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  1. gland located at the base of the brain, two lobes (anterior and posterior)
    pituitary (hypophysis)
  2. anterior or posterior pituitary? master gland that secretes hormones that stimulate release of other hormones from thyroid, adrenals, gonads
    anterior (adenohypophysis)
  3. anterior or posterior pituitary? secretes two neurohormones
    posterior (neurohypophysis)
  4. two neurohormones secreted by the posterior pituitary
    ADH (vasopressin) and oxytocin
  5. hormone released from anterior pituitary in response to TRH from hypothalamus that stimulates release of T3 and T4
    TSH or thyrotropic hormone
  6. hormone secreted from the anterior pituitary in response to CRF from hypothalamus that stimulates release of glucocorticoids (cortisol), mineralcorticoids (aldosterone), and androgen
    stimulates adrenal cortex, adrenocorticotropic (ACTH)
  7. 3 gonadotropic hormones secreted from anterior pituitary
    FSH, LH, prolactin
  8. gonadotropic hormone that promotes maturation of follicles in ovaries and initiates sperm production in testes
  9. gonadotropic hormone that combines with another to stimulate follicle maturation and estrogen production and promotes secretion of androgens from testes
  10. gonadotropic hormone that stimulates milk formation in glandular breast tissue
  11. hormone released from anterior pituitary that acts on all body tissue, esp bones and skeletal muscles
    growth hormone (GH) or somatotropic hormone (STH)
  12. growth hormone is regulated by the release of what 2 hormones from the hypothalamus?
    GH-RH (releasing hormone) and GH-IH (inhibiting hormone or somatostatin)
  13. sympathomimetics, serotonin, and glucocorticoids can inhibit the secretion of what hormone?
    growth hormone
  14. ADH (vasopressin) and oxytocin are secreted and stored in the posterior pituitary after being synthesized here
  15. gland located anterior to the trachea that secretes 2 hormones that control the metabolic activity of nearly every tissue and organ
  16. stimulation by these hormones result in increased CARDIAC output, oxygen consumption, carb use, protein synthesis, and lipolysis. also affect body heat regulation and menstrual cycle.
    T4 and T3
  17. 4 glands that lie on the dorsal surface of the thyroid gland that secrete parathormone or PTH
  18. parathyroid hormone regulates these levels in the blood
  19. 3 ways PTH increases calcium levels
    • mobilizing ca from bone
    • promoting ca absorption from intestine
    • promoting ca reabsorption from renal tubules
  20. glands located at the top of each kidney, consist of medulla and cortex
  21. releases the catecholamines epinephrine and norepinephrine
    adrenal medulla
  22. produces major types of hormones (corticosteroids) and small amounts of androgen, estrogen, and progestin
    adrenal cortex
  23. the principal glucocorticoid
  24. the principal mineralocorticoid
  25. corticosteroid that has major influence on electrolytes and metabolism of carbs, protein, and fat- deficiency can result in serious illness or death
  26. GH must be administered before epiphyses ae fused and can be administered through these routes
    IM and subQ
  27. prolonged therapy with this hormone can antagonize insulin secretion and eventually cause d. mellitus
  28. GH hypersecretion responsible for gigantism and acromegaly are often cause by this
    pituitary tumor
  29. corticosteroid that is controlled by the renin - angiotension - - system
    mineralocorticoids (aldosterone)
  30. 2 drugs used to treat dwarfism or GH hyposecretion
    • somatrem
    • somatropin
  31. 2 drugs to treat GH hypersecretion
    • bromocriptine
    • octreotide (Sandostatin)
  32. drug used to treat GH hypersecretion that is also used to treat intestinal conditions (Crohn's, chronic severe diarrhea)
    octreotide (Sandostatin)
  33. drug used to treat insufficient TSH secretion (secondary hypothyroidism)
    thyrotropin (Thytropar)
  34. ACTH stimulates the secretion of this glucocorticoid
  35. drug used to diagnose adrenal-cortical disorders, as an anti-inflammatory, and acute multiple sclerosis. S/E are edema (Na and H2O retention), hypo-K, and hyperglycemia
    corticotropin (Acthar)
  36. neurohormone that is secreted in response to peaking estrogen levels at the end of 3rd tri
  37. neurohormone that is responds to serum osmolality
  38. caused by the hyposecretion of ADH characterized by polyuria and lowered BP, can occur aafter brain trauma, cerebral edema, and brain cancer
    d. insipidus
  39. 2 drugs used to treat d. insipidus
    • vasopressin (Pitressin) - used in codes to quickly elevate BP
    • desmopressin acetate (DDVAP) - nasal spray, bedwetters
  40. hypersecretion of ADH causes this syndrome, too much H2O is reabsorbed from renal tubules, output falls drastically, BP goes up
    SIADH (syndrome of inappropriate diuretic hormone)
  41. causes myxedema in adults and cretinism in children, primary is most commonly caused by the slowing of secretion with age, secondary is insufficient TSH
  42. symptoms of this include "cold, dry, slow, swollen", cold intoleance, thick dry skin, slow speech and movement, memory impairment, slow GI (constipation), slow emotional response (apathy), bradycardia (possible hypotension), swollen eyelids, edema, weight gain
  43. drug used to treat hypothyroidism, lots of interactions
    levothyroxine (Synthroid)
  44. causes Grave's disease or toxicosis, symptoms are "hot, wet, speeded up, shrunken", heat intolerance, diaphoresis, rapid speech, nervousness and irritability, N/V, diarrhea, tachycard, hypertension, palpitations, dysrhythmias, shrunken eyelids and orbits, weight loss
  45. drug class used to treat hyperthyroidism, lots of interactions
    thioamides (thiourea derivatives) - propylthiouacil (PTU) and methimazole (Tapazole)
  46. thyroid storm (severe hyperthyroidism) can lead to death due to this
    vascular collapse
  47. treatment for thyroid storm can include these
    • radiation reduction of thyroid
    • surgical removal of thyroid
    • thioamides during radiation or before surgery
  48. parathyroid hormone (PTH) responds to changes in these serum levels
  49. hypoparathyroidism will cause this
  50. vit D analogue used to treat hypoparathyroidism, promotes Ca absorption from GI, Ca reabsorption from renal tubules and some secretion of Ca from bone
    calcitriol (Rocaltrol)
  51. hyperparathyroidism cause hypercalcemia and has this effect on muscle
    weakens, become flabby (GI - constipation, cardiac - brady)
  52. drug used for hyperparathyroidism that decreases serum Ca by depositing back at osteoclast and promoting renal excretion
  53. disease process that involves adrenal insufficiency and results in serious illness or death
    Addison's disease
  54. corticosteroids (glucocorticoids or cortisol and mineralcorticoids or aldosterone) regulate these electrolytes and influence carb, protein, and fat metabolism
    • Na (retention)
    • K (excretion)
  55. corticosteroids are produced here
    the adrenal cortex
  56. adrenal hypersecretion results in this syndrome, the same signs and symptoms can be seen with high-level chronic therapy with glucocorticoids
  57. two hormones that help regulate the diurnal rhythm
    • ACTH
    • cortisol
  58. stress like surgery, sepsis, trauma, and emotional keep ACTH and cortisol levels high which leads to what
    • increased glucose
    • sometimes hypoK
  59. oral mineralcorticoid drug used to treat Addison's disease that causes a neg nitro balance causing a need for a high proetin diet, DO NOT STOP ABRUPTLY
    fludrocortisone (Florinef)
  60. signs and symptoms of Cushing's syndrome is rarely caused by adrenal hyperplasia or endocrine cancers but is more commonly caused by this
    glucocorticoid therapy
  61. therapy used as an anti-inflammatory, immunosuppressive, anti-allergic, for COPD, asthma in IV, PO, topical, oral inhalant, nasal inhalant, eyedrop forms...
  62. a common oral steroid used as an anti-inflamm and immunosupp. sometimes as an anti-allergic when topicals fail
    prednisone (Deltasone)
  63. immunosuppression, hyperglycemia, thinning of skin, poor wound healing, abnormal fat accumulation, and electrolyte changes are all signs and symptoms or adverse reactions of this therapy, risk for peptic ulcer, mood changes (irritability, depression) TAPER to prevent Addison's crisis
  64. why suddenly stopping prednisone can cause deadly adrenal insufficiency
    long-term use can cause adrenal atrophy
  65. complication from this disease is the third leading cause of death in the U.S.
    d. mellitus
  66. ethnic cultures within the age group of 45 - 65 with higher incidences of d. mellitus
    • native american
    • hispanics
    • african american
  67. three "polys" of DM
    • polyuria
    • polydypsia
    • polyphagia
  68. the most common cause of type 2 DM
    insulin resistance
  69. two mechanisms of insulin resistance
    • deficiency of insulin receptors
    • receptors become unresponsive to person's own insulin
  70. normal range for serum glucose
    70 - 110 mg/dL
  71. fasting serum blood glucose that indicates DM
  72. onset of rapid acting insulin
    5 minutes
  73. with combination insulins, the first number represents what type of insulin
    intermediate acting
  74. clear insulin with no real peak and a duration of 24 hours. not associated with hypoglycemia, higly acidic, can't be mixed
  75. types of DM patients that use insulin
    • all type 1
    • gestational - oral antidiabetics aren't safe
    • often type 2
    • medication induced diabetics
  76. insulin that is typically the first used for treatment of DM type 2
  77. insulin dosage is determind using this
    sliding scale from HCP or hospital protocol
  78. common meds that raise glucose
    • steroids
    • thiazide diuretics
  79. "wet and crazy" indicate this. (sweating, confusion, slurred speech, uncoordination, nervousness, agitation)
  80. how to treat a hypoglycemic event
    • 15 gm of fast acting glucose (4 oz OJ, soda, candy works slower)
    • check in 15 min (level should be 75 - 100)
    • give long acting glucose with protein and fat
    • in clinical setting D50W IV push or glucagon
  81. "dry and cranky" dry mucous membranes, poor skin turgor, thirst (polydypsia), fruity breath, tachy, polyuria, Kussmaul resp (deep rapid breathing), fatigue indicate this
  82. how to treat hyperglycemia
    • H2O
    • insulin
  83. types of insulin used in insulin pumps
    clear rapid or short acting (regular or humalog) for type 1
  84. first oral antidiabetics
  85. generation of sulfonylureas that are more potent (more effective with lower doses, longer duration, fewer SE but have a higher risk of hypoglycemia, esp in elderly
    second gen
  86. second gen sulfonylureas that stimulate beta cells to secrete insulin and increase insulin receptor sensitivity
    • glipizide (Glucotrol)
    • glyburide (Diabeta)
  87. 4 classes of nonsulfonylureas
    • biguanides
    • thiazolidinediones
    • meglitinides
    • alpha-glucosidase inhibitors
  88. most common antidiabetic PO drug, low incidence of hypogly, lowers post-prandial glucose, increases binding of insulin to receptors, increases cell sensitivity to insulin, decreases hep. production of glucose, reduces of glucose absorption in sm intestine, NOT COMPAT. WITH DYES, hold, flush wih IV fluids, mucomyst
    BIGuanide - glucoPHAGE - does not work in pancrease
  89. nonsulfonyurea that enhance insulin receptor sensitivity decreasing insulin resistance, adverse reactions include cardiac concerns
    Thiazolidinediones "glitazones"
  90. nonsulfonyurea that stimulates release of insulin from betas of pancreas, quick bursts, short duration, frequent dosing if not stable
    meglitinides "glinides"
  91. 2 hyperglycemic agents used to RAISE glucose
    • glucagon (SC, IM)
    • proglycem (oral form)
  92. hypergly agent (raise sugar) that is used for acute insulin-induced hypogly, alpha cells of the islets of Langerhans, works in liver to stimulate breakdown of stored glycogen to glucose
  93. Insulin who's fast - onset 5 - 15 min, peak 30 - 1 h, duration 2 - 4 h
    Lispr, humalog, aspart, exubra
  94. shorty acting insulin - onset 30 to 60 min, peak 2 - 3 h, duration 3 - 4 h
    regular humulin r
  95. Long acting insulin - onset 4 - 8 h, peak 14 - 20, duration 24 - 36 h
    humulin u
  96. insulin that keeps riding for 24 h, evenly dispersed
    Lantus, Lavamer, Insulin Glargine
  97. intermediate acting - onset 2 - 4 h, peak - 4 - 12 h, duration 18 - 24 h
    NPH, humulin N, Lente
  98. combination insulins never include this insulin
    long acting
  99. insulin - increase or decrease hypogly with aspirin, oral anticoags, alcohol, beta blockers, tricyclic anti-depress, MAOIs, tetracyclines
  100. insulin - increase or decrease hypogly with thiazides, glucocorticoids, oral contraceptives, thyroid drugs, smoking
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