Synthroid

Levothyroxine

Hypothyroidism 

synthetic T4

once daily in am on empty stomach

Take Ca supp. at different time; Ca ↓ absoption

PTU

Propythiouracil

Hyperthyroidism

blocks conversion of T3 & T4

improve - 1-2 wks; great results -8wks

esp. for young with Grave's disease

Tapazole

methimazole

Hyperthyroidism

inhibits thyroid hormone synthesis

WATCH: periphreal neuropathy

fever, rash

GI upset

Dizzyness

 Esp. used to prevent thyroid storm w/ surgery and radiation

Iodine

SSKI

Hyperthyroidism: rapidly inhibits the release and syn of thyroid hormone

Dilute and give after meals

ALSO: reduces thyroid vascularity and size; reduce risk of hemorrhage and storm

Beta-blockers

end in -lol

1. Given to treat cardio effects of excessive thyroid

2. used with alpha-adrenergic blockers not alone to treat pheochromcytoma

Lithium

impairs the thyroid hormones

inhibits release of ADH from pituitary; can induce DI

Sodium Iodine solution

Given IV during thyroid storm

treats deficiency in cortisol, Addisons, aldosterone 

mineral & glucocorticoid properties

Divided doses with more in am

life-long therapy

increase dose under stress

Teach sign of (in)effectiveness to increase decrease dose

TAPER dose changes

Florinef

treat addisons, aldosterone deficiency

used for mineralcortico effect

restore regular Na & K excretion & retention

Teach s/s for dose adjustments

Dexamethasone

suppression test to determine if hypercortisol is pituitary caused

If doesn't drop cortisol levels = problem is outside pituitary

Metyrapone

blocks cortisol synthesis in adrenals;

caution may cause acute adrenal insufficiency

Ketoconazole

used usually w/ rad. or surgery to inhibit glucocorticoid synthesis

Aldactone

blocks action of aldosterone

K-sparing diuretic

watch K intake

Clonidine

Suppression test to block sympathetic NS

alpha-2 agonist

doesn't suppress release of catecholamines

Dibenzyline

treat pheochromcytoma;

alpha adrenergic blocker

Arginine

Stimulation test for GH; if doesn't ↑ GH then hypoGH outside pituitary

Comparable results to insulin tolerance test w/ fewer side effects

All meds used in stimulation test for GH

arginine

levadopa

clonidine

epinephrine

glucagons

insulin

Growth Hormone Treatments

Somatrem

somatropin

hypoGH

children: subcut daily inj.; very expensive

Adult: 3x week; less expensive

Octreotide

Sandostatin

inhibits GH release; treats acromegaly

monthly inj.

Parlodel

bromocriptine

dopamine agonist; treats acromegaly

start low then ↑; with meals

Side effects: N/V, constipation, orthostatic HypoTN

Dostinex

cabergoline

dopamine agonist; treats acromegaly

similiar to parlodel but fewer side effects

take twice a week

DDAVP desmopressin acetate

vasopressin

Syn ADH; treats diabetes insipidus

Nasal, subcut, oral dosing

polydipsia, polyuria sign for another dose

Thiazide Diuretics

used with low Na diet to treat nephrogenic Diabetes Insipidus

also limit protein

tegretol (carbamazepine)

atromid-S (clofirate)

treats partial defect in ADH production(diabetes insipidus)

stimulates ADH production

Declomycin

demeclocycline

increase serum Na by reducing responce of renal tubules to ADH

Biphosphates

treats hyperparathyroidism

improve bone density; shrot term relief of bone pain

Calcitonin

treats hyperparathyroidism

promotes renal excretion of Ca; binds to receptor sites on osteoclasts

IM, SQ, or nasal

Vitamin D

with Ca to treat hypoparathyroidism