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PHARM 2
Ch. 17&18 - Hormones, Osteoporosis and DM Drugs
| Testosterone Replacement Patient Teaching | *Dissolvable rx: do NOT eat, drink, smoke or chew tobacco until rx is fully dissolved *Gel rx: do NOT let women or children come into contact with the areas where rx was applied, to prevent drug absorption *Do NOT increase dose w/out consulting PCP |
| Testosterone Replacement Troublesome Symptoms | fluid retention, breast enlargement, SOB, excessive physical or sexual stimulation, prolonged or painful erection of the penis, impotence, retention and jaundice *Report to PCP* |
| Antidiabetic Meds: Incretin Mimetics Drug Class | *albiglutide (Tanzeum) *dulaglutide (Trulicity) *exenatide immediate release (Byetta) *liraglutide (Victoza) *lixisenatide (Adlyxin) **End in -tide |
| Antidiabetic Meds: Increatin Mimetics MOA | *Non-insulin antidiabetic drugs that act like the natural gut hormones secreted in response to food in the stomach *Works with insulin to prevent blood glucose levels from becoming too high after meals |
| Sodium-glucose Cotransport Inhibitors Nursing Implications | *Asses for allergic reaction *Monitor blood glucose level for hypoglycemia *Check weight at the start of therapy *Monitor for UTI or vaginal infections *Assess for dehydration *Monitor serum potassium and symptoms of hyperkalemia |
| Sodium-glucose Cotransport Inhibitors Patient Teaching | *Notify PCP if having allergic reaction *Check blood sugar levels at regular intervals *Weigh once a week and report weight loss *Report signs of UTI or vaginal infection *Drink enough fluids *Presence of glucose in urine-expected |
| Biguanides MOA | *Oral: non-insulin antidiabetic drugs that lower blood glucose levels by reducing the amount of glucose the liver releases and by reducing how much and how quickly the intestines absorb the glucose from food. |
| Biguanides Patient Teaching | *Avoid alcohol *Metformin side effect: GI upset *Metformin should be stopped 24 hours before any test that uses radioactive dye and not started again until 48 hours after test is completed. *Long-term use of Metformin and Vit B6 deficiency |
| DPP-4 Inhibitors Drug Class | *alogliptin (Nesina) *linagliptin (Tradjenta) *saxagliptin (Onglyza) *sitagliptin (Januvia) **End in -liptin |
| Thyroid Hormone Replacement Thyroid Hormone Agonists | A drug that mimics the effects of the thyroid hormones T3 and T4 helping to regulate metabolism |
| Thyroid Hormone Replacement Adverse Effects | Cardiac and Nervous System *angina (chest pain) *myocardial infarction (heart attack) *heart failure |
| Thyroid Hormone Replacement Nursing Implications & Patient Teaching | *1st dx; dosage kept low for 1st weeks *Increased slowly every 2-3 wks *Take 2hrs before meals or fiber supplements at least 3hrs after meal *Do not stop suddenly *Check pulse in AM before taking and in PM before bed *Go to ER if chest pain *No ASA |
| Thyroid Hormone Replacement Drug Interactions | Anticoagulant - Warfarin |
| Antithyroid Drugs MOA | Reduce thyroid hormone levels by entering the thyroid gland and combining with the enzyme responsible for connecting iodine with tyrosine |
| Antithyroid Drugs Nursing Implications & Patient Teaching | *Bone marrow suppression-bleeding, pts who take anticlotting: look for bleeding of gums or bruising, bleeding in IV site, blood in urine, stool or vomit *Hepatotoxic-check qd for yellowing of skin or sclera, coffee-colored urine and clay-colored stools |
| Drugs for Osteoporosis Drug Class | *bisphosphonates *estrogen agonists/antagonists *osteoclast monoclonal antibodies *sclerostin inhibitor |
| Drugs for Osteoporosis: Bisphosphoneates MOA | *Calcium-modifying drugs that used to prevent and manage osteoporosis *Binds calcium into the bone and prevents osteoclasts from destroying bone cells and resorbing calcium *Prevents WBC's from damaging the bone *End in -onate (Fosomax; alendronate) |
| Drugs for Osteoporosis: Bisphosphoneates Patient/Family Teaching | *Take early in AM with full glass of water *Remain upright 30 minutes after taking rx; prevent GERD *Report swelling, pain, redness or gum infection; osteonecrosis *Tell dentist about rx |
| Drugs for Adrenal Gland Hyperfunction | *Corticosteroid Receptor Blocker -mifepristone (Korlym) *Steroid Production Inhibitors -mitotane (Lysodren) |
| Corticosteroid Receptor Blockers Uses | *Is used only for people who have DM2 and hyperglycemia along with hypercortisolism *Instruct sexually active women of childbearing age to use 2 reliable forms of BC while taking mifepristone; can cause pregnancy loss |
| Corticosteroid Receptor Blockers Expected Side Effects | *N/V, rashes and dizziness *Mitotane - blood urine *Mifepristone - menstrual irregularities |
| Corticosteroid Receptor Blockers Nursing Implementation | *Lab work *Report s/s of adrenal insufficiency *Take with food *Instruct sexually active women of childbearing age to use 2 reliable forms of BC while taking mifepristone; can cause pregnancy loss |
| Hormonal Contraceptives | *Hormones to suppress ovulation for the international prevention of pregnancy *Oral contraceptives; most common, topical applications; transdermal patches, vaginal rings or IUD, implanted under the skin, injected parentally |
| Hormonal Contraceptives Adverse Effects | *Blood clot-DVT, PE, MI and stroke *Fluid & sodium retention-HTN; not recommended for HTN pts *Liver toxicity-not recommended for women w/ liver problems *Promotes cancer of cervix, uterus, ovary and breast; not recommended for women with hx of cancer |
| Insulin Adverse Effects | Hypoglycemia |
| Estrogen Agonists/Antagonists Osteoporosis | *Activates estrogen receptors in the bone to help calcium remain in the bone *Block estrogen receptors in the breast tissue and uterine tissue; leads to breast cancer *Over-growth of uterine endometrial tissue (excessive uterine bleeding) *End in -fene |
| Estrogen Agonist/Antagonist Patient Teaching | Smoking cessation; reduce risk of blood clots, heart attacks and stroke |
Created by:
nserna
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