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GH is used in the management of growth failure in children due to what?
- deficiency,
- chronic renal insufficiency
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What is GH used to manage (mostly in adults)?
- short stature associated with Turners syndrome
- AIDS
- Short bowel syndrome
- GH deficiency
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What drug is used for underproduction of GH?
Somatropin
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Adverse effects of Somatropin.
- Hyperglycemia & insulin resistance
- Edema of hands/feet
- H/A & HTN initially but resolve
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Contraindications of GH.
- children w/ epiphiseal closure
- w/ corticosteroids
- caution w/ severe renal & hepatic disease
- DM
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Drug given for overproduction of GH.
Ocreotide
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Adverse rxns of Ocreotide.
- GI systems
- elevated LFTs
- immediate yellowing of skin or sclera
- RUQ pain
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Contraindications of Ocreotide.
- caution w/ renal impairment or failure
- liver & cardiac disease
- DM
- hypothyroidism
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What does Ocreotide do in addition to the natural hormone?
suppresses stomach bleeding and GI secretions
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Most common cause of hypothyroidism.
Hashimoto's thyroiditis
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What two facters characterize hypothyroidism?
- 1. hypometabolic state
- 2. myxedematous changes in body
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What is myxedema?
- An extreme complication of hypOthyroidism.
- a mucous type of edema caused by an accumulation of fatty substances in CT
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Characteristics of hypometabolic state.
- gradual onset of weakness & fatigue
- wt gain & decreased appetite
- GI motility slowing = constipation
- mental dullness, decreased memory, slow reflexes
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Myxedematous changes in the body.
- fluid accumulation
- puffy eyes
- enlarged tongue
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mechanism of axn for Levothyroxine.
increases metabolic rate
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The key in dosing Levothyroxine.
"low & slow"
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Med for hypothyroidism.
Levothyroxine
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Most common cause of hyperthyroidism.
Grave's disease
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Most visible signs of hyperthyroidism.
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Three classes of steroids.
- Mineralocorticoids (Aldosterone 95%)
- Glucocorticoids (cortisol)
- Gonadocorticoids
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Things to report with corticosteroid drugs.
- wt gain > 1 kg in 24 hrs or >2kg in a week
- BP >140/90
- tachycardia
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What side effects would you see with corticosteroid use due to increased fluid retention?
- increased BP
- HTN
- tachycardia
-
Dosing for hydrocortisone.
- PO: 10-320 mg/day, 3-4 divided doses
- IV/IM: 15-800 mg/day, 3-4 divided doses
- max = 2g/day
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Adverse effects of LONG-term corticosteroid use.
- Cushings Syndrome:
- suppresses immune system = increased risk for infection
- peptic ulcers (esp w/ NSAIDS)
- osteoporosis
- nervousness, moodiness, hallucinations
- cataracts & glaucoma
- myopathy
- HYPERglycemia
- HYPERlipidemia HYPERnatremia
- HYPOkalemiaEdema, HTN
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Adverse effects of vasopressin.
- necrosis & gangrene
- water intox
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What is vasopressin used to treat?
- central or neurogenic DI (IM or SQ)
- alternative to epinephrine (IV)
- esophageal or upper GI bleeding
- cardiac arrest
- severe hypotension or shock
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