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Pharm > Module 11 > Flashcards

Module 11 Flashcards

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1
Q

What Hormones are Secreted by the Thyroid

A

T4 (Thyroxine)
T3 ( Triidothyronine )
Calcitonin

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2
Q

What is needed and essential for the sintheses of the Thyroid hormones ?

A

Iodine: through dietary intake of salt.

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3
Q

What is the function of thyroid hormones

A

Regulate Basal Metabolic rate… the speed at which cells perform their functions.

Your metabolism and the body’s ability to break down food and convert it into energy.

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4
Q

Diseases that result from Thyroid Disfunction

A

Hyperthyroidism
Hypothyroidism
Goiter ( Most common )

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5
Q

Normal Thyroid Hormone findings in Male and Female

A

Male : 51-154 nmol/L

Female: 64-154 nmol/L

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6
Q

Hypothyroidism Disorder

Signs and Symptoms

A 
Weight Gain
Hair Loss
Constipation
Muscle Cramps
Depression
Bradycardia
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7
Q

what is TSH

A

Thyroid Stimulating Hormone secreted by the pituitary Gland

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8
Q

Primary Hypothyroidism Diagnosing test

A

Laboratory tests of T4 and TSH levels

Low T4 and high TSH

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9
Q

What effects the TSH and T4 levels in critically ill adults ?

A

Stress.

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10
Q

Therapeutic Class of medication for Thyroid replacement therapy

A

Thyroid Agent

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11
Q

Example of a Thyroid Agent drug

A

Levothyroxine Sodium (Synthroid)

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12
Q

Levothyroxine Sodium (Synthroid)

A

Thyroid Agent: Synthetic form of T4

  • Thyroid hormone replacement in hypothyroidism.
  • Promote Gluconeogenesis
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13
Q

Nursing assessments for thyroid replacement therapy

A
  • Cardiovascular complications such as collapse in clients with undiagnosed heart disease
  • Renal Function increase in metabolic rate increases the work load on the kidneys
  • Monitor TSH levels
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14
Q

Patient teachings for Thyroid Replacement Therapy

A
  • Replacement will most likely be needed for the rest of their lives.
  • Several weeks for the full edict of hormone replacement to be achieved
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15
Q

Side effects/Adverse Effects of Thyroid Replacement therapy.

A
  • Headache
  • Insomnia
  • Weight Loss
  • Heat Intolerance
  • Increased appetite
  • Abdominal Cramps
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16
Q

Hyperthyroidism Signs and Symptoms

A
  • Weight Loss
  • Fatigue
  • Moist Skin
  • Emotional Instability
  • Intolerance to heat
  • Enlarged Thyroid
  • Tachycardia
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17
Q

Most common Cause of Hyperthyroidism

A

Graves Disease

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18
Q

Hyperthyroidism

A

Thyroid Disorder that is excessive in the secretion of thyroid hormones

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19
Q

Hyperthyroidism Medications

A

Thiomides

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20
Q

How do hyperthyroid medications work (Thiomides)

A

Reduce the secretions of thyroid hormones by inhibiting T4 conversion into T3

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21
Q

Methimazole (Tapazole )

A

Thiomide medication that has a much longer half life and less frequent dosage

  • Has more severe side effects
  • Not for pregnant woman as it crosses the placenta
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22
Q

Propylthiouracil (PTU)

A

Thiomide medication preferred for women who are pregnant

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23
Q

Sodium Iodide (I-131)

A

Thiomide medication that uses iodizing radiation to destroy just enough of the thyroid gland for it to return to normal functioning

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24
Q

Nursing Considerations/Assessments for Hyperthyroid Medications

A
  • monitor WBC count
  • Assess for skin rash
  • Thyroid function laboratory tests.
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25
Adverse/Side effects of hyperthyroid medications
``` Rash Headache Drowsiness loss of taste vertigo ```
26
patient Teachings for hyperthyroid medications
- Do not breastfeed | - Report slow speech, slow pulse, excess fatigue
27
What hormones does the Adrenal Cortex secrete ?
Corticosteroids: Gluccorticoids Mineralocorticoids (Sex Hormones)
28
What hormones does the Adrenal Medulla secrete
Epinephrine Norepinephrine (Adrenaline )
29
Corticosteroids
Mineralocorticoids | Gluccorticoids
30
Aldosterone
95% of the mineralocorticoids | - promotes sodium reabsorption and water retention.
31
Primary Functions of Aldosterone
- Conserve sodium - Conserve water - Promote excretion of potassium
32
Cortisol
Primary Gluccocorticoid
33
Function of Cortisol
Increase blood Glucose Suppress immune/inflammatory function Increase sensitivity of vascular smooth muscle to norepinephrine
34
Primary mineralocorticoid
Aldosterone | -promotes sodium reabsorption and water retention.
35
Primary glucocorticoids
Cortisol excreted from adrenal cortex
36
Symptoms of to little corticosteroid production
Hypoglycemia fatigue hypotension GI Disturbances
37
Primary disease resulting from too little corticosteroids
Addisons Disease | Needs aldosterone to retain sodium and water
38
Mineralocorticoid replacement therapy
- for insufficient adrenal hormone - conserve sodium and water - encourages excretion of potassium
39
fludrocortisone ( Florinef )
Mineralocorticoid replacement medication | for hypoaldosteronism
40
Glucocorticoid Replacement
- Anti-inflammatory | - given a lot in autoimmune diseases
41
Hydrocortisone
short acting Glucocorticoid
42
Predisone
Intermediate -acting glucocorticoid
43
Dexamethasone
Long acting glucocorticoid
44
Side/adverse effects of Glucocorticoids
- Hyperglycemia | - Cushings Disease ( after long term use )
45
Primary Disease from too much Glucocorticoids
Cushings Disease
46
Pancrease is responsible for the secretion of what ?
Glucagon | Insulin
47
Glucagon does what
Increases your blood sugars by singling the liver to release stored glucose into the bloodstream
48
Insulin
Helps cells absorb glucose from the blood when sugar is too high. - Responsible for glucose metabolism - reduces blood sugar by increasing use and storage in tissues
49
Type 1 Diabetes
Destruction of insulin producing cells - Dependent on insulin administration - oral agents are not effective.
50
Type 2 diabetes
cell/receptor resistant to insulin. - May require insulin - Oral agents are effective.
51
Non-Pharmacological ways to manage diabetes
- Proper nutrition - regular moderate physical exercise - insulin therapy - oral antidiabetic agent.
52
Hyperglycemia
High blood sugar (glucose )
53
Hypoglycemia
Low blood glucose (sugar)
54
Insulin Therapy
Injected into subcutaneous fat
55
Can insulin be held ?
when they are fasting for tests and npO
56
Nursing considerations for Insulin
Monitor blood glucose carefully always carry a source of sugar incase of hypoglycaemic reactions strictly follow diet
57
Humalog insulin
Rapid acting
58
Humulin R Novolin GE Toronto
Short acting/regular
59
Humulin N Novolin GE NPH
iNTERMEDIATE ACTING
60
Lantus | Levemir
Long-acting | given once a day
61
When do you hold insulin?
if NPO for tests or surgery If BS is too low If LOC is a concern If not eating for persistent vomiting
62
Oral Antidiabetic Agents
- stimulate beta cells to produce more insulin | - type 2 and well controlled diabetes
63
Biguanides ( metformin )
Antidiabetic agent decreases glucose production increases glucose uptake and insulin sensitivity in cells - can cause build up in kidneys causing lactic acidosis - requires kidney function tests
64
Sulfonylureas
Stimulate insulin secretion from pancreas.
65
Meglitinides
Anti diabetic agent | stimulates insulin secretion from pancreas
66
Thiazolidediones
Makes cells more sensitive to the effects of insulin
67
Alpha glucosidase inhibitors
Slows absorption of carbohydrates into the body to allow the body to produce its own insulin.

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