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100 Cards in this Set

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Any of various glands producing hormonal secretions that pass directly into the bloodstream. Also called the ductless gland
Endocrine glands
What are the glands that make up the Endocrine system?
Thyroid
Parathyroids
Ant. & Pos. Pituitary
Pancreas
Adrenals
Gonads
Mammary
Is called the “master gland” of the endocrine system, located at the base of the brain
Pituitary gland
How may lobes does Pituitary gland have?
Two (Anterior & Posterior)
A Pituitary gland lobe that secretes regulating hormone (tropic hormone) that control the actions of other endocrine glands
Anterior lobe
A Pituitary gland lobe that releases antidiuretic hormone (ADH) and oxytocin
Posterior lobe
Regulating hormones that is secreted by the Anterior lobe of the Pituitary gland and are named according to the gland they affect
Tropic hormones
A tropic hormone that affects the Thyroid gland
Thyrotropic
A tropic hormone that affects the cortex of the Adrenal gland
Adrenocorticotropic
A gland that is composed of two lobes located on either side of the larynx
Thyroid gland
Hormone that is secreted by the Thyroid gland which causes all cells to accelerate the rate of their metabolism
Thyroxine
A condition caused by a reduced activity of the Thyroid gland
Hypothyroidism

Note:
↑ TSH, ↓ T4 (thyroxine)
A disorder in children where the Thyroid gland fails to function properly during the formative years of a child's development
Cretinism

Note:
Child is called "Cretin"
Characteristics of Cretinism
·Occurs mostly in regions having iodine defficiency in water & food
·The child fails to develop normally
·Has pronounced mental retardation
·Slow development
·Skin is thickened, dry, & wrinkled
·Tongue is thick & protrudes from mouth
·Abdomen protrudes
·Legs are short
·Body musculature is weak
Treatment for Cretinism
Thyroid hormone therapy. Maybe corrected if given early in infancy
A type of hypothyroidism in adult that is characterized by a gradual slowing of mental & physical functions
Myxedema
Signs & Symptoms of Myxedema
Hands & feet are puffy
Skin is thick & leathery
Is hypersensitive to cold
A condition caused by an overproduction of the thyroid gland
Hyperthyroidism

Note:
↓ TSH, ↑ T4 (thyroxine)
Signs & Symptoms of Hyperthyroidism
Protruding eyes
Weight loss
Increased appetite
Tachycardia & Palpitations
Nervousness
Diarrhea
Abdominal cramps
↑pulse & bp
Headache
Intolerance to heat
Fever
Menstrual irregularities
Treatments for Hyperthyroidism
May be treated with an antithyroid drug:
propylthiouracil (dose: 100 mg)
methimazole (10 mg)
radioactive iodine
gland may be removed surgically
Also known as “chronic lymphocytic thyroiditis – is considered to be caused by an autoimmune process
Hashimoto's disease
Treatment for Hashimoto's disease
Thyroid treatment should be started based on the thyroid studies as soon as the disease is diagnosed
An enlarged thyroid gland.May be caused by hyperthyroidism or hypothyroidism. The growth resulting from a body “reflex” to compensate for the inefficiency of the gland
Goiter
Thyroid Preparations
Either natural or synthetic preparations.
Naturally produced in the thyroid gland.
Synthetic permits greater accuracy & predictability when treating thyroid dysfunction

Ex: thyroid
Obtained primarily from hogs.
May be used in varied dosage as neccessary to attain thyroid function
Antithyroid agents
methimazole (Tapazole)

propylthiouracil


Note: These agents should not be taken by pregnant women because these can induce goiter & hypothyroidism in the developing fetus
An antithyroid agent which:
Inhibits synthesis of thyroid hormone by preventing incorporation of iodine into the hormone.

It is used for palliative treatment of hyperthyroidism & preoperatively before surgical or radiation procedures
methimazole (Tapazole)
Glands that are located directly above the kidneys and are composed of two parts: cortex (outer portion), & medulla (inner portion)
Adrenal glands
The outer portion of the Adrenal glands that secretes number of hormones that are essential to life
Cortex
The inner portion of the Adrenal glands that secretes epinephrine & norepinephrine
Medulla
Name four hormones secreted by the Cortex
cortisone

hydrocortisone

aldosterone

deoxycorticosterone
Three important functions of the hormones secreted by the Cortex
1.Regulation of water & salt metabolism
2.Regulation of carbohydrate metabolism
3.Production of anti-inflammatory effects
Uses of Cortisone & Hydrocortisone
Suppression of the symptoms of rheumatoid arthritis, bursitis, various types of skin diseases

Tx of multiple sclerosis

Note:
Neither of the two drugs cure the disease or causes any real improvement. They only suppress the symptoms
Adrenocorticoid agent side effects
Salt & Water retention
"Moon facies"
Muscular weakness
Hirsutism
Acne
Occasional mental disturbances
Some precautions when using adrenocorticoid agents
In patient with peptic ulcer

They are contraindicated for individuals suffering from tubercolosis or other infectious diseases
A destructive disease of the adrenal cortex
Addison's disease

Note: If untreated, it is gradually progressive, and death occurs within 2 or 3 years
Signs & Symptoms of Addison's disease
Weight loss
Weakness
Disturbed carbohydrate & mineral metabolism
Increased bronzing pigmentation of the skin
Synthetic compounds similar in action to Cortisone & Hydrocortisone
cortisone acetate, (Cortogen, Cortone), (Oral, IM)
hydrcortisone, (Hydrocortone, Cortef, Solu-Cortef), (Oral, IM, IV, Intrathecal)
predisone, (Deltasone, Sterapred), (Oral)
prednisolone, (Prelone, Cotolone), (Oral)
methylprednisolone, (Medrol, Solu-Medrol), (Oral, IM, IV)
triamcinolone acetonide, (Aristocort, Kenalog), (Oral, Intralesional, Intraarticular)
dexamethasone, (Decadron), (Oral, IM, IV, Intraarticular)
betamethasone, (Celestone), (Oral, IM, IV, Intraarticular)
fludrocortisone acetate, (Florinef), (Oral)
fluocinolone, (Synalar), (Topical)
fluradrenolide, (Cordan), (Topical)
This is where the clusters of cells known as the islets of Langerhans are found & are the sources of the hormone known as insulin
Pancreas
Three purpose of insulin
1. Aids in the utilization of glucose as energy

2. Stores excess glucose as glycogen in the liver

3. Responsible for the conversion of glucose to fat
Important things to remember when giving insuling therapy
Be accurate in the dosage of insulin
Overdose can lead to insulin shock
Too small a dose can result in diabetic coma
For mild cases, diet therapy alone may be sufficient, along with regulated exercise to maintain blood sugar level
In more severe cases, oral hypoglycemics or insulin must be given
A condition where the glucose level in the blood becomes quite high after the ingestion of carbohydrates
Diabetes Mellitus

Note:
If diabetes is not treated, sugar spills over into the urine, & acidosis & ketosis occur as a result of the metabolism of fat for energy, resulting in the creation of ketones as by-products
If untreated, , the patient in ketosis eventually becomes comatose & dies
Four factors needed to determine the dose of insulin required to treat Diabetes Mellitus
1. Weight of the patient

2. Metabolic rate

3. Physical activity

4. Any residual function of the pancreas
Examples of Individual Insulin Products
human insulin
human insulin injection, regular (Humulin R, Novolin R)
human insulin injection, isophane (Humulin N, Novolin N)
lente human insulin zinc injection (Humulin L, Novolin L)
ultralente human insulin injection (Humulin U)

Note:
Regular insulin is the only insulin form that may be given IV.
The effect of regular insulin, regardless of the mode of administration last only a few hours
An individual insulin product than can be prepared in various forms to lower blood sugar rapidly or over a prlonged period time
human insulin
An individual insulin product that consists of zinc-insulin crystal that are dissolved in a clear fluid
human insulin injection, regular (Humulin R, Novolin R)

Route(s):
subQ, IV

Takes effect rapidly & last 4 to 6 hours
An individual insulin product also known as isophane insulin, or NPH containing a suspension of zinc-insulin crystals & protamine sulfate
human insulin injection, isophane (Humulin N, Novolin N)

Route(s):
subQ only

A intermediate-acting isulin
Onset of action is in 1 1/2 hours
Peak activity is from 4 to 6 hours
An individual insulin product is a mixture of crystalline & amorphous insulin
lente human insulin zinc injection (Humulin L, Novolin L)

Route(s):
subQ only

An intermediate-acting insulin
Onset of action in 2 1/2 hours
Peak from 7 to 15 hours
Duration is up to 24 hours
An individual insulin product that is a crystalline suspension of human insulin with zinc that provides a slower onset of action & longer duration of activity
ultralente human insulin injection(Humulin U)

Route(s):
subQ only

A long-acting insulin
Onset of activity in 4 to 8 hours
Peak of activity in 12 to 18 hours
Duration of action up to 28 hours
Example of Insulin Analog
insulin lispro (Humalog)

Route(s):
subQ, IV

Note:
There is also a Humalog Pen for self-injection
Example of Combination Insulin Products
Humulin 50/50 - a combination of 50% regular & 50% isophane insulin

Humulin 70/30 & Novalin 70/30 - combinations of 70% isophane & 30% regular insulin
What is Insulin Pump Therapy?
Also called continous subcutaneous insulin infusion, is designed to simulate normal pancreatic beta-cell function & deliver both basal & bolus insulin doses in patients with type 1 diabetes
Several factors that are key to successful treatment with insulin pumps
Blood glucose monitoring

Logbook recording of insulin doses & blood glucose results

Counting of carbohydrates

Use of the long-acting insulin lispro with regular insulin
The most serious adverse effect of intensive insulin therapy
Severe Hypoglycemia
A commonly develop conditon in which a patient who have had a type 1 diabetes for more than 5 years no longer recognize the symptoms of low blood glucose levels, such as fatigue, sweating, dizziness, palpitations, & impaired cognition
Hypoglycemic awaremess
Name one strategy for preventing hypoglycemia
Set a higher target blood glucose level, using a lower basal insulin delivery rate & eliminating the wilde glycemic swings
Examples of Oral Hypoglycemic Agents
chlorpropamide, (Diabinese)

tolbutamide, (Orinase)

glipizide, (Glucotrol)

glyburide, (Diabeta, Micronase, Glynase)

acarbose, (Precose)

metformin hcl, (Glucophage)
A potent oral hypoglycemic agent that acts on pancreatic cells to cause them to release residual insulin
chlorprapamide, (Diabinese)

Route(s):
Oral

Note:
Not all patients with diabetes are suitable candidates for chloroprapamide therapy
An oral hypoglycemic agent that its recommended use has been restricted to those cases in which diet & insulin are ineffective
tolbutamide, (Orinase)

Route(s):
Oral
An oral hypoglycemic agent that lowers blood glucose levels in diabetic & non-diabetic patients
glipizide, (Glutorol)

Route(s):
Oral

Note:
It is used as an adjunct to dietary control in the management of non-insulin-dependent (type 2 diabetes)
An oral hypoglycemic agent that lowers blood sugar & produces a mild diuresis
glyburide, (Diabeta, Micronase, Glynase)

Route(s):
Oral
An oral hypoglycemic agent that inhibits enzymes known as the alpha-glucoside enzymes that break down complex carbohydrates into glucose & other monosacchardies
acarbose, (Precose)
An oral hypoglycemic agent that is believe to improve sensitivity to insulin at the receptor sites
metformin hcl, (Glucophage)
Examples of other Oral Hypoglycemic agents
glimepiride, (Amaryl)

pioglitazone, (Actos)

repaglinide, (Prandin)

miglitol, (Glyset)
Examples of Combination Oral Hypoglycemic agents
metformin plus glyburide, (Glucovance)

rosiglitazone plus metformin, (Avandamet)

glipizide plus metformin, (Metaglip)
Sex glands of the female (ovaries ) & those of the male (testes) are called?
gonads
Hormone secreted by the Anterior Pituitary gland that affect the Gonads
gonadotropic hormones
Name the two gonadotropic hormones
follicle-stimulating hormone (FSH)

luteinizing hormone (LH)
A gonadotropic hormone that stimulates the maturation of the graafian follicles in the ovaries
follicle-stimulating hormone (FSH)
A female hormone produced by the cells around the ovum is responsible for the changes in the accessory organs of reproduction during the first part of the menstrual cyle & the development of the secondary sex characteristics
Estradiol

Note:
Is the naturally occuring female hormone in humans & animals
A female hormone that prepares the uterus for the reception of the ovum
Progesterone
Responsibilities of Progesterone
1. The uterine changes characteristics of the first half of the menstrual cycle.

2. The development of the placenta (organ that enables the embryo to receive nourishment from the mother during pregnancy).

3. The maturation of the mammary glands
4. The multipication of the uterine muscle fibers.

5. The inhibition of uterine contraction.
Is the generic term referring to natural & synthetic agents that exert the biologic effect of estradiol
Estrogen

Note:
Is used to treat conditions such as sexual infantilism & senile vaginitis in perimenopausal women to provide a smooth transition during perimenopause
Examples of agents used to suppress lactation
estradiol suspension, (IM)

estrone (Theelin), (IM)
A type of therapy that has been used for the treatment of menopausal symptoms, urogenital dryness, & the prevention & treatment of osteoporosis
Estrogen Replacement Therapy (ERT)

Note:
Recent studies have shown some increase in breast cancer & cardiovascular complications with the use of this therapy
Examples of Estrogen Replacement Therapy agents
estrogens, conjugated (Premarin), (Oral, Vaginal)

esterified estrogen tablets, (Estratab), (Oral)
Example of Estrogen Agonist-Antagonist agent
raloxifene hcl, (Evista)

Route(s):
Oral

Tx:
For postmenopausal women
Agents that prevent pregnancy by virtue of their estrogen content
Oral contraceptives

Note:
Are contraindicated in patients with a history of:
-Breast or genital cancer
-Thrombophlebitis
-MI or coronary artery disease
-Pre-existing liver, kidney, or heart dysfuntion
Side effects of oral contraceptives
Breast changes
Loss of scalp hair
Dermatoses
Headache
Nervousness
Thromboembolic disorders
Emotional instability

* An important side effect to remember:
Oral contraceptive drugs are LESS EFFECTIVE when taken with ANTIBIOTICS.
Examples of oral contraceptives
levonorgestrel plus ethinyl estradiol, (Triphasil)

levonorgestrel plus ethinyl estradiol, (Seasonale)
Examples of injectable & transdermal contraceptives
medroxyprogesterone acetate, (Depo-Provera), (IM)

norelgestromin plus ethinyl estradiol , (Ortho Evra), (Transdermal)
Side effect of medroxyprogesterone acetate
Menses may cease entirely or become irregular
Disadvantage of using norelgestromin plus ethinyl estradiol
Less satisfactory in warm, humid climates
Example of emergency contraceptives
ethinyl estradiol plus levonorgestrel (Preven)

levonorgestrel plus ethinyl plus estradiol (Ovral)

levonogestrel (Plan B) *Progestin-Only Regimen

Note:
High Doses of of a Combination Oral Contraceptive. The first dose should be taken within 72 hours of unprotected intercourse
Example of a drug that promotes ovulation
clomiphene citrate, (Clomid)
Is a synthetic, nonsteroidal compound that may be administered orally to promote ovulation in women who have been anovulatory
clomiphene citrate (Clomid)

Note:
This drug is contraindicated in patients with a history of liver disesase & those with abnormal uterine bleeding
Agents that are used as a uterine stimulant
Oxytocic agents
Side effects of agents that promote ovulation
Blurred vision
Hot Flashes
Abdominal discomfort
Nausea & Vomiting
Breast engorgement
Headache
Dizziness
Example of oxytocic agents
oxytocin injection (Pitocin, Syntocinon)
ergonovine maleate (Ergotrate)
methylergonovine maleate (Methergine)
sodium chloride 20 % injection
urea 40% to 50% injection(Carbamide)
dinoprostone (Prostin E2)
dinoprostone cervical gel (Prepidil)
mifepristone (RU-486, Mifeprex)
An oxytocic agent that stimulates the uterine muscles & produces rhytmical contractions
oxytocic injection(Pitocin, Syntocinon)

Route(s):
IM, IV

Note:
Overdose may produce tetany
It is contraindicated in the first stage of labor
Must be given with great caution to patients with a cardiovascular disease or previous cesarean section
An oxytocic agent that is used for the tx of postpartum & postabortion hemmorhage
ergonovine maleate (Ergotrate)

Route(s):
Oral, IM, IV

Side effect:
May produce ergotism (a prolonged constriction of the blood vessels in other parts of the body)
An oxytocic agent that is preferred for patients with threatened eclampsia
methylergonovine maleate(Prostin E2)

Route(s):
Oral, IM, IV
An oxytocic agent that is useful in the induction of second trimester abortions
sodium chloride 20% injection

Route(s):
IV

Side effects:
Sensation of heat
Thirst
Mental confusion
Urea Hypothermia
An oxytocic agent that induces fetal death & abortion
urea 40% to 50% injection(Carbamide)

Route(s):
IV

Note:
Pt should take fluids during the procedure to facilitate urea
Nurse should monitor for signs of fluid & electrolyte imbalance during procedure
An oxytocic agent that is used intravaginally to induce abortion during second trimester of pregnancy
dinoprostone (Prostin E2)

Route(s):
Intravaginally
An oxytocic agent that is in pregnant women at or near term with a medical or obstetrical need for labor induction
dinoprostone cervical gel (Prepidil)

Route(s):
Endocervically
An oxytocic agent that is an oral abortifacient taken anytime before the eight week of pregnancy
mifepristone (RU-486, Mifeprex)

Route(s):
Oral
Is responsible for normal development of male reproductive tract and maintains the secondary sex characteristics
testosterone

Note:
It plays a role in the development of the penis, the seminal vesicles, & prostate gland & in the descent of the testes from the abdominal cavity
It can also increase the resistance of the CNS to fatigue
What are the accessory sexual characteristics affected by testosterone?
Development of penis
Depth of voice
Distribution of facial and body hair
Development of the masculine skeletal muscles.
Confers sense of “well being”
Restores mental equilibrium and energy.
What are the three therapeutic uses of testosterone?
1. When a deficiency of the hormone is known
2. In females to treat certain ovarian dysfunctions
3. In females to treat breast engorgement & suppress lactation
Examples of commercially prepared testosterone used as hormone replacement therapy
testosterone gel (Androgel), (transdermal)

Testosterone transdermal system (Androderm), (transdermal)