23 endo drugs
Card Set Information
23 endo drugs
4 categories of endocrine system drugs
refers to an internal secretion (hormone) produced by a ductless gland that secretes directly into the bloodstream
_____ is located at the base of the brain and is called the Master Gland
why is the pituitary gland called the master gland?
because it regulates the function of other glands
what hormones does the pituitary gland secrete?
Thyroid stimulating hormone
the anterior pituitary lobe hormone that is called the human growth hormone?
the hormone that regulates growth
who can only be the one to treat growth abnormalities?
is only available for
a synthetic peptide of adrenocorticotropic hormone that is used for diagnosis of adrenocortical insufficeincy
where are the adrenal glands located?
adjacent to the kidneys (they lay on top)
what type of hormone do the adrenal glands secrete?
____ act on the immune system to suppress the body's response to infection or trauma. relieves inflammation, reduces swelling, and supresses symptoms
2 categories of corticosteroids
1. replacement therapy
is used as a short term therapy and localized to prevent system effects. is also not a curative, but used as a supportive therapy with other meds
prolong use of this can cause suppresion of the pituitary gland
what can be given if corticosteroids is needed for an extended time period?
give intermediate acting corticosteroids with alternate day therapy
1. allergic reactions (poisoning,bites)
2. acute flare-ups of rheumatic or
collagen disorders (inflamed joints, decreased crippling)
3. acute flare ups of severe skin conditions
4. acute respiratory disorders
5. malignancies (luekemia, lymphoma, hodgkins disease)
6. Cerebral edema
7. organ transplant (to prevent rejection)
8. life threatening shock
9. acute flare ups
are all conditions treated with?
abrupt withdrawal of ______ can lead to acute adrenal insufficiency, shock, death
delayed wound healing
, increased susceptibility to infection
w/ fractures (esp. in older women)
, bruising, skin thinning
-fluid & electrolyte imbalances (edema/fluid retention)
-take oral meds during/immediately after meals to reduce gastric irritation, but not near bedtime
-antacids or asprin should be avoided
live virus vaccines/toxoids (inhibits antibody response)
thyroid agent medications
____ absorbs all iodine in blood
______ are released from pituitary gland when levels are low
TSH (thyroid stimulating hormone)
TSH promotes biosynthesis & secretion of 2 bioactive thyroid hormones called
is the major product of the thyroid gland & much is later converted into T3 form
causes slow metabolism w/ symptoms of fatigue, dry skin, thinning hair, weight gain
treatment for hypothyroidism
hypothyroid conditions requiring replacement therapy include:
*thyroid destruction after surgery/radiation
how is hypothyroidism diagnosed?
through blood tests before medication is given
toxic effects are the result of overdosage of thyroid and are manifested in the signs of ______
toxic effects of ________ include:
-palpations, cardiac arrhythmias, tachycardia
-nervousness, insomnia, HA
-weight loss, diarrhea
intolerance to heat
-exopthalmos (bulging eyes)
-normal thyroid function (
-oral coagulants (potentiate)
-insulin & hypoglycemics (dosage required)
-adrenergic effects w/ epinephrine (potentiates) WATCH CLOSELY!
-estrogen, bcp (decrease thyroid response)
-soy products (decrease response)
-calcium/iron/magnesium salts (decrease absorption, space several hours apart)
-meds taken for life
-take on empty stomach 30-60 mins prior to breakfast
-periodic lab test to determine effectiveness & dosage
hypothyroidism is the reult of the thyroid not making enough _____
hyperthyroidism is when the body makes _____ thyroxine
_______ used to relieve symptoms of hyperthyroidism in preparation for surgical & radioactive iodine therapy
(Methimazole & propylthiouracil (PTU)
-rash, pruritus, urticaria
-blood dysrasias (esp. agranulocytosis)
-pts who are older than 40 y.o.
-drugs that cause agranulocytosis (potentiate)
-inform physician if any signs of illness (chills, rash, sore throat)
used to lower blood glucose levels in those with impaired metabolism of carbs, fats, and proteins
characterized by destruction of pancreatic beta cells
DM type 1
characterized by insulin resistance and deficeincy
DM type 2
___ was formally described as juvenile diabetes
most common form of diabetes (90-95%)
DM II is increasing in earlier ages due to?
what is the result of poorly controlled diabetes?
vascular injury (micro/macrovascular)
microvascular complication includes:
macrovascular complications include:
coronary artery disease (MI)
cerebrovascular disease (stroke)
peripheral vascular disease
why is insulin required for type 1 diabetes?
for replacement therapy bc of insufficient production of insulin
why is insulin required for type 2 diabetes?
required for those who have failed to maintain blood glucose
____ is used in the emergency treatment of diabetic ketoacidosis or coma
how is insulin administered?
why is insulin administered parenterally?
bc the GI tract will destroy it
2 types of injected insulin
1. biosynthetic insulin - amino acid structure
2. analog - manmade
types of insulins
how are biosynthetic adn analog insulins created
recombinant DNA technology
in a 100 unit ml insulin syringe how much does each line represent
in a 50 unit ml insulin syringe how much does each line represent
what type of insulin can
ONLY be given intravenously and intramuscularly?
what types of insulin are clear and ultra rapid acting with a short duration?
what types of insulins can be given subcutaneously?
all others EXCEPT regular insulin
what is an intermediate acting insulin?
what are long acting insulins?
regular insulin can sometimes be combined with _______ in the same syringe
isophane (humulin N/novolin N)
if two insulins are ordered at the same time, what must be done first?
draw up the regular insulin in the syringe first
what types of insulin should no tbe mixed with any other types of insulin?
glargine and other mixtures
this is sometimes ordered as a corrective action insulin
what must be done to prevent one of the most common and most dangerous medication error?
crosscheck physician orders and verify with another caregiver
elevated blood glucose is also known as
insufficient insulin dose
surgical or other trauma
can all be a result of:
Symptoms of _____: polydipsia/polyuria
weight loss, anorexia
treatment of acute hyperglycemia
IV fluids to correct electrolyte imbalance with regular insulin added
lowered blood glucose is also known as
loss of consciousness
pallor, hunger, N/V
may result from:
treatment for conscious hypoglycemia
1st – administer 4 oz. oj,candy,honey
2nd – provide protein snack
3rd – recheck blood glucose
treatment for comatose hypoglycemia
1st – administer 10-30 mL of 50% dextrose IV or -1 unit of glucagon (1mg) IM or IV
2nd – follow w/ carb snack when pt awakens
what is the somogyi effect?
a rebound effect of hypoglycemia overdose resulting in hyperglycemia
how are oral anitdiabetic medications administered?
1. single dose before breakfast
2. 2 divided doses before morning and evening meals
what is a principal therapy for DM II management?
weight reduction and modified diet
oral hypoglycemic drugs are also known as:
chlorpropamide & tolbutamide are what generation solfonylureas?
glipizide & glyburide are what generation solfonylureas?
____ work by increasing insulin production from the pancreas and by imporving peripheral insulin activity
major side effect of sulfonylurea
only insulin administered IV, IM and SubQ
side effect of sulfonylureas, biguanides, and alpha-glucosidase inhibitors
stimulates pancreas beta cells to produce insulin
oral hypoglycemic drugs consisting of first-generation agents
therapy for an allergic reaction to poison ivy
should be done to insulin injection sites
hormone used for diagnosis of adrenocortical insufficiency
if possible, corticosteroids are administered this way
time that opened vials of insulin may be stored without loss of potency
adjunctive therapy for clients with type 2 diabetes without glycemic control
side effect of long-term corticosteroid use in children
decreases hepatic glucose output and enhances insulin sensitivity
common side effect of thiazolidinediones
SE of _____:
-pruritus, rash, urticaria
-hepatic dysfunction including jaundice
- hypoglycemia in older adults
- lethargy, vertigo
-increase of cardiovascular death
CI of ___:
-debilitated or malnourished Pt's
-impaired liver and kidney function
which sulfonylurea generation drugs have a higher potency, shorter action duration, better tolerance -& fewer drug interactions
Pt's recieving/discontinuing sufonylurea agents should be monitored closely for?
loss of diabetic control
Alpha-glucosidase inhibitor meds
often used as part of a combination regimen that includes an oral sulfonylurea
delays digestion of complex carbs & subsequent absorption of glucose after meals
Alpha-glucosidase inhibitors (carbose)
SE of _____:
-high rate of GI effects (
flatulance, abdominal distention/pain, loose stools
) which tend to diminish with time or a reduction in dose; take at the start (first bite) of main meals
alpha glucosidase inhibitors
drug interactions w/ _____:
-estrogens and oral contraceptives
alpha glucosidase inhibitor
metformin (glucophage) is an example of a
____ work by decreasing hepatic glucose output and enhancing insulin sensitivity to muscle
can be used as an initial first-line monotherapy or in combination with sulfonylurea to treat type 2 diabetics
SE of ____:
-GI effects- Lactic Acidosis (severe dehydration, cardiorespiratory insufficiency, renal dysfunction)-Hypoglycemia-rare
CI of ____:
- radiocontrast dye
-children and older adults
-impaired kidney adn liver function
DI w/ _____:
-increased metformin effect seen with alcohol, cephelexin, and cimetidine
-radiopaque contrast media (hold metformin day of and 48 hrs after)
two naturally occuring hormones that have been identified adn released by cells in the GI tract in response to food
GIP & GLP-1
_____ activation suppresses the release of glucagon by the pancreas
_____ activation stimulates insulin secretion in order to maintain glucose homeostasis
in type 2 diabetes which enzyme rapidly inactivates GLP-1, which is already reduced in Pt's with impaired glucose intolerance
incretin therapy meds
given SC BID, mimics action of incretin GLP-1, decreases glucagon secretion, delays gastric emptying time, decreases food intake
used as adjunctive therapy for type 2 DM pts who does not have glycemic control & are taking metformin, a sulfonylurea or both
____ is not recommended for use in Pt's with severe renal disease
given orally once daily, inhibits DPP-4 enzyme, increase GLP-1 & GIP levels, increase insulin secretions
when recieving januvia Pt's should be monitored with what med
used as monotherapy in type 2 DM pts or combo w/ meformin or thiozolidinedione when adequate glycemic control has not been achieved
-stimulates pancreatic beta cells to produce insulin
-used as monotherapy or combo w/ metformin
-weight gain, fluid retention, edema
-admin prandin before meals to maximize absorption
-gemfibrozil (lopid) may enhance/prolong effects
meds with black box warnings for both meds, potential increase in myocardial ischemia risk