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119 Cards in this Set
- Front
- Back
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The following are examples of which Hypothalamic Hormone drugs:
- ocreotide (Sandostatin; Sandostatin LAR Depot) |
Growth Hormone Inhibitors
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Which endocrine drugs are indicated for:
- tx of acromegaly - carcinoid tumors - diarrhea (with AIDS) |
Growth Hormone Inhibitors
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True or False:
Side effects common with Growth Hormone Inhibitors |
False: they're rare
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What are the two routes of administration for Growth Hormone Inhibitors?
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- SC
- Depot injections (1x/month) |
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The following are examples of which Hypothalamic Hormone drugs:
- leuprolide (Lupron; Lupron Depot) |
Luteinizing Hormone-Releasing Hormone agonist (similar to GnRH - Gonadotropin Releasing hormone)
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Which Endocrine drug initially stimulates LH & FSH, then inhibits gonadotropin secretion, decreasing the production of testosterone & estrogen
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Luteinizing Hormone-Releasing Hormone agonist (similar to GnRH)
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When are Luteinizing Hormone-Releasing Hormone agonists indicated?
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- prostate Ca
- endometriosis - central precocious puberty (CPP) |
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What are some side effects to Luteinizing Hormone-Releasing Hormone agonists?
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- similar to testosterone or estrogen deficiency
- may increase bone pain - may increase dysuria - may aggravate depression |
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What route are Luteinizing Hormone-Releasing Hormones given?
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- only given parenterally
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Which endocrine drugs stimulate the release of cortisol from the adrenal cortex
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Corticotropin
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the following are examples of which endocrine drugs:
- ACTH - Acthar - Acthar Gel |
Corticotropins
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When are Corticotropins indicated?
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- dx testing of adrenocortical function
- exacerbation of multiple sclerosis - replacement therapy - immunosuppressant |
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What are some side effects to Corticotropin use?
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- Na, H2O retention
- hypokalemia - hyperglycemia - increased susceptibility to infection - osteoporosis |
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What two routes are used with Corticotropins?
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- SC
- IM |
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the following are examples of which endocrine drugs:
- somatropin (Humatrope, Genotropin, Nutropin) - somatrem (Protropin)-[only FDA approved for pediatrics] |
GH Hormones
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What endocrine drugs promote skeletal & muscle growth, increase liver glycogenolysis and increase fat mobilization?
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GH hormones
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When are GH Hormones indicated?
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- linear bone growth in children (i.e. dwarfism)
- replacement therapy |
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When are GH Hormones contraindicated?
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- active tumors
- AFTER PUBERTY |
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What are some side effects to GH Hormones?
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- HA
- hyperglycemia - ketosis - hypothyroidism - hypercalceuria - rash - urticaria - inflammation at injection site |
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Which endocrine drugs are used to induce ovulation in the treatment of infertility and treat hypogonadism
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Human Chorionic Gonadotropin
- HCG (Chorex) |
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What two effects may occur with HCG use?
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- sexual precocity
- breast enlargement in preadolescent boys |
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the following are examples of which endocrine drugs:
- vasopressin (Pitressin)[IV] - desmopressin (DDAVP)[PO & intranasal] |
Antidiuretic Hormone
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What is the MOA of Antidiuretic Hormone?
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increases H2O reabsorption in the kidneys; produces vasoconstriction
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When are Antidiuretic hormones indicated?
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- diabetes insipidus
- trauma-induced bleeding |
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What are some side effects to Antidiuretic Hormone use?
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- water intoxication
- Caution in clients with CV disorders - abd cramps - nausea - diarrhea |
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Which endocrine drug promotes uterine contractions and controls bleeding in post-partum phase?
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oxytocin (Pitocin)
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What are some adverse effects of oxytocin (Pitocin)?
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- excessive uterine contractions
- uterine rupture (from forcefull contraction) |
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the following are examples of which endocrine drugs:
- dexamethasone (Decadron)[PO] - cortisone (Cortone)[PO] - prednisone (Deltasone)[PO] - methylprednisolone (Solu-Medrol)[IV] - hydrocortisone (Solu-cortef)[IV] |
Glucocorticoids
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Which endocrine drugs affect all aspects of inflammatory and immune responses?
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Glucocorticoids
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When are Glucocorticoids indicated?
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- a wide range of disease that have an inflammatory/immunologic component
- hormone replacement |
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When are Glucocorticoids contraindicated?
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- systemic fungal infections
- hypersensitivity - infection - DM |
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What implication applies to Glucocorticoids concerning blood sugar?
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Glucocorticoids may increase blood sugar to levels requiring insulin even for non-diabetics
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Despite the fact that almost anything can be a side effect of Glucocorticoids, what unique condition can be brought about by long-term use?
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Cushings
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True or False:
Unlike some endocrine drugs, Glucocorticoids can be stopped abruptly and don't need to be tapered down over several days |
False; Glucocorticoids must be tapered down over several days
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True or False:
When taking Glucocorticoids, clients should decrease Na intake and increase K+ intake |
True
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Why should PO Glucocorticoids not be administered with antacids?
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Because they will decrease GI absorption
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the following are examples of which endocrine drugs:
- fludrocortisone (Florinef)[PO: 0.1mg qday] |
Mineralcorticoids
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Which endocrine drugs replace a hormone which promotes absorption of H2O & Na and K+ excretion
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Mineralcorticoids
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When are Mineralcorticoids indicated?
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- Addison's disease
- primary hypoaldosteronism - BP control |
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What are some side effects of Mineralcorticoid use?
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- Na & H2O retention
- Hypokalemia |
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What is the acronym for Cushings S&S and what are the symptoms?
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BOHEMI
B uffalo hump O besity H irsutism E motional disturbance I nfection |
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What S&S besides those in the acronym are attributed to Glucocorticoid induced Cushings?
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- increased sugar
- decreased salt - decreased sex - striae |
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Which endocrine drugs produce a euthyroid state?
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Thyroid drugs
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When are Thyroid drugs indicated?
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- primary and secondary hypothyroidism
- cretinism - myxedema |
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the following are examples of which endocrine drugs:
- levothyroxine (Synthroid, Levothroid)[PO or IV] |
Thyroid Drugs
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When is levothyroxine (Synthroid) given?
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give in morning on empty stomach
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Which thyroid hormone is levothyroxine (Synthroid) synthesized as?
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T4
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Which thyroid drug is a short duration act ion
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liothyronine (Cytomel, Triostat)
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Which thyroid hormone is liothyronine (Cytomel, Triostat) synthesized as?
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T3
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Which thyroid hormones is liothyronine (Thyrolar) synthesized as?
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T3&T4 (4:1 ratio)
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What are some side effects of thyroid drugs?
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- dysrhythmias
- tachycardia - palpitations - insomnia - tremor - nervousness - S&S of hyperthyroidism |
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True or False:
therapy for hypothyroidism is LIFETIME |
True
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When should Thyroid drugs be administered?
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In the morning without antacids
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What is the landmark pulse rule for giving Thyroid medications?
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Pulse must be < 100 before taking
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What action may need to be taken for a client given Thyroid medications who is also on anticoagulants?
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May require decreased anticoagulant dose
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What therapeutic effects should be observed in a client taking thyroid medications?
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- increased energy
- increased GI motility - weight loss |
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How long after beginning thyroid drug therapy should results begin to appear?
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several weeks
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When are Antithyroid drugs indicated?
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- hyperthyroidism
- thyroid storm |
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When are Antithyroid drugs contraindicated?
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- pregnancy (could cause fetus to develop hypothyroidism)
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What are some side effects to Antithyroid drug use?
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- hair/taste loss
- agranulocytosis - hepatic dysfunction - rash - S&S hypothyroidism |
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The following are examples of which endocrine drugs:
- propylthiouracil (PTU) - methimazole (Tapazole) - saturated solute ion of potassium iodide (SSKI) |
Antithyroid Drugs
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Which antithyroid tx destroys the thyroid gland?
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Radioactive Iodine (Preg Cat D)
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What beta blocker is used to treat SNS stimulation seen with hyperthyroidism?
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propanolol (Inderal)
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What foods may be restricted for clients on Antithyroid medication?
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Seafood and/or iodized salt
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What method is used in Antithyroid drug administration?
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dilute solutions with glass of juice or milk and have client drink through a straw
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Which 2 hormones and vitamin maintain serum Ca+ levels?
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- PTH
- calcitonin - vitamin D |
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Which hormone secretes in response to serum Ca+ levels - controlled by a negative feedback system?
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PTH
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Which vitamin acts to increase Ca+ levels by increasing absorption of Ca+ from the intestines and mobilizing Ca+ from bone; serves as an essential mineral
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vitamin D
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How do weight bearing exercises help prevent osteoporosis?
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prevents/ reduces calcium resorption
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The following is an example of which endocrine drug?
- teriparatide (Forteo)[SC injection] |
Parathyroid Hormone
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The following is an example of which endocrine drug:
- calcium gluconate |
IV Calcium medication
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The following is an example of which endocrine drug:
- calcium carbonate/citrate - calcium acetate (Phoslo) - calcium carbonate (Tums) - calcium citrate (Citracel) |
PO Calcium medication
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The following is an example of which endocrine drug:
- Os-Cal + D |
OTC combo (calcium and vit D)
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Which mineral and 3 medications should not be taken with Ca+ supplements?
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- Fe
- tetracycline - cipro - phenytoin |
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The following is an example of which endocrine drug:
- calcitriol (Rocaltrol) |
vitamin D [available in dairy products]
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calcitriol (Rocaltrol) is often given to patients on what support procedure?
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Dialysis pts
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When are Calcitonin medications indicated?
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- Paget's disease
- osteoporosis - hypercalcemia |
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How often are Calcitonin medications given?
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- daily, then 3x/week
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What 2 routes can calcitonin-salmon (Miacalcin; Calcimar) be given?
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- SC
- intranasal |
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The following are examples of which endocrine drug:
- alendronate (Fosamax) - ibandronate (Boniva) - risedronate (Actonel) |
Biphosphonates
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Which endocrine drug binds to bone and inhibits resorption of Ca from bone?
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Biphosphonates
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When are Biphosphonates indicated?
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- hypercalcemia
- osteoporosis |
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True or False:
Biphosphonates should be taken with meals |
False; must be taken on empty stomach with H2O (poorly absorbed)
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What nursing implication applies to Biphosphonates due to potential esophageal irritation?
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Have client take in upright position and remain upright for at least 30 minutes
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An important implication for dialysis concerning Rocaltrol and Phoslo administration is that because they both increase serum Ca+ levels they cause a decrease in what other mineral?
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Increased calcium will cause a decrease in phosphorus
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Which endocrine drug mobilizes cellular uptake of glucose and decreases blood glucose levels?
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Insulin
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What major functions does insulin play a role in with cellular uptake of glucose?
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- metabolism of carbs, fats, and proteins
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Which condition seemingly unrelated to diabetes calls for insulin tx?
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- hyperkalemia (with D50) [insulin used to shift potassium out of blood into cell]
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What is the target blood sugar?
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70-120 mg/dL
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When is insulin contraindicated?
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Hypoglycemia
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What is the standard initial dose of insulin?
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0.5-1.0 units/kg
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What is the sliding scale formula for insulin administration
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BS - 100 / 30 (20 if unstable)
ex) If BS < 150 give 0 units BS 150 - 200 give 2 units BS > 351 call MD |
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True or False:
Mixtures are sometimes appropriate with insulin pumps |
False: mixtures are never appropriate with insulin pumps
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How are insulins mixed?
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Roll vial in hand - Do not shake
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Who must always verify your dose in syringe prior to each administration?
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Another lisensed nurse
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When mixing short-acting (R) with intermediate or long-acting, always draw up which first?
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draw up the regular insulin first
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How are insulins kept?
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Keep insulin refrigerated (NOT FROZEN) - administer at room temperature
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Research has indicated that what common hypertension/cardiac medication is useful in preventing nephropathy in clients with Type I/II DM?
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ACE Inhibitors
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Research indicates that what cardiac medication decreases atherosclerotic disease and decreases CV incidents in diabetics?
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statins
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atrophy, dimpling or hypertrophy at injection sites d/t frequent injections in same site
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Lipodystrophy
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How do the following herbal/dietary supplements affect BS levels:
- Bee pollen - Ginkgo biloba - Glucasamine |
May increase BS levels
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How do the following herbal/dietary supplements affect BS levels:
- Basil - Bay leaf - Chromium - Echinacea - Garlic - Ginseng - Clucomannan - Guargum |
May decrease BS levels
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the following are examples of which endocrine drugs:
- ethinyl estradiol [PO] - ethinylestropipate (Ogen) [PO] - conjugated estrogens (Premarin) [PO] - estradiol transdermal gel (Estrogel) [Transdermal] - estradiol cypionate (Depo-Estradiol) [IM] - estradiol valerate (Delestrogen) [IM] |
Estrogens
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When are Estrogens indicated?
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- HRT hormone replacement therapy (menopause, hypofunction)
- part of birth control pills |
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When are Estrogens contraindicated?
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- pregnancy (Cat X)
- thromboembolic disorders - breast/genital Ca - undx vaginal/uterine bleeding - liver impairment - CAD - women > 35 yrs who smoke - Family Hx of breast/reproductive Ca |
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the following are examples of which endocrine drugs:
- megestrol acetate (Megace) [PO] - norethindrone acetate (Aygestin) [PO] - medroxyprogesterone acetate (Depo-Provera) [IM] - Progesterone [IM] |
Progestins
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When are Progestins indicated?
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- part of contraceptives
- suppress ovarian function in dysmenorrheal endometriosis - endometrial cancer - uterine bleeding |
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What are hormonal contraceptives composed of?
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- synthetic estrogen
- synthetic progestin |
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Why would Biphasic & Triphasic hormonal contraceptives be preferred of Monophasic?
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Bi & Triphasic hormonal contraceptives provide varying amounts of estrogen & progestin which mimic normal hormonal secretions better
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This endocrine drug:
- inhibits hypothalamic secretion of gonadotropin releasing hormone -> inhibits pituitary secretion of LH and FSH (ovulation ceases) - produces cervical mucus that resists the penetration of sperm -interferes with endometrial maturation |
Hormonal contraceptives
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What surgical procedure for females requires estrogen & progestin?
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Hysterectomy
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HRT is effective in preventing & treating what disorder common in the elderly?
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osteoporosis
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What schedule are anabolic steroids?
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schedule III
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When are anabolic steroids indicated?
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- androgen deficiency
- breast cancer - endometriosis |
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When are anabolic steroids contraindicated?
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- pregnancy
- liver disease - prostate disorders |
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What are some adverse effects of anabolic steroids?
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- HTN
- hypercholesterolemia - liver disorders - aggression - hostility - combativeness - dependency - testicular atrophy - impotence - amenorrhea in women - fluid & electrolyte disorders - acne |
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The drug below is used to tx what disorder?
- testosterone cypionate (Depo-Testosterone) |
Hypogonadism
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The drug below is used to tx what disorder?
- testolactone (Teslac) |
Breast Ca
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What supplement is taken to increase testosterone but has not been proven effective in research?
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DHEA
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