half life, given once per day and peaks 6-8 weeks. Many drug interactions. Use with caution in elderly with heart disease. Education patients that this is a life long therapy (does not cure). Monitor TSH levels

If hypo low T4 levels and high TSH levels

14

Methimazole (Tapazole)

Hyperthyroidism
Often used prior to thyroidectomy to radioactive iodine therap
Interfered with synthesis of T3 and T4
Adverse effect include symptoms of hyPOthyroidism, hepatotoxicity, bone marrow suppression

*Second line drug for hyPER is propylthiouracil

15

Adrenal Hormones

Glucocorticoids (cortisol) - sugar
Mineralocorticoids (aldosterone) - salt
Androgens/gonadocorticoids (testosterone) - sex

16

Glucocorticoids

ADD INSULIN SECTION

Ex: hydrocortisone, methylprednisolone, cortisone, prednisone, dexamethasone

Can be used to manage adrenal insufficiency (due to Addison's disease, sudden withdrawal of corticosteroids or insufficient amounts in the critically ill)

17

Regular Insulin (Humulin R and Novolin R)

Thera: hormone drug for diabetes
Pharm: hypoglycemic
Indications: treatment of hyperglycemia, treatment of acute ketoacidosis, treatment of hyperkalemia (off-label)
MOA: short acting insulin to promote entry of glucose into cells
Adverse: hypoglycemia (tachy, confusion, sweating; coma/death if severe goes untreated), hypokalemia
Implications: Sc or IV. Only use insulin syringe, admin 30 min before meal

18

Metformin (glucophage)

Thera: antidiabetic
Pharm: biguanide
Indications: Type II diabetes (first line)
MOA: decreases hepatic production of glucose and reduces insulin resistance(benefit is that it does not cause hypoglycemia; also lowers triglyceride, LDL levels and promotes weight loss)
Adverse: N/V, diarrhea, abdominal bleeding, metallic taste
BLACK BOX: increased risk of lactic acidosis (may be fatal) with liver/renal disease, excess alcohol intake or serious infection
Implications: contraindicated with impaired renal function, heart failure, liver failure, serious infection. Must be held 2 before and 2 days after receiving IV contrast

19

Diabetes

Deficiency in insulin secretion or a decreased sensitivity of insulin receptors leading to elevated blood glucose levels (hyperglycemia)

20

Glucose

Major source of energy for the body

21

Insulin

Allows glucose to enter cells in order to be used for energy.

If insulin is not available to facilitate the entry of glucose into the cells, the body then metabolizes lipids as a source of energy leaving to a state of acidosis ~

22

HYPERglycemia

Blood glucose ~ 180
Thirst, hunger, frequent urination

23

HYPOglycemia

BG < 70mg/dL
Usually sudden onset
decreased LOC

24

Types of diabetes

Type I: Pancreas cannot secrete insulin. Patients are insulin dependent
Type II: Pancreas can secrete insulin but usually in small amounts; insulin receptors in target tissues are unreceptive
Gestational: Unknown but possible due to increased hormones from placenta blocking insulin.

25

Sulfonylureas

-1st and 2nd generation equally effective in lowering glucose levels (2nd has fewer drug/drug interactions)
-Stimulate release of insulin & increase sensitivity of insulin receptors on target cells
-Adverse effects: hypoglycemia, weight gain, GI distress, hypersensitivity to sulfonamide drugs, hepatotoxicity
-Taken with alcohol: flushing, palpitations, nausea