25 terms

Endocrine System Drugs Ch.23

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Endocrine
1. Pituitary Hormones
2. Adrenal Corticosteroids
3. Thyroid Agents
4. Antidiabetic Agents
Internal Secretions (hormone) produced by a ductless gland that secretes directly into bloodstream. Includes: Natural or Synthetic.
Pituitary Gland
Location base of brain called Master Gland bc it regulates the function of other glands. Secretes sevreal homrones: Somatotropin & ACTH
Adrenal Corticosteriods
Location adjacent to kidneys. Secrete hormones called CORTICOSTERIODS act on immune system to supress the bodys response to infection or trauma. They relieve inflammation, reduce swelling, & supress sysmptoms in acute conditions.
Corticosteriods 2 Broad Categories
1. Replacement therapy when secretions of pituitary or andrenal gland are deficient.
2. Antinflammatory & immunosupressenat properties.
Coritcosteriods not curative but supporitve thearpy with other meds. Conditions treated:
Allerigic reactions -
Acute flare ups: rhemuatic, collagen, skin, disorders
Malignancies: leukemia, lymphoma, hodgkins.
Cerebral edema: brain tumors & neurosurgery
Organ Transplant: to prevent rejection
Life-threatening shock: adrenocortical insufficiency
Acute Flare-ups: ulcers, short term avoid hemorrhag
Corticosteriods Patient Education
Never stop taking med abruptly.
Report S/S of infection or within 12 months after therapy is discontinued.
Take oral with or STAT after meal. Mutliple doses spaced out during day. Single dose before 9am
SE: long term fluid retention & edema
Dangers of infection, delayed wound healing, osteoporsis, mental disorders.
Thyroid Agent
Used in replacement therapy for HYPOTHYROIDISM caused by absent thyroid function. Its causes slow metabolism, fatigue, dry skin, thinning of hair, weight gain, sensitivity to cold, irregular menses.
Weight loss with use of Thyroid Agents
When thyroid function is normal is contrainindicated, ineffective, & dangerous, leading to decrease in nomral thyroid function & life threatening cardiac arrhythmias.
Thyroid Agent Toxic Effects
(hyperthyroidism)
Palpations, cardiac arrhythmias, >BP
Nervousness, tremor, headace, & insomnia
Weight loss, diarrhea, ab. cramps
Intolerance to heat, fever, excessive sweating
Menstrual irregularities.
Thyroid Patient Education
Usually taken for life on empty stomach 30-60 min prior to breakfast. Report s/s of overdose. Labratory test to determine effectiveness & proper dosage. Not changing brand w/out physicians approval
Antithyroid
Relieve systems of hyperthyroidism in preparation for surgical or radioactive iodine therapy. Notify signs of illness (chills, rash, fever, jaundice, malaise)
Antidiabetic
1. Insulin
2. Hyper/hypo glycemia
Lower blood glucose levels in those w/ impaired metabolism of carbs, fats, & proteins.
1. Type (destruction of pancratic beta cells) insulin.
2. Type( insulin resisistance) obesity
Insulin
More for type 1, only Type 2 if failed to maintain concentrations of blood glucose with diet & excerise.
Regular Insulin: treatment of ketacidosis.
Biosynthetic: similar to human insulin
Analog: substituion changes in human insulin molecule.
Aspart, glulisine, lispro
Ultra-rapid acting & have a very short duration of action. Onset 15 min, clear, Peak 1 hr, last 4 hr.
Regular Insulin
Rapid acting and of short during & short duration. Only type may be give IV, IM, Subcutaneouslly. All other insulins can only be given sub cu.
Isophane (NPH)
Glargine & detemir
-Intermediate acting
-long acting
Regular Insulin & Isophave (NPH)
Can be combined
When 2 insulin are ordered at the same time, the regular insulin should be drawn into syringe first. Rapid onset for duration up to 24 hrs.
Hyperglycemia Side Effects
Treatment: IV fluids to correct electrolyte imbalance. Regular Insulin.
Dehydration, thrist, Polyuria,Anorexia unexplained weight loss, Fruity Breath, Lethargy, weakness, vision, KETOACIDOSIS - test urine for acetone
Hypoglycemia Side Effects
Treatment: 4oz OJ, candy, syrup. Comatose: 10-30mL of 50% detrose solution IV or 0.5-1 u glucagon.
Prespiration, pallor, hunger, n/v, irritabilty, confusion, tremor, headache, tingling of fingers, Blurred vision, Tachycardia, shallow breath, Loss LOC, convulsion. Older adults may mimic CVA.
Oral Antidiabetic Type 2
Results from insulin resistance combined w/ relative insulin deficiency. Can be treated w/ diet alone.
Symptoms of Type 2 DM
Excessive weight gain, thirst, urination, weakness, poor ciruculation, & slow healing, visual problems.
Sulfonylureas Oral Hypoglycemic
1st & 2 Generation Agents. Work by increasing insulin production from the pancreas & improving peripheral insulin activity.
Alpha-Glucosidas Inhibitors
acrbose (Precose)
Delay digestion of complex carbs & subsequent absorption of glucose, resulting in smaller rise in blood glucose concentration following meals.
Biguanides
metformin (Glucophage)
Work by decreasing hepatic glucose output & enhancing insulin sensitivity in muslce. Metformin can be used 1st line monothreapy to treat type 2
Incretin Therapies
GIP & GLP-1
Naturally occuring hormones are released by cells in GI track in response to food.