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119 Cards in this Set

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The following are examples of which Hypothalamic Hormone drugs:

- ocreotide (Sandostatin; Sandostatin LAR Depot)
Growth Hormone Inhibitors
Which endocrine drugs are indicated for:

- tx of acromegaly
- carcinoid tumors
- diarrhea (with AIDS)
Growth Hormone Inhibitors
True or False:

Side effects common with Growth Hormone Inhibitors
False: they're rare
What are the two routes of administration for Growth Hormone Inhibitors?
- SC
- Depot injections (1x/month)
The following are examples of which Hypothalamic Hormone drugs:

- leuprolide (Lupron; Lupron Depot)
Luteinizing Hormone-Releasing Hormone agonist (similar to GnRH - Gonadotropin Releasing hormone)
Which Endocrine drug initially stimulates LH & FSH, then inhibits gonadotropin secretion, decreasing the production of testosterone & estrogen
Luteinizing Hormone-Releasing Hormone agonist (similar to GnRH)
When are Luteinizing Hormone-Releasing Hormone agonists indicated?
- prostate Ca
- endometriosis
- central precocious puberty (CPP)
What are some side effects to Luteinizing Hormone-Releasing Hormone agonists?
- similar to testosterone or estrogen deficiency
- may increase bone pain
- may increase dysuria
- may aggravate depression
What route are Luteinizing Hormone-Releasing Hormones given?
- only given parenterally
Which endocrine drugs stimulate the release of cortisol from the adrenal cortex
Corticotropin
the following are examples of which endocrine drugs:

- ACTH
- Acthar
- Acthar Gel
Corticotropins
When are Corticotropins indicated?
- dx testing of adrenocortical function
- exacerbation of multiple sclerosis
- replacement therapy
- immunosuppressant
What are some side effects to Corticotropin use?
- Na, H2O retention
- hypokalemia
- hyperglycemia
- increased susceptibility to infection
- osteoporosis
What two routes are used with Corticotropins?
- SC
- IM
the following are examples of which endocrine drugs:

- somatropin (Humatrope, Genotropin, Nutropin)
- somatrem (Protropin)-[only FDA approved for pediatrics]
GH Hormones
What endocrine drugs promote skeletal & muscle growth, increase liver glycogenolysis and increase fat mobilization?
GH hormones
When are GH Hormones indicated?
- linear bone growth in children (i.e. dwarfism)
- replacement therapy
When are GH Hormones contraindicated?
- active tumors
- AFTER PUBERTY
What are some side effects to GH Hormones?
- HA
- hyperglycemia
- ketosis
- hypothyroidism
- hypercalceuria
- rash
- urticaria
- inflammation at injection site
Which endocrine drugs are used to induce ovulation in the treatment of infertility and treat hypogonadism
Human Chorionic Gonadotropin

- HCG (Chorex)
What two effects may occur with HCG use?
- sexual precocity
- breast enlargement in preadolescent boys
the following are examples of which endocrine drugs:

- vasopressin (Pitressin)[IV]
- desmopressin (DDAVP)[PO & intranasal]
Antidiuretic Hormone
What is the MOA of Antidiuretic Hormone?
increases H2O reabsorption in the kidneys; produces vasoconstriction
When are Antidiuretic hormones indicated?
- diabetes insipidus
- trauma-induced bleeding
What are some side effects to Antidiuretic Hormone use?
- water intoxication
- Caution in clients with CV disorders
- abd cramps
- nausea
- diarrhea
Which endocrine drug promotes uterine contractions and controls bleeding in post-partum phase?
oxytocin (Pitocin)
What are some adverse effects of oxytocin (Pitocin)?
- excessive uterine contractions
- uterine rupture (from forcefull contraction)
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
Which endocrine drugs affect all aspects of inflammatory and immune responses?
Glucocorticoids
When are Glucocorticoids indicated?
- a wide range of disease that have an inflammatory/immunologic component
- hormone replacement
When are Glucocorticoids contraindicated?
- systemic fungal infections
- hypersensitivity
- infection
- DM
What implication applies to Glucocorticoids concerning blood sugar?
Glucocorticoids may increase blood sugar to levels requiring insulin even for non-diabetics
Despite the fact that almost anything can be a side effect of Glucocorticoids, what unique condition can be brought about by long-term use?
Cushings
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
True or False:

When taking Glucocorticoids, clients should decrease Na intake and increase K+ intake
True
Why should PO Glucocorticoids not be administered with antacids?
Because they will decrease GI absorption
the following are examples of which endocrine drugs:

- fludrocortisone (Florinef)[PO: 0.1mg qday]
Mineralcorticoids
Which endocrine drugs replace a hormone which promotes absorption of H2O & Na and K+ excretion
Mineralcorticoids
When are Mineralcorticoids indicated?
- Addison's disease
- primary hypoaldosteronism
- BP control
What are some side effects of Mineralcorticoid use?
- Na & H2O retention
- Hypokalemia
What is the acronym for Cushings S&S and what are the symptoms?
BOHEMI

B uffalo hump
O besity
H irsutism
E motional disturbance
I nfection
What S&S besides those in the acronym are attributed to Glucocorticoid induced Cushings?
- increased sugar
- decreased salt
- decreased sex
- striae
Which endocrine drugs produce a euthyroid state?
Thyroid drugs
When are Thyroid drugs indicated?
- primary and secondary hypothyroidism
- cretinism
- myxedema
the following are examples of which endocrine drugs:

- levothyroxine (Synthroid, Levothroid)[PO or IV]
Thyroid Drugs
When is levothyroxine (Synthroid) given?
give in morning on empty stomach
Which thyroid hormone is levothyroxine (Synthroid) synthesized as?
T4
Which thyroid drug is a short duration act ion
liothyronine (Cytomel, Triostat)
Which thyroid hormone is liothyronine (Cytomel, Triostat) synthesized as?
T3
Which thyroid hormones is liothyronine (Thyrolar) synthesized as?
T3&T4 (4:1 ratio)
What are some side effects of thyroid drugs?
- dysrhythmias
- tachycardia
- palpitations
- insomnia
- tremor
- nervousness
- S&S of hyperthyroidism
True or False:

therapy for hypothyroidism is LIFETIME
True
When should Thyroid drugs be administered?
In the morning without antacids
What is the landmark pulse rule for giving Thyroid medications?
Pulse must be < 100 before taking
What action may need to be taken for a client given Thyroid medications who is also on anticoagulants?
May require decreased anticoagulant dose
What therapeutic effects should be observed in a client taking thyroid medications?
- increased energy
- increased GI motility
- weight loss
How long after beginning thyroid drug therapy should results begin to appear?
several weeks
When are Antithyroid drugs indicated?
- hyperthyroidism
- thyroid storm
When are Antithyroid drugs contraindicated?
- pregnancy (could cause fetus to develop hypothyroidism)
What are some side effects to Antithyroid drug use?
- hair/taste loss
- agranulocytosis
- hepatic dysfunction
- rash
- S&S hypothyroidism
The following are examples of which endocrine drugs:

- propylthiouracil (PTU)
- methimazole (Tapazole)
- saturated solute ion of potassium iodide (SSKI)
Antithyroid Drugs
Which antithyroid tx destroys the thyroid gland?
Radioactive Iodine (Preg Cat D)
What beta blocker is used to treat SNS stimulation seen with hyperthyroidism?
propanolol (Inderal)
What foods may be restricted for clients on Antithyroid medication?
Seafood and/or iodized salt
What method is used in Antithyroid drug administration?
dilute solutions with glass of juice or milk and have client drink through a straw
Which 2 hormones and vitamin maintain serum Ca+ levels?
- PTH
- calcitonin
- vitamin D
Which hormone secretes in response to serum Ca+ levels - controlled by a negative feedback system?
PTH
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
vitamin D
How do weight bearing exercises help prevent osteoporosis?
prevents/ reduces calcium resorption
The following is an example of which endocrine drug?

- teriparatide (Forteo)[SC injection]
Parathyroid Hormone
The following is an example of which endocrine drug:

- calcium gluconate
IV Calcium medication
The following is an example of which endocrine drug:

- calcium carbonate/citrate
- calcium acetate (Phoslo)
- calcium carbonate (Tums)
- calcium citrate (Citracel)
PO Calcium medication
The following is an example of which endocrine drug:

- Os-Cal + D
OTC combo (calcium and vit D)
Which mineral and 3 medications should not be taken with Ca+ supplements?
- Fe
- tetracycline
- cipro
- phenytoin
The following is an example of which endocrine drug:

- calcitriol (Rocaltrol)
vitamin D [available in dairy products]
calcitriol (Rocaltrol) is often given to patients on what support procedure?
Dialysis pts
When are Calcitonin medications indicated?
- Paget's disease
- osteoporosis
- hypercalcemia
How often are Calcitonin medications given?
- daily, then 3x/week
What 2 routes can calcitonin-salmon (Miacalcin; Calcimar) be given?
- SC
- intranasal
The following are examples of which endocrine drug:

- alendronate (Fosamax)
- ibandronate (Boniva)
- risedronate (Actonel)
Biphosphonates
Which endocrine drug binds to bone and inhibits resorption of Ca from bone?
Biphosphonates
When are Biphosphonates indicated?
- hypercalcemia
- osteoporosis
True or False:

Biphosphonates should be taken with meals
False; must be taken on empty stomach with H2O (poorly absorbed)
What nursing implication applies to Biphosphonates due to potential esophageal irritation?
Have client take in upright position and remain upright for at least 30 minutes
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?
Increased calcium will cause a decrease in phosphorus
Which endocrine drug mobilizes cellular uptake of glucose and decreases blood glucose levels?
Insulin
What major functions does insulin play a role in with cellular uptake of glucose?
- metabolism of carbs, fats, and proteins
Which condition seemingly unrelated to diabetes calls for insulin tx?
- hyperkalemia (with D50) [insulin used to shift potassium out of blood into cell]
What is the target blood sugar?
70-120 mg/dL
When is insulin contraindicated?
Hypoglycemia
What is the standard initial dose of insulin?
0.5-1.0 units/kg
What is the sliding scale formula for insulin administration
BS - 100 / 30 (20 if unstable)

ex) If BS < 150 give 0 units
BS 150 - 200 give 2 units
BS > 351 call MD
True or False:

Mixtures are sometimes appropriate with insulin pumps
False: mixtures are never appropriate with insulin pumps
How are insulins mixed?
Roll vial in hand - Do not shake
Who must always verify your dose in syringe prior to each administration?
Another lisensed nurse
When mixing short-acting (R) with intermediate or long-acting, always draw up which first?
draw up the regular insulin first
How are insulins kept?
Keep insulin refrigerated (NOT FROZEN) - administer at room temperature
Research has indicated that what common hypertension/cardiac medication is useful in preventing nephropathy in clients with Type I/II DM?
ACE Inhibitors
Research indicates that what cardiac medication decreases atherosclerotic disease and decreases CV incidents in diabetics?
statins
atrophy, dimpling or hypertrophy at injection sites d/t frequent injections in same site
Lipodystrophy
How do the following herbal/dietary supplements affect BS levels:

- Bee pollen
- Ginkgo biloba
- Glucasamine
May increase BS levels
How do the following herbal/dietary supplements affect BS levels:

- Basil
- Bay leaf
- Chromium
- Echinacea
- Garlic
- Ginseng
- Clucomannan
- Guargum
May decrease BS levels
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
When are Estrogens indicated?
- HRT hormone replacement therapy (menopause, hypofunction)
- part of birth control pills
When are Estrogens contraindicated?
- 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
the following are examples of which endocrine drugs:

- megestrol acetate (Megace) [PO]
- norethindrone acetate (Aygestin) [PO]
- medroxyprogesterone acetate (Depo-Provera) [IM]
- Progesterone [IM]
Progestins
When are Progestins indicated?
- part of contraceptives
- suppress ovarian function in dysmenorrheal endometriosis
- endometrial cancer
- uterine bleeding
What are hormonal contraceptives composed of?
- synthetic estrogen
- synthetic progestin
Why would Biphasic & Triphasic hormonal contraceptives be preferred of Monophasic?
Bi & Triphasic hormonal contraceptives provide varying amounts of estrogen & progestin which mimic normal hormonal secretions better
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
What surgical procedure for females requires estrogen & progestin?
Hysterectomy
HRT is effective in preventing & treating what disorder common in the elderly?
osteoporosis
What schedule are anabolic steroids?
schedule III
When are anabolic steroids indicated?
- androgen deficiency
- breast cancer
- endometriosis
When are anabolic steroids contraindicated?
- pregnancy
- liver disease
- prostate disorders
What are some adverse effects of anabolic steroids?
- HTN
- hypercholesterolemia
- liver disorders
- aggression
- hostility
- combativeness
- dependency
- testicular atrophy
- impotence
- amenorrhea in women
- fluid & electrolyte disorders
- acne
The drug below is used to tx what disorder?

- testosterone cypionate (Depo-Testosterone)
Hypogonadism
The drug below is used to tx what disorder?

- testolactone (Teslac)
Breast Ca
What supplement is taken to increase testosterone but has not been proven effective in research?
DHEA