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6) ch 51 endocrine drugs
pharmacology fscj 2011
67
Nursing
Undergraduate 3
12/08/2011

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Term
hypophysis
Definition
The pituitary gland
Term
adenohypophysis
Definition
anterior pituitary gland
Term
. The anterior pituitary gland, called the adenohypophysis, secretes which horomones?
Definition
Growth hormone (GH), which stimulates growth in tissue and bone

• Thyroid-stimulating hormone (TSH), which acts on the thyroid gland

• Adrenocorticotropic hormone (ACTH), which stimulates the adrenal gland

• Gonadotropins (follicle-stimulating hormone [FSH] and luteinizing hormone [LH]), which affect the ovaries. (FSH and LH are discussed in more detail in Chapter 56.)
Term
which Two hypothalamic hormones regulate GH
Definition
(1) growth hormone–releasing hormone (GH-RH) and (2) growth hormone–inhibiting hormone (GH-IH; somatostatin).
Term
Growth hormone drugs cannot be given ______, because they are inactivated by gastrointestinal enzymes.
Definition
orally
Term
Prolonged GH therapy can antagonize insulin secretion and eventually cause
Definition
diabetes mellitus
Term
a product that has the identical amino acid sequence as human growth hormone
Definition
Somatropin
Term
acromegaly
Definition
(excessive growth after puberty
Term
excessive growth during childhood
Definition
Gigantism
Term
a potent synthetic somatostatin used to suppress GH release.
Definition
Octreotide
Term
The adenohypophysis secretes WHAT in response to thyroid-releasing hormone (TRH) from the hypothalamus
Definition
thyroid-stimulating hormone (TSH)
Term
WHICH electrolyte to you pay special attention to if the patient is on adrenocorticotropic hormone?
Definition
Potassium
Term
adrenocorticotropic hormone (ACTH) Nursing interventions
Definition
monitor growth in children

monitor weight, edema, and electrolytes (especially K)

warn client to reduce salt intake

instruct clients about reporting symptoms.
Term
neurohypophysis
Definition
The posterior pituitary gland,
Term
The posterior pituitary gland, known as the neurohypophysis, secretes which hormones?
Definition
antidiuretic hormone (ADH) (vasopressin) and oxytocin.
Term
diabetes insipidus
Definition
When there is a deficiency of ADH, large amounts of water are excreted by the kidneys.
Term
ADH (antidiuretic hormone) replacement therapy drugs
Definition
vasopressin (Pitressin) and desmopressin acetate (DDAVP)
Term
The posterior pituitary gland, known as the neurohypophysis, secretes which hormones?
Definition
antidiuretic hormone (ADH) (vasopressin) and oxytocin.
Term
When there is a deficiency of ADH, large amounts of water are excreted by the kidneys. This is called...
Definition
diabetes insipidus
Term
Head injury and brain tumors resulting in trauma to the hypothalamus and pituitary gland can cause
Definition
diabetes insipidus
Term
what is secreted by the thyroid gland.
Definition
Thyroxine (T4) and triiodothyronine (T3)
Term
The functions of T4 and T3 are to regulate what
Definition
regulate protein synthesis and enzyme activity and to stimulate mitochondrial oxidation.
Term
a decrease in thyroid hormone secretion is called..
Definition
Hypothyroidism
Term
Hypothyroidism can have 2 causes..
Definition
a primary cause (thyroid gland disorder) or a secondary cause (lack of TSH secretion).
Term
evere hypothyroidism in the adult;
Definition
Myxedema
Term
symptoms of Myxedema
Definition
e lethargy, apathy, memory impairment, emotional changes, slow speech, deep coarse voice, edema of the eyelids and face, thick dry skin, cold intolerance, slow pulse, constipation, weight gain, and abnormal menses
Term
drug of choice for replacement therapy for the treatment of hypothyroidism.
Definition
Levothyroxine sodium (Synthroid)
Term
drug of choice for replacement therapy for the treatment of hypothyroidism.
Definition
Levothyroxine sodium (Synthroid)
Term
drug of choice for replacement therapy for the treatment of hypothyroidism.
Definition
Levothyroxine sodium (Synthroid)
Term
a synthetic T3 that has a short half-life and duration of action; it is not recommended for maintenance therapy.
Definition
Liothyronine (Cytomel)
Term
an increase in circulating T4 and T3 levels, which results from an overactive thyroid gland or excessive output of thyroid hormones from one or more thyroid nodules.
Definition
Hyperthyroidism
Term
the most common type of hyperthyroidism caused by hyperfunction of the thyroid gland.
Definition
. Graves disease, or thyrotoxicosis,
Term
characteristics of graves disease
Definition
a rapid pulse (tachycardia), palpitations, excessive perspiration, heat intolerance, nervousness, irritability, exophthalmos (bulging eyes), and weight loss.
Term
Hyperthyroidism can be treated by
Definition
surgical removal of a portion of the thyroid gland (subtotal thyroidectomy), radioactive iodine therapy, or antithyroid drugs, which inhibit either synthesis or release of thyroid hormone
Term
The purpose of antithyroid drugs is to
Definition
reduce the excessive secretion of thyroid hormones (T4 and T3) by inhibiting thyroid secretion.
Term
The parathyroid glands secrete
Definition
parathyroid hormone (PTH),
Term
what regulates calcium levels in the blood
Definition
parathyroid hormone (PTH)
Term
what regulates calcium levels in the blood
Definition
parathyroid hormone (PTH)
Term
A decrease in serum calcium stimulates the release of
Definition
parathyroid hormone (PTH),
Term
a vitamin D analogue that promotes calcium absorption
Definition
Calcitriol
Term
Hyperparathyroidism can be caused by...
Definition
can be caused by malignancies of the parathyroid glands or ectopic PTH hormone secretion from lung cancer, hyperthyroidism, or prolonged immobility, during which calcium is lost from bone.
Term
the adrenal glands consist of
Definition
adrenal medulla and adrenal cortex.
Term
The adrenal cortex produces which two types of hormones,
Definition
glucocorticoids (cortisol) and mineralocorticoids (aldosterone).
Term
Corticosteroids promote
Definition
sodium retention and potassium excretion
Term
A decrease in corticosteroid secretion is called
Definition
adrenal hyposecretion (adrenal insufficiency, or Addison disease
Term
an increase in corticosteroid secretion is called
Definition
adrenal hypersecretion (Cushing syndrome).
Term
the adrenal cortex produces which horomones?
Definition
both glucocorticoids (cortisol) and mineralcorticoids (aldosterone).
Term
aldosterone is one of the hormonal agents integral to the regulation of
Definition
fluid balance and blood pressure.
Term
what hormone initiates uterine contraction for labor/delivery and is secreted in response to peaking estrogen levels at the end of the third trimester.
Definition
Oxytocin
Term
diabetes insipidus drug treatments
Definition
Drugs are vasopressin (Pitressin) and desmopressin acetate (DDAVP).
Term
drug treatment for HYPOthyroidism?
Definition
synthroid
Term
drug class that controls hyperthyroidism?
Definition
thioamides
Term
drug names to control HYPERthyroidism?
Definition
). Drugs are propylthioruacil (PTU) and methimazole (Tapazole).
Term
treatment options for SEVERE HYPERthyroidism
Definition
radiation and surgical removal
Term
Hypoparathyroidism causes
Definition
hypocalcemia
Term
Hyperparathyroidism causes
Definition
hypercalcemia
Term
• Because steroids are immunosuppressive drugs you must constantly be screening for any and all
Definition
any and all infections (NANDA: Risk for infection)
Term
Steroids DON’T affect pancreatic function. They DO make a patient’s cells resistant to their own ....
Definition
insulin
Term
oral prednisone (Deltasone) side effects
Definition
IMMUNOSUPRESSION
HYPERGLYCEMIA
THINNING OF SKIN
POOR WOUND HEALING
ABNORMAL FAT ACCUMULATION
ELECTROLYTE CHANGES
RISK FOR PEPTIC ULCERS
IRRITABILITY/MOOD CHANGES/DEPRESSION
Term
How does a patient stop taking Prednisone properly?
Definition
taper it off. Stopping the meds abruptly can cause a adrenal insufficiency crisis (addison's disease)
Term
1. A client is receiving the growth hormone drug somatrem (Protropin). The nurse understands that the action of this drug is to do what?

a. To act as an antiinflammatory agent

b. To increase metabolic rate and oxygen consumption

c. To stimulate growth in long bones at epiphyseal plates

d. To promote water reabsorption form the renal tubules
Definition
C
Term
2. A client is given desmopressin acetate (DDAVP). The nurse knows that this drug is to treat which condition?

a. Gigantism

b. Diabetes mellitus

c. Diabetes insipidus

d. Adrenal insufficiency
Definition
C
Term
3. A client is taking levothyroxine (Synthroid). For which adverse effect would the nurse monitor the client?

a. Tachycardia

b. Drowsiness

c. Constipation

d. Weight gain
Definition
A
Term
4. A client has just begun taking dihydrotachysterol (DHT). What is a nursing implication of this drug?

a. To monitor the client's weight

b. To monitor weekly calcium levels

c. To teach side effects of alopecia and petechiae

d. To instruct the client to avoid persons with respiratory infections
Definition
B
Term
5. A client is given corticotropin (Acthar). The nurse knows to monitor the client for which condition?

a. Weight gain

b. Hyperkalemia

c. Hypoglycemia

d. Hypercalcemia
Definition
A
Term
6. A nurse is administering prednisone (Deltasone) to a client newly admitted to the hospital who is taking multiple other drugs. The nurse should consider which drug interactions with prednisone? (Select all that apply.)

a. The cardiac and CNS actions are increased when taken with an adrenergic agent.

b. Potassium-wasting diuretics increase potassium loss resulting in hypokalemia.

c. The risk of GI bleeding and ulceration increases when taken with aspirin and other NSAIDs.

d. The action of prednisone is decreased when taken with phenytoin (Dilantin) as phenytoin increases glucocorticoid metabolism.

e. The risk of dysrhythmias and digitalis toxicity increases when taken with cardiac glycosides.

f. The dosage of antidiabetic agents may need to be increased when taken concurrently with glucocorticoids.
Definition
B, C, D, E, F
Term
7. The nurse is administering vasopressin (Pitressin) to a client. The nurse realizes that nursing implications for this drug would include which implications? (Select all that apply.)

a. Record urinary output.

b. Observe the client's weight and note edema.

c. Monitor the client for decreased blood pressure.

d. Closely monitor the client's blood glucose levels.

e. Monitor the client's pulse for increased heart rate.

f. Record the client's daily calcium levels.
Definition
C, E
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