- Growth, metabolism - Reproductive cycle - Electrolyte balance - Water retention or loss

pharm 2 Flashcards by Chelsea Morin

Anterior Pituitary =

adenohypophysis

How well did you know this?

Not at all

Perfectly

Posterior Pituitary =

neurohypophysis

How well did you know this?

Not at all

Perfectly

“Master Gland” regulates _____

numerous vital processes.

How well did you know this?

Not at all

Perfectly

Hormones regulate:

Growth, metabolism
Reproductive cycle
Electrolyte balance
Water retention or loss

How well did you know this?

Not at all

Perfectly

posterior pituitary regulates

ADH

Oxytocin

How well did you know this?

Not at all

Perfectly

example of ADH

vasopressin (Pitressin synthetic)

How well did you know this?

Not at all

Perfectly

ADH function

Regulates reabsorption of water by the kidneys

How well did you know this?

Not at all

Perfectly

ADH is secreted by pituitary when body ____

fluids must be conserved.

-Water reabsorbed into the blood
-Urine becomes concentrated

How well did you know this?

Not at all

Perfectly

ADH treats-

Diabetes insipidus (failure to secrete vasopressin)

How well did you know this?

Not at all

Perfectly

Vasopressin adverse reactions

Tremors, sweating
Nasal congestion
Nausea, vomiting, abdominal cramps
Water intoxication (toxicity, med. overdose)

How well did you know this?

Not at all

Perfectly

vasopressin:

Use cautiously in individuals with

history of: asthma, seizures, migraines, heart failure or vascular disease.

How well did you know this?

Not at all

Perfectly

Anterior pituitary regulates which hormones?

Prolactin
Lutenizing Hormone (LH)
Follicle-Stimulating Hormone (FSH)
Thyroid-Stimulating Hormone (TSH)
Adrenocorticotropic Hormone (ACTH, corticotropin)
Growth Hormone (GH)

How well did you know this?

Not at all

Perfectly

Influence the gonads (reproductive organs)

Gonadotropins (LH and FSH)

How well did you know this?

Not at all

Perfectly

Contributes to the growth of the body during childhood, mainly the muscles and bones

Growth Hormone (GH), also called Somatotropin

How well did you know this?

Not at all

Perfectly

Stimulates the adrenal cortex to produce and secrete adrenocortical hormones, especially the glucocorticoids

Adrenocorticotropic Hormone (ACTH)

How well did you know this?

Not at all

Perfectly

Stimulates the production of breast milk in the postpartum patient

Prolactin

How well did you know this?

Not at all

Perfectly

(ACTH) Corticotropin used to test —

adrenocortical function.

Reactions may be multisystem (Display 43.2)
Report symptoms of infection
Monitor blood sugar

How well did you know this?

Not at all

Perfectly

In response to ACTH, the adrenal cortex secretes:

Glucocorticoids (sugar)
Mineralcorticoids (salt)
Sex hormones (androgens)

How well did you know this?

Not at all

Perfectly

the adrenal glands are located:

on top of each kidney. (outer cortex, inner medulla)

How well did you know this?

Not at all

Perfectly

Glucocorticoids: Most prominent hormones

Hydrocortisone and cortisone

How well did you know this?

Not at all

Perfectly

Glucocorticoid functions

Immune response
Regulation of glucose, fat, protein metabolism
Anti-inflammatory action

How well did you know this?

Not at all

Perfectly

glucocorticoid examples

Prednisone, cortisone, hydrocortisone

How well did you know this?

Not at all

Perfectly

glucocorticoid actions

Enter target cells and bind to receptor sites

- –Some outcomes are desirable and some are not which lead to the adverse reactions

How well did you know this?

Not at all

Perfectly

glucocorticoids used to treat:

Adrenocortical insufficiency (replacement therapy)
Allergic reactions
Systematic lupus erythematosus
Dermatologic disorders
Rheumatic disorders
Shock

How well did you know this?

Not at all

Perfectly

GLUCOCORTICOID ADVERSE REACTIONS: Fluid and electrolyte disturbances:

fluid and sodium retention, potassium loss, hypertension, hypocalcemia, shock

GLUCOCORTICOID ADVERSE REACTIONS: Musculoskeletal

muscle weakness, osteoporosis, fractures

GLUCOCORTICOID ADVERSE REACTIONS: | Cardiovascular

thromboembolism, arrhythmias, CHF

GLUCOCORTICOID ADVERSE REACTIONS: GI

abdominal distention, nausea/vomiting, increased appetite and weight gain

GLUCOCORTICOID ADVERSE REACTIONS: Dermatologic

impaired wound healing, thin –fragile skin, bruising, increased sweating, itching

GLUCOCORTICOID ADVERSE REACTIONS: Neurological

convulsions, headache, vertigo, paresthesias, insomnia

GLUCOCORTICOID ADVERSE REACTIONS: Endocrine

amenorrhea, development of Cushings syndrome, increased s/s of diabetes

Mineralocorticoids

Aldosterone and Deoxycorticosterone

- Conserves sodium and increases excretion of potassium - Controls salt and water balance - Aldosterone most potent - Deficiencies = loss of salt and water, and retention of potassium

Mineralocorticoids: Aldosterone and Deoxycorticosterone

Mineralocorticoids adverse reactions most often occurs when ----

the dose is too high, prolonged use, and d/c too rapidly.

- Edema, hypertension, heart failure, enlargement of the heart - Increased sweating, allergic skin rash - Hypokalemia, muscular weakness, headache, hypersensitivity

Mineralocorticoids adverse reactions

Admin of glucocorticoids (5-10) days can result in:

shutting off the pituitary’s release of ACTH (because of high levels in blood)

acute adrenal insufficiency

can result in circulation collapse

Abrupt discontinuation=

acute adrenal insufficiency

- Located in neck in front of trachea - Secretes two hormones: - -T4 (Thyroxine) - -T3 (Triiodothyronine)

Thyroid Gland

____ is essential for manufacture of both T3 and T4

Iodine

TSH (Thyroid Stimulating Hormone) regulates the

manufacture of T3 & T4 by the thyroid gland

When the level of T3 and T4 in the blood is low,

the anterior pituitary gland secretes TSH which activates the cells of the thyroid to release stored T3 and T4

-Decrease in the amount of thyroid hormones manufactured and secreted Ex = Myxedema (severe)

Hypothyroidism

-Increase in the amount of hormones manufactured and secreted Ex = Grave’s disease, Tumors of thyroid

Hyperthyroidism

Rx with thyroid Hormones

Hypothyroidism

- Rx with Antithyroid drugs and radioactive iodine | - Rx with thyroidectomy

Hyperthyroidism

S&S Hypothyroidism

- Decreased Metabolism - Intolerance to cold, low body temp. - Bradycardia, mod hypotension - Lethargy - Pale, cool dry skin, nails thick and hard - Heavy menses, low sperm count

S&S Hyperthyroidism

- Increased metabolism, increased appetite, elevated temp, - Weight loss despite increased appetite - Tachycardia, mod hypertension - Anxiety, nervousness - Flushed warm moist skin - Irregular or scant menses

- Influence every organ and tissue of body - Contains both natural and synthetic hormones - Primary goal: increase metabolic rate of tissues - Used as replacement therapy when patient is hypothyroid : attempt at creating a “Euthyroid” state

thyroid hormones

Medication for Hypothyroidism

Levothyroxine (Synthroid) is the drug of choice - -Inexpensive - -Once a day dosage - -Uniform potency

Thyroid hormone signs of therapeutic response:

- Weight loss - Mild diuresis - Increased appetite - Sense of well being - Increase in mental activity - Decreased puffiness

- Vital Signs - Weigh patient - Observe for signs of therapeutic response - Monitor for hyperglycemia in the diabetic patient - Meds given once a day, early in morning before breakfast - Dose adjusted based on blood levels (thyroid function tests) - Monitor for signs of drug-induced hyperthyroidism

Nursing Process for Hypothyroidism

Replacement therapy is for:

life

take hypothyroid med ___

before breakfast in AM

Treated by: - Anithyroid drugs - Iodine solutions - Thyroidectomy (partial or total)

Hyperthyroidism

Does not affect existing thyroid hormones - Effect of meds may not be observed for 3-4 weeks - Tapazole and PTU (propylthiouracil) - May need surgery anyway - Meds will reduce vascularity of thyroid gland decreasing risk of intra and post up bleeding

antithyroid medication

used because the thyroid gland has an affinity for iodine. Destroys hyperactive tissue without damaging cells outside thyroid gland

Radioactive Iodine –

decrease the vascularity of the thyroid gland by rapidly inhibiting the release of the thyroid hormones

Iodine solution --

decrease in the number of WBC’s (Neutrophils, basophils and eosinophils) = agranulocytosis

adverse reactions of tapazole and PTU

Metallic taste in mouth, swelling of parotid gland, burning of mouth

adverse reactions of strong iodine solution

sore throat, N,V, bone marrow depression

adverse reactions of radioactive iodine

antithyroid meds nursing process

- Obtain history of symptoms of hyperthyroidism - -Vital signs - -Weight - -Symptoms - If taking Iodine preparation, is patient allergic to iodine or seafood? - Fever, sore throat, easy bruising, signs of infections (relationship to decreased blood cells) - Assess for s/s of thyroid storm (thyrotoxicosis) - -High fever - -Extreme tachycardia - -Altered mental state - Monitor for difficulty swallowing large tablet - Iodine drops added to juice to disguise taste (drink through straw to prevent teeth staining - Observe for signs of hyperthyroidism - Help develop time schedule for q 8 hour doses.

pt teaching for antithyroid meds

- Take meds as directed - Notify provider of symptoms (sore throat, fever, bruising etc) - Record weight twice a week; notify MD for sudden weight gain or loss - Dilute iodine solution with juice

pharm 2 Flashcards

(63 cards)