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What is the treatment for Dwarfism?
- Somatrem (Protropin)
- Soatotropin, Recombinant (Humatrope)
What is a successful response of Protropin and Humatrope?
Growth > 2cm per year
Which replacement drug has the potential to be abused by athletes?
Protropin and Humatrope
What is the treatment for gigantism or acromegaly?
Besides gigantism and acromegaly what else does the drug Octreotide (Sandostatin) treat?
Symptoms of tumors and AIDs (diarrhea)
What does vasopressin (Pitressin) treat?
Diabetes insipidus, esophogeal varices, septic shock and ACLS in sudden death
Which of the posterior pituitary replacement drugs has the greatest vasoconstrictive effect?
Which of the posterior pituitary replacement drugs treats diabetes insipidus through the intranasal route?
* Dose may be adjusted to treat nocturnal enuresis
What does Desmopressin (DDAVP) treat?
- treats nocturnal enuresis
- commonly prescribed intranasally
What are the three antithyroid agents used to treat Graves disease?
- 1. Propylthiouracil (PTU) - Graves disease, adjunct to radiation to prepare for surgery
- 2. Potassium Iodide (SSKI)- Temporary (used prior to surgery)
- 3. Radioactive Iodine (RAI)- destroys thyroid tissue, radiation precautions, NPO after midnight, encourage fluids
What are some nursing considerations when administering SSKI?
- Temporary (used prior to surgery)
- Dose is in gtts-mix w. juice for taste and tooth discoloartion Reduce iodine intake
What are the adverse effects of PTU?
- 1. Agranulocytosis
- ◦Within first 2 months of therapy
- 2. Hypothyroidism
- ◦Occurs with excessive dosing
- 3. Neonatal hypothyroidism
- ◦Crosses the placenta
- ◦Enters breast milk
- 4. Give WITH MEALS to reduce GI distress
What is drug is used to treat thyrotoxicosis?
- Prophylthiouracil (PTU)
- (Thyroid antagonist)
- ◦Inhibits synthesis of T3 and T4
- ◦Inhibits iodine uptake in thyroid gland
What are radiation precautions?
Double flush toilet, private room, no pregnant visitors or nurses, no sharing/disposable utensils, proper disposal of excreta (waste)- wear gloves, no children
- 24 hours for hyperthyroidism
- 3 days for thyroid cancer
What is SIADH and how is it treated?
- SIADH= increased ADH
- Treatment = diuretics, fluid restriction, hypertonic IV solution
What is necessary for thyroid hormone synthesis and how is it controlled?
- Iodine is necessary for TH synthesis
- and it is controlled by negative feedback loop
What is the other name for hypothyroidism and what medication is used to treat it?
- Levothyroxine (Synthroid, Levothroid) : Highly protein bound.
Which drug interacts with coumadin and may require an increase in insulin and digoxin?
What are the adverse effects of Synthroid?
Tachycardia, angina, tremors
What should you teach your patient taking Synthroid?
- Dosing is individualized, compliance is important
- Take before breakfast
- May be life long therapy
- Require periodic check-ups and labs
- Alert all healthcare providers
- Call Doctor if chest pain or papitations occur
Your patient just returns from PACU after having a partial thyroidectomy for cancer. In reviewing the orders you see that he has a Ca++ ordered. Why?
- Secondary hyperparathyroidism due to damage/removal of parathyroid.
- Causes decreased caclium, inccreased phosphorus (like in hypoparathyroidism) but also causes renal osteodystrophy
What are two bedside tests for hypocalcemia?
- 1. Tetany= tonic spasms of muscles d/t decreased
- 2. Check Chovstek’s sign = facial spasm after tapping over
- facial nerve and Trousseau’s sign spasm of upper arm after pressure applied to vessels or nerves
What are the 4 drugs used in addisons disease (hypocortisol)
- 1. Prednisone
- 2. Hydrocortisone
- 3. Methylprednisone
- 4. Dexamethasone (Decadron)
What are the uses of hydrocortisone?
- **Glucocorticoid for addisons or hypodisorders
- – Adrenal insufficiency: ADDISONS DISEASE
- – Allergy: Asthma, derma, neoplasms
- – Inflammation: RA, IBS
- – Cancer chemotherapy: Systemic lupus erythematosus
- Adverse effects
- ◦Adrenal suppression
- ◦Cushing’s syndrome
What are the adverse effects of cortisone?
- Adrenal insufficiency - Cushings
- Fluid imbalance
- Growth retardation
What to do for Glucocorticoid withdrawal..
- 1. Taper the dosage over 7 days
- 2. Switch from multiple to single dosing
- 3. Monitor for signs of insufficiency
What is the mineralocorticoid that is in the treatment of Addisons disease?
- Fludrocortisone (Florinef)
- - Potent -
- ◦Addison’s disease
- ◦Primary hypoaldosteronism
- ◦Congenital adrenal hyperplasia
- Adverse effects
- – Cardiac enlargement
What is used to treat Cushings disease?
- 1. Aminoglutethimide (Cytadren)
- 2. Metyrapone (Metopirone)
What does ACTH help diagnose?
- Adequacy of adrenal function
- 1. Addisons disease
- 2. Cushings syndrome