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59 Cards in this Set
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- Back
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Drugs relating to thyroid function Thyroid replacement drugs
Treatment: |
replacement therapy in hypothyroidism.
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Drugs relating to thyroid function Thyroid replacement drugs
Response evaluation: |
evaluated by monitoring T4 levels every 1 to 3 months, adjusting levels as needed.
TSH levels although useful for screening of thyroid function are less reliable to monitor response to these drugs. |
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Drugs relating to thyroid function Thyroid replacement drugs
Adverse Effects |
mimics the symptoms of hyperthyroidism.
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Drugs relating to thyroid function Thyroid replacement drugs
Caution: |
several drug interactions.
patients with renal failure, angina, HTN. Check pulse before administering, hold if pulse > 100 or angina during early adjustment to the drug. Give in AM before breakfast. |
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Drugs relating to thyroid function Thyroid replacement drugs
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levothyroxin (Synthroid)
leiothyronine (Cytomel) Other drugs in this category include liotrix (Thyrolar), thyroid extract (Armour Thyroid) |
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Antithyroid drugs/therapies (goitrogens)
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Chemical agents that lower the basal metabolic rate by interfering with the formation, release, or action of thyroid hormones
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Antithyroid drugs/therapies
Thioamide drugs |
Inhibit thyroid hormone synthesis and release by inhibiting the incorporation of iodide into tyrosine (T4) and inhibiting the coupling of iodothyrosines.
It also blocks the effects of the hormone in the peripheral target cells. Frequently used to establish euthyroidism (2-3 weeks) before surgery or radioactive iodine treatment. |
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Antithyroid drugs/therapies
Thioamide drugs Caution |
Caution: Drug interactions with amiodarone and other drugs.
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Antithyroid drugs/therapies
Thioamide drugs Adverse Effects |
Adverse effects: leukopenia, agranulocytosis, fever, loss of taste, nausea, dizziness, skin rash.
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Antithyroid drugs/therapies
Thioamide drugs Drug names |
propylthiouracil (PTU)
Other drugs in this category include methimazole (Tamazole) |
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Antithyroid drugs/therapies
Iodine and Iodide drugs |
Inhibit thyroid hormone synthesis and release from the
hyperfunctioning thyroid gland. |
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Antithyroid drugs/therapies
Iodine and Iodide drugs Indicated to |
Indicated to protect the thyroid gland from radiation before and after the administration of radioactive isotopes of iodine o in radiation emergencies.
Also used with an antithyroid drug in preparation for thyroidectomy in patients with hyper thyroidism. Decreases vascularity of the gland. |
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Antithyroid drugs/therapies
Iodine and Iodide drugs Contraindications |
Contraindications: allergy to iodine, pregnancy, hyperkalemia, pulmonary edema or acute bronchitis (can increase secretions)
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Antithyroid drugs/therapies
Iodine and Iodide drugs Adverse effects |
Adverse effects: diarrhea, nausea, vomiting, gastric pain, rash, swelling of the salivary glands, metallic taste in mouth, sore gums and teeth, burning sensation in mouth and throat
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Antithyroid drugs/therapies
Iodine and Iodide drugs Caution |
Caution: administer through a straw to prevent tooth discoloration.
After meals to minimize gastric irritation. Absorption decreases with dairy products. Store in airtight, light-resistant container. Several drug interactions. |
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Antithyroid drugs/therapies (goitrogens)
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Chemical agents that lower the basal metabolic rate by interfering with the formation, release, or action of thyroid hormones
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Antithyroid drugs/therapies
Thioamide drugs |
Inhibit thyroid hormone synthesis and release by inhibiting the incorporation of iodide into tyrosine (T4) and inhibiting the coupling of iodothyrosines.
It also blocks the effects of the hormone in the peripheral target cells. Frequently used to establish euthyroidism (2-3 weeks) before surgery or radioactive iodine treatment. |
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Antithyroid drugs/therapies
Thioamide drugs Caution |
Caution: Drug interactions with amiodarone and other drugs.
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Antithyroid drugs/therapies
Thioamide drugs Adverse Effects |
Adverse effects: leukopenia, agranulocytosis, fever, loss of taste, nausea, dizziness, skin rash.
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Antithyroid drugs/therapies
Thioamide drugs Drug names |
propylthiouracil (PTU)
Other drugs in this category include methimazole (Tamazole) |
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Antithyroid drugs/therapies
Iodine and Iodide drugs |
Inhibit thyroid hormone synthesis and release from the
hyperfunctioning thyroid gland. |
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Antithyroid drugs/therapies
Iodine and Iodide drugs Indicated to |
Indicated to protect the thyroid gland from radiation before and after the administration of radioactive isotopes of iodine or in radiation emergencies.
Also used with an antithyroid drug in preparation for thyroidectomy in patients with hyper thyroidism. Decreases vascularity of the gland. |
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Antithyroid drugs/therapies
Iodine and Iodide drugs Contraindications |
Contraindications: allergy to iodine, pregnancy, hyperkalemia,pulmonary edema or acute bronchitis (can increase secretions)
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Antithyroid drugs/therapies
Iodine and Iodide drugs Adverse effects |
Adverse effects: diarrhea, nausea, vomiting, gastric pain, rash, swelling of the salivary glands, metallic taste in mouth, sore gums and teeth, burning sensation in mouth and throat
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Antithyroid drugs/therapies
Iodine and Iodide drugs Caution |
Caution: administer through a straw to prevent tooth discoloration.
After meals to minimize gastric irritation. Absorption decreases with dairy products. Store in airtight, light-resistant container. Several drug interactions. |
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IAntithyroid drugs/therapies odine and Iodide drugs
Drugs |
iodine solution (Lugol’s solution)
Other drugs in this category include potassium iodide (Thyro-Block, KI, SSKI) |
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Antithyroid drugs/therapies
Radioactive Iodine |
Accumulates in the thyroid tissue and selectively damages or destroys it.
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Antithyroid drugs/therapies
Radioactive Iodine |
Treatment of: hyperthyroidism and thyroid cancer
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Antithyroid drugs/therapies
Radioactive Iodine Caution |
NPO before the treatment, after treatment increase fluid intake to enhance excretion of the isotope.
Full radiation precautions for 24 hours. Isotope has a half-life of approximately 8 days. Signs of hypothyroidism may follow treatment. |
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Antithyroid drugs/therapies
Radioactive Iodine |
I-131 (radioactive isotope of iodine)
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Nursing process and patient teaching involved in the administration of drugs affecting thyroid function.
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- Monitor clinical response to treatment: signs and symptoms of hypothyroidism or hyperthyroidism
- Monitor TSH, T3, T4, cholesterol levels, CBC - Monitor appetite, caloric intake, body weight - Monitor vital signs (apical pulse), chest pain - Patient needs to wear medical identification tag or bracelet - Do not change brands of thyroid replacement drug because different brands of the same drug are not bioequivalent. Give medication in the morning |
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Drugs relating to pituitary function
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Vasopressin or antidiuretic hormone (ADH) and oxytocin hormone are secreted by the posterior pituitary gland.
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Drugs relating to pituitary function
Antidiuretic Hormone-type Drugs |
Desmopressin and lypressin are synthetic derivatives of vasopressin and have less pressor effects than vasopressin.
Desmopressin has a longer duration of activity, also used to treat enuresis. Antidiuretic hormone-type drugs increase water re-absorption in the collecting ducts of the nephron. Also stimulate peristalsis, increase blood pressure secondary to vasoconstriction, increase secretion of corticotrophin, GH and FSH. |
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Drugs relating to pituitary function
Antidiuretic Hormone-type Drugs |
Treatment of Diabetes Insipidus, GI bleeding, resuscitation protocol for asystole.
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Drugs relating to pituitary function
Antidiuretic Hormone-type Drugs Adverse Effects |
water intoxication, hypertension, MI, abdominal cramping
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Drugs relating to pituitary function
Antidiuretic Hormone-type Drugs |
vasopressin (Pitressin, Pressyn)
desmopressin (DDAVP, Stimate, Octostim) Other drugs in this category include lypressin (Diapid) |
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Drugs relating to pituitary function
Oxytocin Hormone-type Drugs |
Oxytocin (“rapid birth”) contracts the pregnant uterus and facilitates milk ejection during lactation
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Drugs relating to pituitary function
Oxytocin Hormone-type Drugs |
Treatment : to induce labor in women who are
at term, to control postpartum and post-abortion bleeding and to stimulate lactation |
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Drugs relating to pituitary function
Oxytocin Hormone-type Drugs |
Adverse effects: nausea, vomiting, tachycardia, arrhythmias. Has a slight antidiuretic effect.
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Drugs relating to pituitary function
Oxytocin Hormone-type Drugs |
oxytocin (Pitocin, Syntocinon)
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Drugs relating to pituitary function
Nursing process and patient teaching |
- Monitor vital signs (hypertension), apical pulse
- Monitor intake and output (polyuria or fluid retention) - Monitor electrolytes - Monitor signs and symptoms of water intoxication - Assess for chest pain - Teach patient side effects of vasopressin |
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Drugs relating to the adrenal functions
Mineralocorticoid hormones/drugs (aldosterone) |
Increase the rate of sodium and water re-absorption by the kidneys.
Increase the excretion of potassium and hydrogen ions into the urine. |
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Drugs relating to the adrenal functions
Mineralocorticoid hormones/drugs (aldosterone) |
Treatment of Addison’s Disease and symptomatic orthostatic hypotension
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Drugs relating to the adrenal functions
Mineralocorticoid hormones/drugs (aldosterone) |
Caution in patients who cannot tolerate increases in intravascular volume.
Also patients with hypokalemia and alkalosis. |
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Drugs relating to the adrenal functions
Mineralocorticoid hormones/drugs (aldosterone) |
Adverse effects: severe or persistent headache, hypertension, dizziness, edema of lower extremities, joint pain, hypokalemia, hypernatremia, heart failure.
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Drugs relating to the adrenal functions
Mineralocorticoid hormones/drugs (aldosterone) |
fludrocortisone (Florinef)
Other drugs in this category include desoxycortisterone acetate (DOCA) |
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Drugs relating to the adrenal functions
Glucocorticoid hormones/drugs (cortisol) |
Anti-inflammatory action: in larger doses cortisol can stabilize lysosomal membranes and prevent the release of proteolytic enzymes during inflammation.
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Drugs relating to the adrenal functions
Glucocorticoid hormones/drugs (cortisol) |
Maintenance of normal blood pressure: potentiate the vasoconstrictor effect of norepinephrine
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Drugs relating to the adrenal functions
Glucocorticoid hormones/drugs (cortisol) |
Carbohydrate and protein metabolism: Hyperglycemia. Inhibit protein synthesis, facilitate protein breakdown in muscle and extrahepatic tissues.
Inhibit glycolytic enzymes, increase the activity of enzymes important to gluconeogenesis. |
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Drugs relating to the adrenal functions
Glucocorticoid hormones/drugs (cortisol) |
Fat metabolism: promote mobilization of fatty acids from adipose tissue increasing their concentration in the plasma and their use for energy. Redistribution of fat (moon-face, buffalo-hump)
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Drugs relating to the adrenal functions
Glucocorticoid hormones/drugs (cortisol) |
Thymolytic, lympholytic, eosinopenic actions: can cause atrophy of the thymus and decrease the number of lymphocytes, plasma cells, and eosinophils.
Block the release of cytokines and interfere with the role of T and B lymphocytes, macrophages, and monocytes in the immune response, and thus interfere with immune and allergic responses. Slow wound healing. Prescribed as immunosuppressants to prevent rejection of organ or tissue transplants, as anti-allergenics. |
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Drugs relating to the adrenal functions
Glucocorticoid hormones/drugs (cortisol) |
Stress effects: maintain homeostasis during stressful situations
(injury, major surgery). |
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Drugs relating to the adrenal functions
Glucocorticoid hormones/drugs (cortisol) |
Central Nervous System: affect mood and behavior.
Abrupt withdrawal with chronic dosing can cause Addisonian Crisis (Acute Adrenal Insufficiency) due to an hypothalamic-pituitary axis(HPA) suppression of endogenous cortisol release. Cortisol also increases gastric secretion (GI bleeding, peptic ulcers, heartburn) |
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Drugs relating to the adrenal functions
Glucocorticoid hormones/drugs (cortisol) |
Other adverse effects: fluid retention, edema, weight gain, stretch marks (striae), acne, increased body and facial hair, osteoporosis.
Cushing’s Syndrome. |
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Drugs relating to the adrenal functions
Glucocorticoid hormones/drugs (cortisol) |
Caution: Significant drug interactions
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Drugs relating to the adrenal functions
Glucocorticoid hormones/drugs (cortisol) |
Short-Acting agents
cortisone (Cortone, Solu-Cortef, etc) hydrocortisone (Hydrocortone, Cortef) |
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Drugs relating to the adrenal functions
Glucocorticoid hormones/drugs (cortisol) |
Intermediate-Acting agents
methylprednisolone (Medrol) prednisone (Deltasone) prednisolone (Delta-Cortef) triamcinolone (Aristocort, Kenalog) |
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Drugs relating to the adrenal functions
Glucocorticoid hormones/drugs (cortisol) |
Long-Acting agents
betamethasone (Celestone) dexamethasone (Decadron) |
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Nursing process and patient teaching involved in the administration of drugs affecting adrenal function.
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- Monitor intake and output
- Monitor vital signs (hypertension), apical pulse (arrhythmia), fever - Prevent infections - Monitor fluid retention, weight gain - Monitor electrolytes, PH, blood glucose, CBC, lipid profile - Provide emotional support: body image changes - Monitor behavioral changes. Provide counseling support. - Careful scheduling (circadian rhythm) - Teach patient not to discontinue treatment abruptly (Addisonian Crisis) - Monitor drug interactions. |
