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Pharmacology Final > Module 11 - Endocrine Medication > Flashcards

Module 11 - Endocrine Medication Flashcards

1
Q

What is disease result in a thyroid dysfunction?

A
  • Hyperthyroidism
  • Hypothyroidism
  • Goiter (Enlarged thyroid)
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2
Q

What are the signs/symptoms of hypothyroidism?

A
  • Weight gain
  • Hair loss
  • Constipation
  • Fatigue
  • Depression
  • Dry, coarse skin
  • Bradycardia
  • Muscle cramps
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3
Q

Thyroid hormone Replacement - Medication Type

A

Levothyroxine sodium (Synthroid)

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4
Q

Levothyroxine sodium - Action and Use

A

Natural/synthetic thyroid drug that mimics the effects thyroid hormone

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5
Q

Levothyroxine sodium - Side/Adverse Effects

A
  • Headaches
  • Tremors
  • Isomnia
  • Fever
  • Diarrhea
  • Weight loss
  • Sweating
  • Hypertension
  • Tachycardia
  • Heart palpation
  • Increased appetite
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6
Q

Levothyroxine sodium - Precaution

A

Increases heart sensitivity - increases EP/NE

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7
Q

Levothyroxine sodium - Nursing consideration

A
  • Vitals (HR,BP,RR)
  • Renal function
  • Assess for thyroid disease
  • ECG - Check Cardiac function
  • TSH lab values
  • Provide education on use of medication - side effects and may take several weeks for therapeutic effect to show
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8
Q

What are the signs and symptoms of hyperthyroidism?

A
  • Bulging eyes
  • Facial flushing
  • Hypertension
  • Tachycardia
  • Weight loss
  • Muscle wasting
  • Diarrhea
  • Edema
  • Finger clubbing
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9
Q

Anti-thyroid (Thyroid Antagonist)- Medication Type

A

Methimazole (tapazole)

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10
Q

Methimazole - Actions and Uses

A
  • Reduces secretion of thyroid hormone

- Inhibits T4 conversion into T3 - decreases signs and symptoms of hyperthyroidism

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11
Q

Methimazole -Side/Adverse Effects

A
  • Abdominal cramps
  • Palpitations
  • Hypertension
  • Granulocytopenia (too many white blood cells)
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12
Q

Methimazole - Nursing considerations

A
  • Assess TSH
  • Monitor liver function
  • Vitals (HR, BP)
  • Assess nutrition
  • Monitor pregnant women on medication - can cause congenital defects
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13
Q

Mineralocorticoids is produced where and what is the primary mineralcorticoid?

A
  • Produced in Adrenal Cortex
  • Aldosterone is primary mineralcorticoid
  • Controlled by the renin-angiotensin-aldosterone system (RAAS)
  • Excretes Potassium
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14
Q

Mineralocorticoids - Medication type and function

A

Fludrocortisone

  • Replacement therapy for adrenal insufficiency
  • Encourages excretion of potassium and conserves sodium and water - Acts like ALDOSTERONE
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15
Q

Fludrocortisone - Side/Adverse Affects

A
  • Hypertension
  • Edema
  • CHF
  • Cardiac enlargement
  • Abdominal pain
  • Headaches
  • Fever
  • Heart burn
  • Hypokalemia
  • Blurred vision
  • Depression
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16
Q

Fludrocortisone - Precaution

A

Should not take when sick or have a viral infection can be fatal

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17
Q

Fludrocortisone - Nursing consideration

A
  • Assess K+, Na+ and Mg+ levels
  • Vitals (HR,BP)
  • ECG
  • Assess for Edema
  • Assess mood/behaviour
  • Assess kidney function
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18
Q

Glucocorticoids - Function

A
  • Produced in Adrenal Cortex and secretes Cortisol
  • Increases blood glucose
  • Suppresses immune/inflammatory function
  • Increases sensitivity to smooth muscle
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19
Q

Symptoms of low cortisol?

A
  • Hypoglycemia
  • Fatigue
  • Weakness
  • Nausea
  • Vomiting
  • Hypotension
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20
Q

What is Addison’s Disease?

A
  • Auto-immune disorder
  • Destruction of both adrenal glands
  • Decrease in aldosterone and cortisol
  • Kidneys unable to retain sodium and water so affects are dehydration
  • Can lead to shock
21
Q

Glucocorticoids - Anti-Inflammatory - Function

A

Suppress acute inflammatory responses by preventing cell-medicated immune reaction

22
Q

Anti-Inflammatory Glucocorticoid- Medication types (3)

A

1) Short-Acting - hydro-cortisone (cream) and NSAID’s
2) Intermediate - Prednisone
2) Long-Acting - Dexamethesone

23
Q

Hydro-cortisone - Action and Use

A
  • Available in creams/ointment solution and used on the superficial skin layer
  • Reduces inflammation
24
Q

Hydro-cortisone - Side/Adverse effects

A
  • Edema
  • Burning
  • Itching
  • Irritation
  • Dryness
  • Folliculitis (hair follicles become inflamed)
25
Q

Hydro-cortisone - Nursing considerations

A
  • Educate on use of cream - do not over apply
  • Assess risk of infection
  • Assess for signs of Cushing’s Disease - not advisable to use if client has disease
  • Skin assessment
  • Assess for Edema
26
Q

Prednisone - Action and Use

A
  • Intermediate acting anti-inflammatory
  • Taken orally
  • Prevents inflammation response
  • Suppress immune system
    Treatment: Arthritis, Allergies and Immune disorders
27
Q

Prednisone - Precaution

A

Avoid using if you have a fungal infection as can have an adverse effect

28
Q

Prednisone - Side/Adverse effects

A
  • Mood changes
  • Blurred vision
  • Bradycardia
  • Urinary retention
  • Dizziness
  • Headaches
  • Edema
  • Weight gain
29
Q

Prednisone - Nursing considerations

A
  • Vitals (HR, BP)
  • Assess Edema
  • Assess mood/behavior
  • Skin Assessment
  • Increase fluid
  • Assess input vs output
  • LFT
  • Kidney function
  • WBC count
  • Educate on use of medication - do not take if there is a risk of infection
30
Q

Dexamethasone- Action and Use

A
  • Long-Acting anti-inflammatory
  • Taken orally and once/day in the AM
  • Prevent the release of substances in the body that cause inflammation ex) Bradykinin and Histamine
    Treatment: Severe skin conditions, Arthritis and Allergies
31
Q

Dexamethasone- Side/Adverse Effect

A
  • Depression
  • Dizziness
  • Blurred vision
  • Urinary retention
  • Bradycardia
  • Numbess
32
Q

Dexamethasone- Nursing Considerations

A
  • Vitals (HR, BP)
  • Increase fluid
  • Assess intake vs output
  • Assess Mood/behavior
  • Assess skin condition and risks of infection
33
Q

Insulin - Function and Production

A
  • Produced by the pancreas naturally (Beta-cells)
  • Medication treatment of metabolic disorder Diabetes Mellitus (Type 1 and 2)
  • Lowers blood glucose levels
34
Q

Diabetes Mellitus Type 1 - What is it?

A
  • Destruction of insulin Beta cells
  • Little or no insulin production
  • Onset is abrupt and rapid - usually in Childhood
  • Insulin dependent
35
Q

Diabetes Mellitus Type 2 - What is it?

A
  • Cell receptor sites resist insulin
  • Below normal or above normal insulin production
  • Can occur due to obesity
  • Onset is slow
  • Oral or insulin administration
  • Can be reversed by lifestyle changes
36
Q

Long term complications from Diabetes?

A
  • Cardiovascular disease
  • Hypertension
  • Stroke
  • Obesity
  • Kidney failure
  • Vision problems
  • Nerve damage
  • Mood/Behaviour changes
37
Q

Insulin types (4)

A

1) Rapid acting - Humalog
2) Short -Acting/Regular - Humulin R
3) Intermediate Acting - Humulin N
4) Long - Acting - Lantus

38
Q

Rapid - Acting Insulin - Onset, Peak and Duration

A
  • Onset = 10-15 min
  • Peak = 1-2 hours
  • Duration = 3-5 hours
  • Used at the start of a meal
  • Works over a narrow/predictable time range
39
Q

Short -Acting/Regular - Onset, Peak and Duration

A
  • Onset = 30 min
  • Peak = 2-3 hours
  • Duration = 6.5 hours
  • Taken 30-60 min before a meal so it allows time to work
40
Q

Intermediate Acting - Onset, Peak and Duration

A
  • Onset = 1-3 hours
  • Peak = 5-8 hours
  • Duration = 18 hours
  • Usually cloudy insulin
  • Works throughout the day
41
Q

Long-Acting -Onset, Peak and Duration

A
  • Onset = 90 min
  • Peak = None
  • Duration = 24 hours( cloudy) and 16-24 hours (clear)
  • Can be clear and cloudy
  • Works throughout the day
42
Q

Ways to administer insulin?

A
  • Pen - replaceable cartilages
  • Pumps - continuous under the skin - SC diffusion devices
  • Syringe
43
Q

Insulin - Side/Adverse effects

A
  • Hypoglycemia
  • Headache
  • Sweating
  • Trembling
  • Anxiety
  • Confusion
  • Irritability
  • Rapid breathing
  • Tachycardia
  • Weight gain
44
Q

Insulin - Nursing Considerations

A
  • Promote proper nutrition
  • Promote regular moderate exercise
  • Educate on insulin therapy
  • Assess blood glucose levels
  • Vitals (HR, BP, RR)
  • Respiratory Assessment
  • ECG
  • Assess mood/behavior
45
Q

Oral anti-diabetics - Actions and Uses

A
  • Stimulate beta cells to produce more insulin
  • Increases receptor response to insulin
  • Decreases glucose production by the liver
  • Effective for Type 2 and well controlled diabetes
46
Q

Oral anti-diabetics - Side/Adverse Effects

A
  • Hypoglycemia
  • Weight gain
  • Edema
  • Dizziness
  • Fatigue
  • Risk of liver disease
  • Diarrhea
  • Gas/Bloating
47
Q

Oral-anti-diabetics - Nursing Considerations

A
  • Assess blood glucose levels
  • Assess edema
  • Encourage healthy diet/exercise
  • Assess LFT
  • Intake/output
48
Q

What are some behavior management techniques to minimize symptoms of endocrine disease?

A
  • Adapt a healthy lifestyle (Nutrition, Exercise, No Smoking)
  • Schedule follow ups with health provider
  • Taking blood glucose levels regularly
  • Blood tests – K+, Na+, Mg+, TSH, HbA1C, LFT’s
  • Education on proper use of medication
  • Signs and Symptoms of hypoglycemia and hyperglycemia

Pharmacology Final (6 decks)

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