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Pharm II Unit 3
Endocrine System and Drugs
89
Nursing
Undergraduate 1
09/15/2011

Additional Nursing Flashcards

 


 

Cards

Term

 

This drug is an anti-inflammatory that may slow activity of leukocytes, suppress tissue repair and granulation, reducing ESR.

Definition

 

 

Glucocorticoids

 

Prednisone (Deltasone)

Term

 

prednisone (Deltasone) has an Immunosuppressive action that is due to suppression of _____(1)____, and the decrease in the # of ____(2)_____, and lymphocytes

Definition

 

 (1) phagocytosis

 

 (2) eosinophils

Term

 

Glucocorticoid

 

prednisone (Deltasone) results in increased gluconeogenesis and decreased glucose use--

hence an increase in_________

Definition

 

 

 

blood glucose

Term

 

What Glucocorticoid drug decreases antigen-antibody reactions, and decreases the # of plasma immunoglobulins?

Definition

 

 

prednisone (Deltasone)

Term

 

 

Glucocorticoid activity may cause salt and water retention, resulting in ______ and ______.

Definition

 

 

edema and hypertension

Term

 

If a glucocorticoid is used as a topical for a localized action for a prolonged or excessive time it can lead to _______ effects.

Definition

 

 

SYSTEMIC EFFECTS

Term

True or False

 

 (1) Glucocorticoids can be given orally?

 

(2) Cannot be given IV?

Definition

 

(1)  True

 

(2) False, they can also be given by IV

Term

 

Prednisone requires what (organ) to be healthy in order to have effective utilization?

Definition

 

The (Liver)

 

because prednisone is activated with metabolism in the Liver to prednisolone.

Term

 

What part of the endocrine system can cause slow metabolism?

Definition

 

 when (the thyroid) is not producing enough T3 and T4

 

(hypothyroidism)

Term

True or False?

 

Prednisone should not be given with food?

Definition

 

False, may cause GI upset, so food is recommended with dosage

Term

 

What are the uses for prednisone (Deltasone)?

Definition

 

*Asthma, allergies, inflammatory bowel disease

 

*Immunosuppressive to prevent organ transplant rejection

 

*As a replacement for adrenal insufficiency

Term

Glucocorticoid

 

 

You should not take prednisone (Deltasone) if.....

Definition

*Hypersensitivity

 

 * Systemic fungal infection or administered live viruses(immune suppression)

 

*People allergic to -Sulfites- may develop severe allergic or anaphylactic reactions

Term

 

Closely Monitor Patients that take

 

prednisone(Deltasone)with:

 

                           (Pre-existing illnesses)                      

Definition

 

DM, or GI disorders, HTN, or myasthenia gravis

 

they may have exacerbations

 

 

Term

 

Common adverse effect for pednisone(Deltasone)

 

CNS?

Definition

 

CNS complaints: anxiety mood swings, insomnia, and headache

Term

 

Common adverse effects prednisone(Deltasone)

 

GI ?

Definition

 

 

GI complaints: N/V, increased appetite, weight gain, and dyspepsia

Term

 

Common adverse effects for the endocrine system while using

prednisone (Deltasone)?

Definition

 

hyperglycemia, menstrual irregularities, suppression of pituitary ACTH release

Term

 

Patients on prednisone (Deltasone) because of immune suppression have an increased risk for:

Definition

 

 

-INFECTION-

 

  prednisone also may suppress bone growth

Term

 

 

Acne, and delaying healing of wounds is increased with what drug?

Definition

 

 

 

prednisone (Deltasone)

Term

 

 

Long term use of prednisone (Deltasone) can lead to:

Definition

 

*Cushingoid characteristics such as buffalo hump, moon face and trance obesity

*May also see loss of muscle mass and thinning extremities

*Hyperlipidemia and thrombus formation

Term

 

 

prednisone (Deltasone) results in increased parathyroid activity which causes what to happen?

Definition

 

 

Calcium loss from bones which increase risk of osteoporosis

Term

 

Patients should be weened off prednisone (Deltasone) to prevent......

Definition

 

 

acute adrenal insufficency caused by abrupt withdrawl

Term

 

 

Acute Adrenal Insufficiency signs and symptoms:

Definition

 

anorexia, hypoglycemia, lethargy, restlessness

 

if this happens pt. needs to call provider ASAP

Term

What must be taught to a Patient on prednisone (Deltasone) besides.......

 

*Eat with meals or antacids

*Teach to avoid infections and how to recognize S/S

Definition

*Wear Medical Identification

 

*Discuss alterations in appearance

 

*Take-1500 mg Calcium and 510 of Vit D

 

*Admin at an establishes schedule

Term

 

Fludrocortisones (Florinef Acetate) is what kind of catagory Drug?

Definition

 

Mineralocorticoids

Term

 

What does Fludrocortisones (Florinef Acetate) do on a cellular level?

Definition

 

Acts on distal renal tubule to enhance reabsorption of Na and to increase the urinary excretion of both K+

and H+ ions

Term
How can Fludrocortisones (Florinef Acetate) be administer?
Definition

 

Orally

 

absorbed in GI, metabolized in Liver

Term

 

What drug gives partial replacement therapy for primary adrenocortical insufficency?

Definition

 

 

Fludrocortisones (Florinef Acetate)

Term

 

What are Contraindications to Fludrocortisones (Florinef Acetate)?

Definition

*Hypersensitivy

 

*Systemic Fungal Infections

Term

 

Why would B/P rise in a person taking Fludrocortisones (Florinef Acetate)?

Definition

 

Because of the sodium retention and potassium excretion

Term

 

Patients need sufficient protien intake while on Fludrocortsones (Florinef Acetate) other wise......

Definition

 

the drug can produce a negative nitrogen balance

Term

Edema, HTN, CHF and cardiomegaly

 

bruising, diaphoresis, Urticaria, allergic skin rash

 

Hypokalemic alkalosis

 

 All SERIOUS sides effects that are from what drug?

Definition

 

 

Fludrocortisones (Florinef Acetate)

 

mineralocorticoid

Term

 

What needs to be taught with a Patient on Fludrocortisones (Florinef Acetate)?

Definition

Follow a diet high in K+ and low in Na to reduce the risk for HTN, weight gain, and edema

 

Wear medication ID bracelet and regular F/U's

 

Report unusual weight gain, lower extremity edema, muscle weakness and severe or continuing HA, also monitor their own B/P

Term
What is monitored for F/U's with pts. on Fludrocortisones (Florinef Acetate)?
Definition

 

electrolyte status, fluid balance, and B/P

Term

 

 

What is  the med Aminoglutethimide (Cytadren) used  to treat?

Definition

 *Used to treat Hypercortisolism (Cushings Syndrome)

 

*Non FDA approved but used also for breast cancer in postmeopausal Women and metastic prostate cancer in Men

Term

What drug inhibits enzymatic conversion of cholesterol to pregnenolone.

 

Reduces synthesis of all adrenal steroids.

Definition

 

 

Aminoglutethimide (Cytadren)

 

Steroid Hormone Antagonist

 

Term

 

 

The decrease in adrenal steroids induces a compensatory increase in secretion of ______

Definition



ACTH

 

 

Term

 

 

What is necessary to maintain aminoglutehimide's effect?

Definition

 

 

hydrocortisone

 

Term

 

 

What are the contraindications of

 

Aminoglutethimide (Cytadren)?

Definition

Hypersensitivity

 

and

 

Pregnancy Category D

Term

 

Common Adverse effects in

 

Aminoglutethimide (Cytadren)

Definition

 

Drowsiness, dizziness, skin rash, nausea, and anorexia.

Term

 

What happens with the adverse effects of

 

Aminoglutethide (Cytadren)?

Definition

 

 

 

They usually disappear spontaniously in 1-2 weeks

Term

What is a Serious Adverse effect from suppression of aldosterone production by the adrenal cortex

 

when taking

 

Aminoglutethimide (Cytadren)

Definition

 

 

Hypotension and tachycardia

Term

What kind of Blood dyscrasias can happen as a Serious Adverse Effect with the Med

 

Aminoglutethimide (Cytadren)

Definition

 granulocytosis, leucopenia, neutropenia, and pancytopenia

 

(Also rare but may cause elevated liver enzymes)

Term

What kind of drugs may interact with

 

Aminoglutethimide  (Cytadren)?

Definition

Oral Anticoagulants

 

Caution clients

will need increased monitoring.

Term

 

What are the Nursing Interventions with a patient taking

 

Aminoglutethimide (Cydadren)?

Definition

Change positions slowly, prevent injury

 

Take meds with small frequent meals to lessen GI effects

 

Do not drive or perform other tasks that require alertness- until effects known.

 

Report rash, drowsiness, HA's or severe nausea

Term

 

 

This drug is used for Hypothyroidism?

Definition

 

 

levothyroxine (Synthroid)

Term

 

 

Sythroid has increased absorption when-

 

 

Definition

 

on an empty stomach

 

(it is taken at the same time each day

 

usually before breakfast)

Term

 

Common Adverse Effects for

 

levothyroxine (Synthyroid)?

Definition

 hyperthyroidism symtoms (increased sweating, HTN, tachycardia, hyperreflexia, anxiety)

 

Alopecia with intial Therapy

 

Term

 

What history of the Patient would be a Contraindication to taking levothyroxine (Synthroid)?

Definition

 

*Acute MI

 

*Thyrotoxicosis

 

"Be cautious with hypoadrenalism"

Term

What must a nurse monitor for a Patient on

 

levothyroxine (Synthroid)?

Definition

Monitor:

 

drug response carefully

cardiac reponse

weight and pulse

 

(suggest wearing a Med ID bracelet)

Term

 

Which drug inhibits thyroid sythesis

 

 treating  Hyperthyroidism?

Definition

 

 

methamazole (Tapozole)

Term

 

What kind of a patient should not take methamazole (Tapazole)?

Definition

Hypersensitivity to drug or properties of

 

OR

 

Someone who is pregnant or lactating

Term

 

What are some common adverse effects you might see

with a patient taking

 

methamazole (Tapazole)?

Definition

 

GI:  N/V, epigastric pain

Itching

Rash

Hives

Arthralgia

Term

 

Aplastic anemia, Liver Damage, Agranulocytosis, and Vasculitis

 

Serious Adverse Effects of this Drug?

Definition

 

 

methamazole (Tapazole)

Term

What are Nursing Interventions when taking methamazole (Tapazole)?

Administer around the _____

Periodic ____ ____ (CBC, thyroid function)

Report to provider with:____ ____, unusual _____ or _____, malaise

Definition

Clock

 

sore throat

 

unusual bleeding or bruising

Term

What drug regulates Calcium and bone metabolism,

 

therefore inhibiting bone reabsorbtion?

Definition


calcitonin, salmon (Miacalcin)


Parathyroid Medication

Antihypercalcemic, Calcium Regulator Drug

Term

T or F

 

calcitonin, salmon (Miracalcin)

 

has a Direct effect and action on the GI tract

Definition

 

 

True

Term

 

How can calcitonin, salmon (Miacalcin)

be

administered: (3 ways)

Definition

 

 

SQ, intramuscularly, or intranasally

Term

What drug is used for:

 

*Pagets disease of the bone

*Tx of postmenopausal osteoporosis and hypercalcemia

*Inhibiting bone absorbtion

Definition

 

 

calcitonin, salmon (Miacalcin)

Term

Why a patient could not use

 

calcitonin, salmon (Miacalcin)

Definition

Allergies 2ndary to salmon antigens.

 

If a person has multiple allergies (skin testing)

 

No serious allergies with nasal spray

Term

What are some common Adverse Effects of

 

calcitonin, salmon (Miacalcin)

 

Definition

GI disturbances: mild and decrease with use

 

Skin site reactions: flushing of face and hands, and nasal irritation or rhinitis with nasal spray.

Term

Allergic-anaphylaxis can result with __(1)___ calcitonin, salmon.

 

Persons allergic to __(2)__ products are more at risk

Definition

 

(1) injectible

 

(2) fish

Term

calcitonin, salmon (Miracalcin)

 

Clients using:

nasal spray should_____nostrils

 

SQ injections should use ____ ____

Definition

 

alternate nostrils

 

sterile technique

Term

Nursing Interventions calcitonin, salmon (Miracalcin)

 

 (1)How should nasal formula be stored?

 

(2)Small frequent meals may decrease what?

 

(3)Observe Urine periodically for what?

Definition

Store unopened bottle in fridge

 

N/V

 

urine sediments-can indicate renal calculi

Term

What are the uses of


Calcitril (Rocaltrol) oral


Calcijex-parenteral

Definition

Both used to manage hypocalcemia and bone disorders

associated with Chronic Renal Falure/dialysis,

 

hypoparathyroidism

 

Increasing bone mass in osteoporosis

Term

Calcitriol can be administered 2 ways

 

Name them

 

Definition

 

Orally

 

and

 

IV

Term

hypercalcemia can happen with Calcitriol or Calcijex

 

 

if given:

Definition

 

in excessive doses

Term

What Patients CANNOT or should use CAUTION taking

 

Calcitriol(Rocaltrol) oral

or

Calcijex parenteral

Definition

*Pts taking Digoxin can have cardiac arrhythmias

 

*Pts with end-stage renal disease are unable to adequatly synthesize

 

USE CAUTION IN ELDERLY PTS with CORONARY or RENAL DISEASE

 

Term

Weakness, HA, N/V, dry mouth, constipation and bone pain are all common adverse effects due to what Vitamin associated with

 

Calcitriol (Rocaltrol)

Calcijex

Definition

 

 

Vitamin D

Term

Calcitriol (Rocaltrol) oral

Calcijex parental

 

Meds have most active for of Vitamin _(1)_

Stimulates intestinal CA and _(2)_ transport

Helps to maintain _(3)_ homeostasis, bone growth and maintenance

Definition

 

(1) Vitamin D

 

(2) Phosphate

 

(3) CA (calcium)

Term

 

 

Chronic hypercalcemia can lead to:

Definition

generalized vascular calcification,

 

nephorcalcinosis,

 

other soft tissue calcifications

Term

 

What dietary supplement is necessary for a clinical response in


Calcitriol (Rocaltrol) or Calcijex?

Definition

 

 

Adequate dietary Calcium or Calcium Supplement

Term

 

What should a Patient Avoid while taking


Calcitriol (Rocaltrol)

or Calcijex?

Definition

 

Avoid us of nonprescription drugs, including magnesium containing antacids.

 

Avoid dehydration, take in adequate fluid.

Term

Calcitriol (Rocaltrol) or Calcijex

 

Encourage pts to eat-

 

Encourage pt to keep-

 

Monitor-

Definition

 

Eat- small frequent meals to decrease GI nausea

 

Keep- Follow Up appointments

 

Monitor- blood levels

Term

 

What drug stimulates cell growth and cellular mitosis, promoting use of fatty acid for energy?

 

(Equilvalent to pituitary GH)

Definition

 

 

Somatropin (Humatrope)

Term

 

How can

Somatropin (Humatrope)

be administered?

Definition

 

 

 

SC and IM

Term

 

Somatropin (Humatrope)

 

is used for children who have growth failure

only if what?

 

(Contraindications)

Definition

 

 

The epiphyses is not closed

 

(also pts with intracranial tumors and pediatric pts with endocrine disorders)

Term

 

Patients with these issues should be cautious to take

 

Somatropin (Humatrope):

Definition

 

*Patients with renal and hepatic disorders

 

*Diabetics may become hyperglycemic

Term

What are commom Adverse Effects with

 

Somatropin (Humatrope)?

Definition

*HA, joint and back pain, muscle aches, rhinitis

 

*Peripheral edema

 

*Hypertension

 

*Hyperglycemia

Term

 

Antibodies to GH, Hypothyroidism, and Insulin Resistance may Happen in this drug as

 

Serious Side Effects?

Definition

 

Somatropin (Humatrope)

Term

 

Nursing Interventions for

 

Somatropin (Humatrope)?

Definition

Take baseline Height and Weight

Monitor thyroid, blood glucose and levels of GH therapy

Pts on dialysis dose according to their shedule

Monitor Nutrition Balance

Teach appropriate technique (Drug only injection)

Refrigerate-reconstituted and stable for 14 days

Should be reconstituted w/ bacteriostatic water

Term

 

What drug interacts with V1 and V2 receptors found on the renal tubles and can mediate antidiuresis by stimulating resorption?

Definition

 

Desmopressin (DDAVP)

Term

 

 

Dessmopressin (DDAVP) has a _____ half life and can be administered 4 different ways?

Definition

Long Half Life

 

Can be aministered:

 

intranasally, orally, IV or SC

Term

 

 

What are the reasons for Dessmopressin (DDAVP)

to be used?

Definition

*Diabetes Insipidus

 

*Primary nocturnal enuresis

 

*Trauma-induced bleeding

 

*Hemophilia A and Von Wilebrand disease

Term

 

Use Caution with Desmopressin (DDAVP)

 

with Patients who have:

Definition

CAD or HTN

 

clients with fluid and electrolyte imbalanced

 

cystic fibrosis

 

renal disease-can experience Hyponatremia

Term

 

Adverse Effects of

 

Desmopressin (DDAVP):

 

Definition

 

Mild abd pain and cramps

HAs, nasal congestions, nausea, rhinitis and facial flushing

Injections associated with-erythema, burning, pain and swelling

Term

Watch Out!!!

 

Serious Side Effects for

 

Dessmopressin (DDAVP):

Definition

 

Hyponatremia

 

Changes in BP either high or low

Term

 

Nursing Interventions for

 

Dessmopressin (DDAVP):

Definition

Pregnacy Category B-no breast feeding

Establish baseline for weight, BP, electrolytes, urine specific gravity

Protect med for excessive heat or freezing

Refridgerate intranasal and parenteral solutions

Limit fluid intake 1 hr before and 8 hrs after dose to decrease the risk of Hyponatremia and water intoxication

Monitor urine volume and Osmolality as well as pt electrolyte levels.

Alcohol can alter therapeutic reponse

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