Neoplasia; endocrine
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| The Endocrine System | Consists of glands that secrete hormones Hormones are released as changes in the body occur Hormones are transported by the blood through the body
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| What is hormone action is controlled by? | negative feedback mechanism
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| Parafollicular cells in the parathyroid secrete calcitonin | Parathyroid gland is big in calcium homeostasis
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| Thyroid releasing hormone (TRH) | from the hypothalamus stimulates the pituitary gland to produce and secrete thyroid stimulating hormone (TSH)
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| thyroid stimulating hormone (TSH) | stimulates the thyroid gland to produce and secrete thyroid hormones into the blood
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| That does the Thyroid Hormone do? | Regulates basal metabolic rate Critical to growth of the nervous system
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| Hypothyroidism | by insufficient secretion of TSH or thyroid hormone
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| myxedema | Hypothyroidism in adults
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| Signs and symptoms of myxedema | Everything SLOWS down: Slowed body metabolism Slurred speech Bradycardia Weight gain Low body temperature Intolerance to cold
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| Treatment for hypothyroid | Levothyroxine (Synthroid)
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| Levothyroxine (Synthroid) side effects | Hyperthyroidism and the associated side effects
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| Hyperthyroidism | Too Much Thyroid Hormone Secreted
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| Graves’ disease | severe form of hyperthyroidism
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| Hyperthyroidism S and Sx | Increased body metabolism Tachycardia Weight loss High body temperature Anxiety
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| Hyperthyroidism treatment | Propylthiouracil (PTU) (Propacil) Anti-thyroid hormone Can take a while to be effective – up to 12 wks
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| Adrenal Glands | Lie atop the kidneys; Cortex - Corticosteroids Medulla - Epinephrine and norepinephrine
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| Adrenal Cortex | Secretes corticosteroids (2 classes) Glucocorticoids Mineralocorticoids
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| Mineralocorticoids | Aldosterone Increases the renal absorption of sodium in exchange for potassium More sodium and water retention in body
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| Glucocorticoid | CRF (corticotropin-releasing factor) secreted from the hypothalamus; Causes release of ACTH (adrenocorticotropic hormone) from the pituitary glands; During long-term stress, mobilize the formation of glucose (release of cortisol); Potent anti-inflammatory
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| Adrenocortical Insufficiency | Decrease production of corticosteroid
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| Adrenocortical Insufficiency S and SX | Hypoglycemia Fatigue Hypotension GI disturbances
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| Addison’s Disease | Primary adrenocortical insufficiency; rare; Deficiency of both glucocorticoids and mineralocorticoids Treated with glucocorticoid replacement therapy
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| Secondary Adrenocortical Insufficiency | Common; Results from long-term therapy with glucocorticoids that is abruptly discontinued…pituitary has received message to stop secreting ACTH
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| Glucocorticoids Are Used to Treat: | Inflammatory and immune responses: Allergies, seasonal rhinitis, asthma Contact dermatitis and rashes Hodgkin’s disease, leukemias, lymphomas Shock Rheumatoid arthritis, ankylosing spondylitis, bursitis Ulcerative colitis, Crohn’s disease Hepatic,
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| Cushing’s Syndrome | Adverse Effect Can Occur During Long-Term use of glucocorticoids
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| Cushing's syndrome S an SX | Adrenal atrophy Osteoporosis Increased risk of infections Delayed wound healing Peptic ulcer Accumulation of fat around shoulders and neck Moon face Buffalo hump Mood and personality changes Hyperglycemia
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| Common glucocorticoids (end in sone or lone) | Predinisone (Deltasone) Hydrocortisone (Solu-cortef) Methylprednisolone (Solu-Medrol) Dexamethasone (Decadron) Betamethasone (Celestone) Fetal lung development
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| glucocorticoids nursing considerations | D/C gradually Always use at the smallest dose possible for the shortest time possible Stay away from IV – go for the least invasive route
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| Somatotropin | Growth Hormone; secreted by the pituitary gland; Administered prior to the closure of the growth plates or is not effective
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| Growth Hormone Medications for Dwarfism in Children | Somatrem (Protopin) Somatropin (Humantrope) Not approved to stimulate growth in short children
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| Antidiuretic Hormone | Increases water absorption by kidneys…conserves water in body Also called vasopressin…raises blood pressure if secreted in large amounts Diabetes insipidus - deficiency of ADH Massive amounts of urination
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| Diabetes Insipidus TX | Vasopressin (Pitressin) Desmopressin used for enuresis (bed wetting) - nasal spray
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| Cancer | characterized by abnormal, uncontrolled cell division
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| Cancer cells | Lose normal functions Invade surrounding cells Can metastasize- the abnormal cells travel to distant sites where they populate new tumors
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| Adenoma | benign tumor of glandular tissue
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| Lipoma | benign tumor of adipose tissue
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| Malignant Tumors | Rapid growth, can easily metastasize Resistant to treatment Can results in death
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| Carcinoma | any malignant tumor derived from epithlial
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| Sarcoma | tumor from connective tissue (bone, fat, muscle, etc)
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| Leukemia | blood-forming cells
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| Lymphoma | lymphatic tissue
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| Glioma | central nervous system
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| Associated with a higher risk of acquiring cancer | Smoke Environment Sun Dietary HPV
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| Chemicals in tobacco smoke | Responsible for one-third of all cancers
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| chemical carcinogens associated with the workplace | Asbestos - lung cancer Benzene - leukemia
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| Physical Factors Associated with Cancer | Exposure to large amounts of x-rays - leukemia Ultraviolet (UV) light from the sun - skin cancer
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| Biological Factors | Viruses - associated with 15% of all human cancers; Examples - herpes simplex viruses types I and II, Epstein-Barr virus, papillomavirus, cytomegalovirus; Immune system suppression (HIV patients Transplant patients)
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| Oncogenes | predispose client to certain cancers
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| Healthy Lifestyle Habits to Lower CA Risk | Eliminate tobacco use and exposure to secondhand smoke Limit/eliminate alcohol use Reduce animal fats in diet Increase fiber in diet - plant sources Exercise regularly Keep weight within normal guidelines Exam body monthly for abnormal lumps and ski
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| Radiation Therapy | High doses of ionizing radiation aimed directly at tumor May follow surgery Sometimes used for palliation with inoperable cancers - shrink size of tumor Relieve pain, difficulty breathing or swallowing
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| Chemotherapy | Transported through blood - potential to reach every cancer cell Some drugs cross blood-brain barrier - treat brain tumors Some drugs instilled directly into body cavities - treat bladder cancers Different classes affect different stages of the cancer’
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| Cancer drug classifications | Alkylating agents Antimetabolites Antitumor antibiotics Plant alkaloids/natural products Hormones and hormone blockers Biologic response modifiers Miscellaneous drugs
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| Alkylating Agents | Most widely used antineoplastic drugs; Act by chemically binding to nucleic acids (DNA) and inhibiting cell division; Cyclophosphamide (Cytoxan)
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| Antimetabolites | Are drugs that chemically resemble essential building blocks of the cell; When CA cells attempt to construct proteins or DNA, they use the antimetabolite drug instead of the normal building blocks - This disrupts metabolic pathways; Methotrexate(Mexate)
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| Other uses for Antimetabolites | Rheumatoid arthritis Psoriasis Ectopic pregnancy M.S.
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| Antitumor Antibiotics | Not widely prescribed because of their cytotoxicity, but very effective against certain tumors; Cardio toxic; Doxorubicin (Adriamycin)
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| Plant alkaloids/natural products | Chemicals with antineoplastic activity have been isolated from a number of plants - Derived from the periwinkle plant; Vincristine (Oncovin)
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| Hormones and Hormone blockers | Used to slow the growth of hormone-dependent tumors (reproductive hormones); Anti-estrogen blocker chemo used for breast cancer - Many take is prophalaxis; Tamoxifen (Nolvadex)
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| Biologic Response Modifiers | Biologic response modifiers stimulate the body’s immune system No not kill CA cells directly, but stimulate the body’s immune system to fight the CA; Interferon alfa 2 (RoferoneA, Intron A)
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| Miscellaneous Anticancer Drugs | Some other miscellaneous drugs given to limit or counteract the toxicity of antineoplastics Epoetin alfa (Epogen, Procrit)- stimulates RB production to limit anemia
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