endocrine medication

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sojialiu
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76862
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endocrine medication
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2011-04-05 18:48:00
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endocrine meds
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endocrine meds
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  1. Oral Hypoglycemia
    are used for type 2 diabetic mellitus only
  2. Sulfonylureas
    stimulate beta cell of pancreas to release insulin.
  3. Sulfonylureas side effect
    • Hypoglycemia
    • Nausea, constipation
    • Agranulocytosis
    • Allergic skin reaction
    • Weight gain
  4. Alpha-glucosidase
    inhibitor
    oral anti-diabetic drugs used for diabetes mellitus type 2 that work by preventing the digestion of carbohydrates
  5. Alpha-glucosidase inhibitor side effect
    • Flatulence and diarrhea
    • Hypoglycemia
  6. Biguanides
    lower blood sugar by blocking glucose production from the liver and increasing sensitivity of body cells to insulin
  7. Biguanides side effect
    • Hypoglycemia
    • Abdominal discomfort, nausea and diarrhea
    • Metallic taste in the mouth may occur at
    • first as your body adjusts to the medication. This okay tell patient it will go away Can cause lactic acidosis-
  8. Biguanides contraindicated
    • Diabetic ketoacidosis
    • Liver diseases
  9. Thiazolidinediones
    they increase cell sensitivity to insulin thus allowing insulin to push more glucose into the cell
  10. Thiazolidinediones side effect
    hypoglycemia
  11. Nursing Teaching in Oral Hypoglycemia
    • Teach patient to avoid Aspirin, alcohol they also cause hypoglycemic effect
    • Teach the patient to avoid Glucocorticoids, thiazide diuretics, and estro­gen because they increase blood glucose levels
    • Patient with hypersensitivity reaction to sulfur or urea containing medication cannot take sulfonylurea
  12. Types of insulin
    • Rapid Insulin
    • Short acting Insulin
    • Intermediate Acting Insulin
    • Long Acting Insulin
  13. Administration of Insulin
    • Usually given subcutaneously except regular or rapid insulin that can be given IV under emergency
    • Rotation should be 1.5 inches apart within the
    • anatomical site.
    • Insulin syringe come in 27 to 29 gauge needle which is
    • approximately 0.5 inches long
    • DO NOT aspirate when giving the injection
    • Administer insulin subcut at 90 degree angle, but If the patient is too thin at 45 degree angle
  14. Insulin injection site
    • Abdomen- best site
    • Arm- posteriorsurface
    • Thigh- anterior surface
    • Hips
  15. Mixture of insulin
    • Draw the Regular insulin into syringe FIRST before drawing the intermediate acting
    • Insulin zinc suspension can only be mixed with each other or with regular insulin
    • Mixed insulin must be administered within 5 to 15 minutes of preparation otherwise regular insulin will bind to NPH thereby decreasing the action
  16. Steps involved in mixing insulin in ascending order
    • Wipes off vials with alcohol swab
    • Inject 12 units of air into NPH (cloudy)vial
    • Inject 6 unit of air into Humalog (clear) vial
    • Withdraw 6 unit of humalog (clear) insulin
    • Withdraw 12 units of NPH (cloudy)insulin
  17. Storing Insulin
    • Do not expose insulin to sunlight or extreme of temperature
    • Keep insulin in cool place (refrigerator) but should not be frozen.
    • Before administration let it warm to room temperatur Label vial with date, time opened and when due to expire
    • Mixture of insulin in prefilled syringes should be kept in the refrigerator flat or with the needle in upright position to avoid clogging the needle
  18. Complications of insulin therapy
    Local allergic reactions
  19. Insulin complication Nursing intervention
    • Instruct the client to avoid the use of alcohol to cleanse the skin prior to injection
    • Give antihistamine to be taken 1 hour prior to injection
  20. Insulin lipodystrophy
    Lipoatrophy is loss of subcutaneous fat and appears as slight dimpling or pitting
  21. Lipohypertrophy
    is the development of fibrous fatty masses at the injection site; caused by repeated use of an injection site
  22. Insulin resistance
    occurs when the client receiving insulin develops immune antibodies that bind the insulin, thereby decreasing the insulin available for use in the body.
  23. Insulin resistance Nursing intervention
    Administering a pure form of insulin preparation-Human is the purest
  24. Dawn phenomenon
    • Morning blood glucose levels
    • blood glucose level may rise between 4 am and 8am.
  25. Dawn phenomenon nursing intervention
    • includes administering an evening dose of intermediate-acting insulin at 10 PM
    • by checking the blood glucose level in the middle of the night (around 3 AM).
  26. Somogyi's phenomenon
    • this occurs during the night when there is rapid drop of blood glucose
    • hypoglycemia occurs at 2 to 3 AM
  27. Insulin waning
    • the gradual increase in blood glucose levels from bedtime to morning.
    • blood sugars must be checked 3 times over night
  28. Glucagon-(GlucaGen)
    Increases blood glucose level by stimulating glycogenolysis
  29. Glucagon-(GlucaGen) nursing intervention
    All patients with diabetes should have a glucagon emergency kit available.
  30. Diazoxide (Proglycem)
    Increases blood glucose level by inhibiting insulin release from the beta cells and stimulating the release of epinephrine from the adrenal medulla
  31. Medication used in Growth Hormone disorders ends in
    Tropin
  32. Medication used in Growth Hormone disorders side effects
    body can dev antibodies to the growth hormone
  33. Somatropin (Humatrope)
    Used for-Growth failure in children

    ·
  34. Bromocriptine (Parlodel)
    inhibit growth hormone
  35. Somatropin (Humatrope) Side effect
    hyperglycemia, hypertension, allergic reaction(rash,swelling), pain at injection site
  36. Octreotide (Sandostatin)
    Uses
    inhibit secretion of growth hormone treatment of Acromegaly
  37. Octreotide (Sandostatin)-Side Effect
    Diarrhea, nausea, abdominal discomfort, increased or decreased glucose level
  38. Octreotide (Sandostatin)- Nursing Interventions
    • Teach client how to document monthly height and weight measurements and to report any
    • less-than-expected growth to physician

    Monitor blood and urine glucose levels and teach the client about the impor­tance of follow-up regarding blood and urine glucose testing
  39. ANTIDIURETIC HORMONES uses
    used in diabetes insipidus
  40. ANTIDIURETIC Side effects
    • tachycardia and Hypertension
    • Nasal congestion with nasal administration
  41. ANTIDIURETIC Contraindication
    congestive heart failure ; coronary artery or vascular disease and vasoconstriction causes blood pressure elevation
  42. THYROID HORMONES

    • Used to replace thyroid hormone deficit in the treat­ment of hypothyroidism, myxedema, or cretinism
    • Used to diagnose thyroid deficiency and myxedema
  43. Tyroid hormone Side effects

    • drug over dose can manifiest as signs and symtoms of hyperthyrodism
    • hypertension,tachycardia, dysrthmias
  44. tyroid homone Interventions
    • level of thyroxine -T3 and T4 and TSH
    • avoid asprine and tartrazines
    • avoid food that can inhibit tyroid secretion
    • tyroid has no treatment care so tyroid homones is life long
    • intruct patient no to change brand of tyroid medicaton with out doctor approval
    • intruct client to wear a medi-alert braclet
  45. ANTITHYROID MEDICATIONS
    These are medication that Inhibit the synthesis of thyroid hormone
  46. anti-thyroid medication side effect
    • Agranulocytosis with leucopenia
    • Hypothyroidism
    • loss of hair- alopecia
    • nausea, jaundice, loss of taste
    • Diarrhea
  47. Medication used in Diseases of Adrenal Gland
    • Glucocorticoid
    • Mineralocorticocoid
    • Adrenal androgen
  48. Glucocorticoid (Corticosteroid)
    are medication that have same effect as cortisone produced in the adrenal gland
  49. Glucocorticoid (Corticosteroid) ending name
    • -cort
    • -sone
  50. Glucocorticoid (Corticosteroid) Side effects
    • decrease immunity
    • Fluid and electrolyte imbalance
    • Poor wound healing
    • direct bone loss leading to increase risk of osteoporosis
    • peptic ulcer
    • Hyperglycemia
  51. Glucocorticoid (Corticosteroid) Contraindications
    • patient with immunosuppressive condition
    • avoid immunizations
  52. Glucocorticoid (Corticosteroid) Nursing intervention
    • Never discontinue or stop the use of glucocorticoid medication abruptly this could lead to a serious adrenal insufficiency. Dosage should be tapered off gradually
    • Patient must not increase or decrease dose without consulting the doctor.
  53. Mineralocorticoid –steroids
    acts on kidneys to retain sodium and water but facilitate loss of potassium and hydrogen
  54. Mineralocorticoid –steroids side effect
    • hypertension, tachycardia, edema, weight gain and heart failure
    • Hypokalemia
    • Metabolic alkalosis- due to loss of hydrogen
    • Hypocalcemia
    • Thromboembolism
  55. Adrenocorticotropic hormones
    stimulate the adrenal cortex to secrete cortisol.
  56. PARATHYROID MEDICATIONS
    Drug used to treat low calcium –hypocalcemia
  57. Risedronate (Actonel)
    Alendronate (Fosamax)
    CALCIUM REGULATORS
  58. CALCIUM REGULATORS Side Effects
    • renal stones
    • fatigue, ataxia, irritability, somnolence and seizure. Hypotonia in infant
    • Bone-bone decalcification
    • distress or constipation
    • hypertension, dysrhythimias in a client taking digoxin
  59. CALCIUM REGULATORS Nursing Intervention
    • main­tain an adequate intake of vitamin D, because vitamin D enhances absorption of calcium
    • swallow tablet whole with water at least 30 minutes before breakfast and not to lie down for at least 30 minutes after taking medication
  60. Medications to treat Hypercalcemia
    • Promote urinary excretion of calcium
    • Inhibit mobilization of calcium from bone to the blood
    • Decrease intestinal absorption of calcium
    • Bind with free calcium in blood to form complexes that are not calcium
  61. Side/adverse effects of hypocalcmia
    low serum calcium level, which increases neuromuscular excitability

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