322 Endocrine & Diabetes
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| levothyroxine | replacement therapy, increases levels of T4 and deionized to T3
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| levothyroxine interventions | monitor height and weight in infants and children, take on an empty stomach, safe during pregnancy
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| liothyronine | synthetic T3, rapid onset; best absorbed in the GI tract; initial treatment for myxedema
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| methimazole | inhibits thyroid synthesis, does not destroy existing; avoid during pregnancy
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| methimazole side effect | agranulocytosis; report sore throat and fever
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| propylthiouracil | inhibits thyroid production and prevents conversion of T4 to T3; safe in 1st trimester of pregnancy; preferred for thyroid storm
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| propylthiouracil side effects | agranulocytosis, risk for liver injury
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| propylthiouracil administration | shorter half life; requires multiple doses per day
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| radioactive iodine thyroid cancer | high dose
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| radioactive iodine hyperthyroidism | low dose
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| somatropin | administered to a child before the epiphyses are fused; can be abused by athletes
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| somatropin side effects | paresthesia, glucose fluctuations
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| somatropin adverse reactions | seizures, intracranial hypertension, secondary malignancy
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| somatostatin | helps regulate GH release and is produced in the hypothalamus; can cause cardiac toxicity - bradycardia
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| dopamine agonist | inhibits secretion of GH caused by pituitary adenomas
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| dopamine agonist adverse effects | cardiac toxicity - hypertension, MI, angina; cerebrovascular toxicity
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| oral antidiabetics | sulfonylureas and biguanides
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| sulfonylureas | type 2, can be combined with other drugs
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| 1st generation sulfonylureas | associated with increased risk of cardiovascular disease
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| 2nd generation sulfonylureas | increase tissue response to insulin and decrease glucose production in the liver; glipizide and glyburide
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| 2nd generation sulf | longer duration of action and fewer side effects; greater hypoglycemia potency and cannot be used with liver or kidney dysfunction
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| biguanides | metformin, glucophage
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| metformin side effects | anorexia, N/V, decreased B12 levels and folic acid deficiency
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| metformin toxicity | lactic acidosis; drug interaction with alcohol and not recommended with renal impairment
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| metformin withheld | 48 hours before or after administration of IV contrast
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| external insulin pump | blood sugar check hourly, how to change tubing, know when to bolus
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| conscious hypoglycemia | fast acting oral sugar
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| unconscious hypoglycemia | IV glucose, parenteral glucagon
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