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MU Pharm quiz 4
Thyroid, Reproduction, Antidiabetic, Endocrine System
| Question | Answer |
|---|---|
| In Hypothyroidism the TSH is ____________? | increased |
| in Hyperthyroidism the TSH is ___________? | Decreased |
| What does the Thyroid Do? | influences rate of metabolism and O2 consumption, Heart Rate, CHO, and Fat metabolism |
| Hypothyroidism does what to the body? | decreases HR, everything in the body decreases, gain weight (obese), dry skin, cold a lot |
| Hyperthyroidism does what to the body? | increases HR, oily skin, losing weight (skinny), hot a lot |
| What thyroid disorders could you have with hypothyroidism? | Hashimotos thyroiditis, treatment of hyperthyroidism, medications, congentital (cretinism) and myxedema (adult) |
| What thyroid disorders could you have with hyperthyroidism? | Graves disease, pituitary ademoma, thyroiditis, and overtreatment with thyroid drugs |
| What are the secondary thyroid disorders? | decreased TSH from AP (anterior piturtary) and decreased TRH from HT (hypothalumus) |
| Thyroid hormones stimulate what? | metabolism and caridac function and are needed for normal growth and development |
| Replacement hormones are given for what? | Hypothyroidism and myxedema coma |
| What are the adverse effects of the thyroid? | none unless given in inappropriate doses |
| What is the drug of choice for Hypothroidism? | Levothyroxine (Synthroid) |
| Levothyroxine (Synthroid) can be given how? | Oral or IV |
| What is the name of the drugs that treat Osteoporosis that deals with the clasts? | Bisphosphonates *Alendronate (Fosamax) daily or weekly *Ibandronate (Boniva) monthly formation *Risedronate (Actonel) daily or weekly |
| What are the nursing considerations for Bisphosphonates? | *give on an empty stomach 30 min before any food or fluid * do not lay down for 30 min *contraindicated with dysphagia (swallowing problems)/severe esophagitis |
| What is the name of the drugs that treat Osteoporosis that deals with the blasts? | Teriparatide (Forteo) Raloxifene (Evista) |
| What does the drug Teriparatide (Forteo) do and how is it given? | increases bone formation (builds it back up) SQ injection daily |
| What does the drug Raloxifene (Evista) (it acts like estrogen) do and how is it given? | Given PO, decrease bone loss, and it is approved for postmenapausal osteoporosis |
| Name the three treatments for hypocalcemia | Vit D (Calciferol) Ca+ carbonate precipitated (Os-cal) Ca+ gluconate IV |
| What is the goal of therapy for treatment of Osteoporosis? | Avois or slow bone loss |
| What is the lifestyle advice for Osteoporosis? | adequate dietary calcium (+/- supplement) adequate Vit D Reg exercise smoking cessation |
| Name the drugs in Hypercalcemia treatments | Furoseminde (Lasix) Phosphate Salt (Neutra-Phos) NaCl IV-0.9% Normal Saline |
| What does Furosemide (Lasix) do in treatment of hypercalcemia? | increases Ca+ excretion |
| What does Phosphate Salt (Neutra-Phos) do in treatment of hypercalcemia? | inhibits intestinal absorption of Ca+ and increases deposition of Ca+ in the bone |
| What does NaCl IV-0.9% Normal Saline do in treatment of hypercalcemia? | inhibits reabsorption of Ca+ in the renal tubules (pee out Ca+) |
| What are the hyperthyroid nursing interventions? | *Monitor pulse, BP and weight *Mix idodine in a full glass of fluid, drink with straw, metallic taste *Iodine toxicity-abdominal pain, vomiting, diarrhea, glottis edema (must be isolated) *Radiation (from radioactivce iodine) for diagnosis is small |
| Name the three hormone regulating Ca+ and Bone Metabolism | *parathyroid hormone *calcitonin *vit D (Calciferol) |
| What is the adverse effects for hyperthyroid treatment? | hypothyroidism, iodine toxicity, agranulocytosis |
| Often patients are on what other medication with hyperthyroid treatment for their increased HR? | propanolol |
| Fort hyperthyroid treatment, what is contraindicated in pregnancy? | Iodine preparation and thioamide |
| Name the antithyroid drugs | *PTU (propylthiouricil) *Methimazole (Tapizole) *Satuated solution of potassium iodine solution (SSKI) *Strong iodine solution (Lugol's solution) *radioactice iodine (131 I) |
| What drug is Synthetic T4? | Levothyroxine (Synthroid) |
| How is Levothyroxine (Synthroid) given? | Oral or IV |
| Levothyroxince (Synthroid) is given IV for__________? | Myxedema Coma |
| How long is the treatment of levothyroxine (Synthroid) | lifelong |
| How is the dose started for Levothyroxine (Synthroid)? | started low and ramped up if needed, 4-6 weeks check serum values to adjust dose |
| What does the Ovulation suppressants do? | *block the follicle stimulationg hormone and luteinizing hormone *Increase vaginal mucous viscosity *Endometrial changes |
| What are the oral contraceptives drugs? | Ortho Novum-biphasic Loestrin-Monophasic |
| What are the precautions with oral contraceptives? | Women over 35 who smoke |
| What are the nursing interventions for oral contraceptives? | Many interactions, caution against possible CVA, missed dose may result in pregnancy, stop taking medication if become pregnant, possible weight gain, teach that they do not prevent STD's |
| What are the names of the two fertility drugs? | Clomiphene citrate (Clomid) and Bromocriptine mesylate (parlodel) |
| What are the side effects of fertility drugs? | DVT ovarian hyperstimulation mutiple pregnancies |
| What are the four Ovulation stimulants? | Enhance or enable reproduction Treat infertility Ovaries are normal Same effects as natural hormones |
| What are the interventions of fertility drugs? | emotional support base line vitals, weight pregnancy tests ovulation monitoring |
| What are the name of the drugs used for estrogen replacement therapy? | Conjugated estrogens (Permarin) |
| Estrogen Replacement Therapy is used to treat? | Menopause some breast cancers Prostate (androgen dependent) cancer in men |
| What are the interventions for Estrogen Replacement Therapy? | Female characteristics in men check blood pressure advise against smoking |
| What does Progestins do? | Inhibit gonadotropin and decrease endometrial tissue proliferation prepare uterus and maintain pregnancy |
| Name the Progestin drug | Medroxyprogeserone injections (Provera) |
| What is the interventions for Progestin? | Monitor for DVT |
| What is Androgens used for? | Testosterone Maintain muscular and skeletal proteins Use for delayed puberty |
| Name the drug for Androgens? | Testosterone (depo-testosterone) |
| What are the precautions for Androgens? | abuse |
| Hypothalamic and pituitary hormones are given how? | SQ, IV, or Intranasal because they are destroyed by the GI tract |
| Hypothalamic and pituitary hormones may aggravate or cause what? | depression |
| What hormones are rarely used clincally? | hypothalamic and pituitary hormones |
| What is the name of the Hypothalamic hormone drug? | Octreotide (Sandostatin) |
| What is the action of the drug Octreotide (Sandostatin)? | it is similar to growth hormones release-inhibiting hormone (somatostatin) |
| Hypothalamic hormone inhibits what? | the release of growth hormone=GH+Somatotrophin |
| What are the uses of Hypothalamic hormone? | *acromegaly-inhibits growth hormone *carcinoid tumors-inhibits diarrhea and flush *anti diarrhea (decreases GI motility and secretions)-pancreatic diarrhea, HIV diarrhea |
| What does the Anterior Pituitary hormones do? | Replace naturally occurring hormones |
| What are the names of the drugs for Anterior Pituitary Hormones? | Cosyntropin (Cortrosyn) Growth hormone-Somatropin (Humatrope) |
| What does Cosyntropin (Cortrosyn) test for? | adrenal insufficiency |
| How is the growth hormone given and for how long? | IM 3x/wk |
| What are the nursing intervention for anterior pituitary hormones? | inappropriate use of growth hormone use of anti aging link between GH and tumor growth Watch for appropriate height growth |
| What is Posterior pituitary hormones? | Synthetic antidiuretic hormone (ADH) -not producing enough so you void all the time |
| What is the name of the drugs for Posterior pituitary hormones? | Vasopressin (Pitressin) Desmopressin (DDAVP) |
| How is Vasopressin (Pitressin) given? | IM, SQ, Intranasal on Qtip |
| How is Desmopressin (DDAVP) given? | intranasal |
| Posterior pituitary hormones are given to a patient with what kind of disease? | Diabetes insipidus |
| What do you watch for in diabetes insipidus patients with posterior pituitary hormones? | watch for water intoxication-chest pain, MI, high BP, abdominal cramps, nausea, diarrhea..TOO much ADH |
| What some of the things we use posterior pituitary hormones used for? | Given to induce labor: Oxytocin (Pitocin: IV), used to control postpartum bleeding |
| Corticosteroids are hormones produced by what? | adrenal cortex |
| Corticosteroids maintain what in the body? | Homeostasis |
| What drugs are Corticosteroids? | Hydrocortisone (Cortel) Prednisone (Deltasone) Dexamethasone (Decadron) |
| What are the uses for Corticosteroids? | Antiinflammatory immunosuppressive Anti allergic Anti stress |
| What drug does not cure but controls the symptoms? | Corticosteroids |
| Corticosteroids should be used short term for less than _____ weeks? | two |
| Wean off Corticosteroids if taking longer than _______ days? | ten |
| Abrupt stoppage of Corticosteroids can result in what? | acute adrenocortical insufficiency |
| What are the adverse effects of Corticosteroids? | moon face, obese trunk with thin extremities, hyperglycemia, osteoporosis, delayed healing |
| Contraindications in Corticosteroids in fungal infections is what? | infected wounds |
| Suppression of the HPA axis in what hormones? | Corticosteroids |
| What should you watch for in alternative dose therapy? | every other day and taper dose |
| What is the caution in diabetic with insulin? | hypoglycemia |
| How is insulin given? | IV and SQ |
| Insulin is given in how many units? | U-100 per mL |
| What are the types of Insulin that are fast acting/Rapid? | Insulin lispp (Humalog)SQ, Aspart (Novolog) and Glulisine (Apidra) |
| What is the name of the short-acting insulin? | Regular (Humulin R) SQ and IV |
| Which insulin can only be given IV? | Clear Regular (Humulin R) |
| What is the name of the Intermediate-acting insulin? | Isophane Insulin suspension (NPH) SQ Humulin N/Novalin N |
| What is the name of the long-acting Insulin? | Extended insulin zinc suspension (Ultralente)SQ Glargine (Lantus) and Levemir (Determir) |
| When giving insulin which always goes first; cloudy or clear? | Clear before cloudy; RN-regular before NPH |
| What are the nursing interventions of insulin? | individualized dose, check dose with another RN, monitor blood sugar, maintain diet, regular insulin of choice in acute situations (IV), time for food at peak action, keep emergency "sugar" on hand |
| Name the Sulfonylureas drugs | Glipizide (Glucotrol/Glucotrol XL) Glyburide (DiaBeta, Micronase) Glimepiride (Amaryl) |
| What do Sulfonylureas do? | Increase insulin from the pancreas |
| Sulfonylureas are for type I or type II DM? | type 2 diabetes |
| What are the adverse effects of Sulfonylureas? | hypoglycemia, weight gain, GI disturbances |
| Sulfonylureas are contraindicated with? | pregnancy/sulfa allergy |
| First generation drugs are rarely used for what drug? | Sulfonylureas |
| What are the nursing interventions for Sulfonylureas drugs? | monitor Blood sugar teach s/s of hypoglycemia and have a plan maintain diet and exercise |
| What does Meglitinides do? | Facilitates pancreas to produce more insulin after a meal |
| Meglitinides is used for Type I or type II diabetes? | Type 2 diabetes |
| What are the adverse effects of Meglitinides? | hypoglycemia (but less), weight gain, Gi disturbances |
| What is a precaution of meglitinides? | pregnancy |
| What is the drug of Meglitinides? | Repaglinide (Prandin) |
| What are the nursing implications of Meglitinides? | meal based 15-30 min before meals maintain nutrition and exercise monitor BS Do not take if you skip meal, add a dose if you add a meal |
| What does Alpha glucosidase inhibitors do? | Inhibit enzymes in the GI tract delaying digestion of complex CHO decreasing blood glucose after meals? |
| What adverse reactions are there with Alpha glucosidase inhibitors? | GI upset bloating |
| Name the alpha glucosidase inhibitor drugs | Miglitol (Glyset) Acarbose (Precose) |
| Alpha glucosidase inhibitors must be take with what? | a meal |
| Alpha glucosidase inhibitors will not cause what? | hypoglycemia |
| Biguanide Metformin (Glucophage/XR) does what? | increases the use of glucose by muscle and fat, decreases hepatic glucose production, decreases intestinal absorption of glucose |
| Metformin is used for Type I or Type II Diabetes? | type 2 diabetes |
| What are the precautions of Metformin? | stress illness diabetes pregnancy |
| Metformin interacts with what? | radioactive contrast media |
| What are the nursing interventions for Metformin (Glucophage)? | take with meals to decrease stomach upset discontinue 48 hrs before diagnostic tests monitor BS continue diet and exercise |
| Glitazones: Pioglitazone (Actos) and Rosiglitazone (Avandia) FDA warning do what? | increases or restores the effectiveness of circulating insulin-decreased insulin resistance |
| Glitazones: Pioglitazone (Actos) and Rosiglitazone (Avandia) is used for type I or type II Diabetes? | Type 2 diabetes |
| What are the precautions of Glitazones Pioglitazone (Actos) and Rosiglitazone (Avandia) | active liver disease, CHF (may cause fluid retention and heart failure) |
| What are the adverse effects of Glitazones? | HF, weight gain, anemia |
| What are the nursing interventions of Glitazones? | monitor BS, weight, edema, often given with sulfonylurias, check LFT's baseline and periodically |
| What is the name of the drug for Amylin Analog, what route is it given and when? | Pranlintide (Symlin) Route: SQ before meals |
| When is Pranlintide (Symlin) used? | Used with insulin to slow gastric emptying thereby regulating the postprandial rise in blood glucose |
| Pranlintide (Symlin) can also be combined with what other drugs? | metformin or sulfonylurias-but may slow their absorption |
| What is the warnings with Pranlintide (Symlin)? | can cause severe hypoglycemia cannot be mixed with insulin dont even give in same area |
| Name the Incretin mimetic drug and its route. | Exenatide (Byetta) Route: SQ 2xd |
| What does Exenatide (Byetta) do? | Helper hormone that stimulates the pancreas to secrete only the right amount of insulin |
| What is the advantage of Exenatide (Byetta)? | increased satiety and weight loss |
| What is the FDA warning for Exenatide (Byetta)? | renal impairment |
| GLP-1 is like what? | peptide |
| Name the Dipeptidyl peptidase-4 inhibitors (DPP4) drug | Sitagliptin (Januvia) |
| What does Sitagliptin (Januvia) do? | balances the release of insulin and limit the release of additional glucose from the liver |
| Sitagliptin (Januvia) limits what? | glyconeogenesis |
| Contraindications to Januvia | Type I Diabetes, insulin, sulfonylureas, High urine ketones, ESRD (End stage renal disease) |
| Sitagliptin (Januvia) is linked to beta cell neoenesis and decreases what? | Beta Cell apoptosis (programmed cell death |
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