Ati Endocrine System Meds (Endocrine Disorders)

Front 1

thyroid hormone

Back 1

proto: levothyroxine (Synthroid, Levothroid)

other: liothyronine (Cytomel)
liotrix (Thyrolar)
thyroid: (Thyroid USP)

Front 2

thyroid hormone MOA

Back 2

synthetic form of thyroxine (T4), form of liothyronine (T3) or a combination of T4 and T3 that increase metabolic rate, protein synthesis, cardiac output, renal perfusion, oxygen use, body temp, blood volume, growth processes

Front 3

thyroid hormone use

Back 3

treatment of hypothyroidism
emergency treatment of myxedema coma (IV route)

Front 4

thyroid hormone adverse

Back 4

overmedication can result in hyperthyroidism

Front 5

thyroid hormone contraindications

Back 5

pregnancy and lactation
thyrotoxicosis
following an MI
caution: cardiovascular problems
not for use in treatment of obesity

Front 6

thyroid hormone interactions

Back 6

binding agents and sucralfate (Carafate) reduce levothyroxine absorption with concurrent use
antiseizure and antidepressant meds- increase levothyroxine metabolism
increases anticoagulant effects of warfarin by breaking down Vit. K- monitor PT and INR, check for signs of bleeding or bruising

Front 7

thyroid hormone admin

Back 7

monitor clients T4 and TSH levels
take daily on an empty stomach
inform client of importance of lifelong replacement
check with provider before switching to another brand of levothyroxine

Front 8

thyroid hormone effectiveness

Back 8

decreased TSH levels
T4 levels within expected reference range
absence of hypothyroidism

Front 9

antithyroid meds

Back 9

proto: propylthiouracil (PTU)
other: methimazole (Tapazole)

Front 10

antithyroid meds MOA

Back 10

blocks synthesis of thyroid hormones
prevents oxidation of iodide
blocks conversion of T4 into T3

Front 11

antithyroid meds use

Back 11

treatment of Grave's disease
produces a euthyroid state prior to thyroid removal surgery
adjunct to irradiation of the thyroid gland
emergency treatment of thyrotoxicosis

Front 12

antithyroid meds adverse

Back 12

overmedication can result in indications of hypothyroidism- (drowsiness, depression, weight gain, edema, bradycardia, anorexia, cold intolerance, dry skin, menorrhagia)
agranulocytosis
liver injury, hepatitis

Front 13

antithyroid contraindications

Back 13

pregnancy
lactation
bone marrow depression
clients at risk for liver failure

Front 14

antithyroid interactions

Back 14

anticoagulants- may increase anticoagulation- monitor PT, INR, and aPTT
digoxin (Lanoxin)- may increase glycoside level

Front 15

antithyroid admin

Back 15

take meds with meals
monitor for signs of hyperthyroidism
clients with hyperthyroidism may be given a etaadrenergic antagonist to decrease tremors and tachycardia
monitor for hypothyroidism
monitor CBC

Front 16

antithyroid effectivness

Back 16

weight gain
decreased T4 levels
absence of signs of hyperthyroidism

Front 17

radioactive iodine (antithyroid)

Back 17

absorbed by the thyroid and destroys some of the thyroid producing cells
at high doses, thyroid-radioactive iodine destroys thyroid cells

Front 18

radioactive iodine uses

Back 18

High doses:
hyperthyroidism
thyroid cancer

Low doses:
thyroid function studies

Front 19

radioactive iodine adverse

Back 19

radiation sickness
bone marrow depression
hypothyroidism

Front 20

radioactive iodine contraindications

Back 20

pregnancy
lactation

Front 21

radioactive iodine interactions

Back 21

concurrent use of other antithyroid meds- reduces reuptake of radioactive iodine

Front 22

radioactive iodine admin

Back 22

void frequently
increase fluid intake
avoid coughing and expectoration
limit contact with clients to 30 min day

Front 23

strong iodine solution (Lugol's solution)- nonradioactive iodine

Back 23

creates high levels of iodinethat will reduce iodine uptake, inhibit thyroid hormone production, and block release of thyroid hormones into the bloodstream

Front 24

strong iodine solution uses

Back 24

development of euthyroid state and reduction of thyroid gland size prior to thyroid removal surgery
thyroid- nonradioactive iodine is used for emergency treatment of thyrotoxicosis

Front 25

strong iodine adverse

Back 25

iodism due to corrosive property - administer sodium thiosulfate to reverse

Front 26

strong iodine interactions

Back 26

concurrent intake of foods high in iodine increases risk for iodism

Front 27

strong iodine admin

Back 27

dilute strong iodine solution with juice to improve taste
increase fluid intake

Front 28

strong iodine effectiveness

Back 28

weight gain
decreased T4 levels
reduction in size of thyroid gland
client will be able to get adequate sleep, free of complications of hyperthyroidism

Front 29

anterior pituitary hormones/growth hormones

Back 29

somatropin (Genotropin, Nutropin)
other: somatrem (Protropin)

Front 30

anterior pituitary hormone MOA

Back 30

stimulate overall growth and production of protein and decrease of the use of glucose

Front 31

anterior pituitary hormone use

Back 31

treat growth hormone deficiencies

Front 32

anterior pituitary hormone adverse

Back 32

hyperglycemia
hypercalciuria and renal calculi

Front 33

anterior pituitary hormone contraindications

Back 33

severe obesity
severe respiratory impairment (sleep apnea)
diabetes- risk of hyperglycemia
treatment should be stopped prior to epiphyseal closure

Front 34

anterior pituitary hormone interactions

Back 34

glucocorticoids- counteract growth-promoting effects

Front 35

anterior pituitary hormone effectivess

Back 35

client increases height and weight

Front 36

antidiuretic hormone

Back 36

proto: vasopressin (Pitressin synthetic)
other: desmopressin (DDAVP, stimate)

Front 37

antidiuretic hormone MOA

Back 37

promotes reabsorption of water within the kidney
natural ADH causes vasoconstriction because of the contraction of vascular smooth muscle

Front 38

antidiuretic hormone Use

Back 38

treat diabetes insipidus
antidiuretic hormones are sometimes used during CPR to temporarily decrease blood flow from the periphery and increase flow to the brain and heart

Front 39

antidiuretic hormone adverse

Back 39

reabsorption of too much water
myocardial ischemia from excessive vasoconstriction

Front 40

antidiuretic hormone contraindications

Back 40

carbamazepine and TCAs may increase antidiuretic hormone
alcohol, heparin, lithium and phenytoin may increase antidiuretic effects

Front 41

antidiuretic effectiveness

Back 41

reduction in large volumes of urine output associated with diabetes insipidus
cardiac arrest survival

Front 42

adrenal hormone replacement

Back 42

hydrocortisone (Hydrocortone, Solu-Cortef)
other: prednisone (Deltasone) dexamethasone (Decadron)
mineral corticoids: fldrocortisone (Florinef)

Front 43

adrenal hormone MOA

Back 43

mimic effect of natural hormones

Front 44

adrenal hormone use

Back 44

acute and chronic replacement therapy for adrenocortical insuffieciency (Addison's disease)
Nonendocrine disorders include cancer, inflammation, allergic reactions

Front 45

hydrocortisone adverse (glucocorticoid)

Back 45

osteoporosis
adrenal suppression
PUD
GI discomfort
infection

Front 46

fludrocortisone (mineralocorticoid) adverse

Back 46

retention of sodium and water- leads to hypertension, edema, HF and hypokalemia

Front 47

hydrocortisone interactions

Back 47

NSAIDS
alcohol
oral anticoagulants
potassium depleting agents
vaccines and toxoids- may reduce antibody response

Front 48

fludrocortisone interactions

Back 48

barbiturates
phenytoin
insulin , sulfonylureas- antidiabetic effects are decreased when used with fludrocortisone

Front 49

adrenal hormone replacement contraindications

Back 49

viral, bacterial infection
recent MI, gastric ulcer, hypertension, kidney disorder, osteoporosis, DM, hypothyroidism, myasenthia gravis, glaucoma, seizure disorders

Front 50

adrenal hormone replacement nursing admin

Back 50

monitor for indcation of acute adrenal insufficiency ( fever, muscle, joint pain, weakness, fatigue

Front 51

adrenal hormone replacement effectiveness

Back 51

relief of effects of adrenocortical deficiency, weakness, hypoglycemia, hyperkalemia, fatigue, minimal adverse effects