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51 Cards in this Set
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thyroid hormone
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proto: levothyroxine (Synthroid, Levothroid)
other: liothyronine (Cytomel) liotrix (Thyrolar) thyroid: (Thyroid USP) |
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thyroid hormone MOA
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synthetic form of thyroxine (T4), form of liothyronine (T3) or a combination of T4 and T3 that increase metabolic rate, protein synthesis, cardiac output, renal perfusion, oxygen use, body temp, blood volume, growth processes
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thyroid hormone use
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treatment of hypothyroidism
emergency treatment of myxedema coma (IV route) |
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thyroid hormone adverse
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overmedication can result in hyperthyroidism
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thyroid hormone contraindications
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pregnancy and lactation
thyrotoxicosis following an MI caution: cardiovascular problems not for use in treatment of obesity |
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thyroid hormone interactions
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binding agents and sucralfate (Carafate) reduce levothyroxine absorption with concurrent use
antiseizure and antidepressant meds- increase levothyroxine metabolism increases anticoagulant effects of warfarin by breaking down Vit. K- monitor PT and INR, check for signs of bleeding or bruising |
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thyroid hormone admin
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monitor clients T4 and TSH levels
take daily on an empty stomach inform client of importance of lifelong replacement check with provider before switching to another brand of levothyroxine |
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thyroid hormone effectiveness
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decreased TSH levels
T4 levels within expected reference range absence of hypothyroidism |
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antithyroid meds
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proto: propylthiouracil (PTU)
other: methimazole (Tapazole) |
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antithyroid meds MOA
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blocks synthesis of thyroid hormones
prevents oxidation of iodide blocks conversion of T4 into T3 |
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antithyroid meds use
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treatment of Grave's disease
produces a euthyroid state prior to thyroid removal surgery adjunct to irradiation of the thyroid gland emergency treatment of thyrotoxicosis |
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antithyroid meds adverse
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overmedication can result in indications of hypothyroidism- (drowsiness, depression, weight gain, edema, bradycardia, anorexia, cold intolerance, dry skin, menorrhagia)
agranulocytosis liver injury, hepatitis |
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antithyroid contraindications
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pregnancy
lactation bone marrow depression clients at risk for liver failure |
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antithyroid interactions
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anticoagulants- may increase anticoagulation- monitor PT, INR, and aPTT
digoxin (Lanoxin)- may increase glycoside level |
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antithyroid admin
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take meds with meals
monitor for signs of hyperthyroidism clients with hyperthyroidism may be given a etaadrenergic antagonist to decrease tremors and tachycardia monitor for hypothyroidism monitor CBC |
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antithyroid effectivness
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weight gain
decreased T4 levels absence of signs of hyperthyroidism |
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radioactive iodine (antithyroid)
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absorbed by the thyroid and destroys some of the thyroid producing cells
at high doses, thyroid-radioactive iodine destroys thyroid cells |
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radioactive iodine uses
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High doses:
hyperthyroidism thyroid cancer Low doses: thyroid function studies |
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radioactive iodine adverse
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radiation sickness
bone marrow depression hypothyroidism |
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radioactive iodine contraindications
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pregnancy
lactation |
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radioactive iodine interactions
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concurrent use of other antithyroid meds- reduces reuptake of radioactive iodine
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radioactive iodine admin
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void frequently
increase fluid intake avoid coughing and expectoration limit contact with clients to 30 min day |
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strong iodine solution (Lugol's solution)- nonradioactive iodine
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creates high levels of iodinethat will reduce iodine uptake, inhibit thyroid hormone production, and block release of thyroid hormones into the bloodstream
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strong iodine solution uses
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development of euthyroid state and reduction of thyroid gland size prior to thyroid removal surgery
thyroid- nonradioactive iodine is used for emergency treatment of thyrotoxicosis |
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strong iodine adverse
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iodism due to corrosive property - administer sodium thiosulfate to reverse
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strong iodine interactions
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concurrent intake of foods high in iodine increases risk for iodism
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strong iodine admin
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dilute strong iodine solution with juice to improve taste
increase fluid intake |
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strong iodine effectiveness
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weight gain
decreased T4 levels reduction in size of thyroid gland client will be able to get adequate sleep, free of complications of hyperthyroidism |
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anterior pituitary hormones/growth hormones
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somatropin (Genotropin, Nutropin)
other: somatrem (Protropin) |
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anterior pituitary hormone MOA
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stimulate overall growth and production of protein and decrease of the use of glucose
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anterior pituitary hormone use
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treat growth hormone deficiencies
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anterior pituitary hormone adverse
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hyperglycemia
hypercalciuria and renal calculi |
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anterior pituitary hormone contraindications
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severe obesity
severe respiratory impairment (sleep apnea) diabetes- risk of hyperglycemia treatment should be stopped prior to epiphyseal closure |
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anterior pituitary hormone interactions
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glucocorticoids- counteract growth-promoting effects
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anterior pituitary hormone effectivess
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client increases height and weight
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antidiuretic hormone
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proto: vasopressin (Pitressin synthetic)
other: desmopressin (DDAVP, stimate) |
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antidiuretic hormone MOA
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promotes reabsorption of water within the kidney
natural ADH causes vasoconstriction because of the contraction of vascular smooth muscle |
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antidiuretic hormone Use
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treat diabetes insipidus
antidiuretic hormones are sometimes used during CPR to temporarily decrease blood flow from the periphery and increase flow to the brain and heart |
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antidiuretic hormone adverse
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reabsorption of too much water
myocardial ischemia from excessive vasoconstriction |
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antidiuretic hormone contraindications
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carbamazepine and TCAs may increase antidiuretic hormone
alcohol, heparin, lithium and phenytoin may increase antidiuretic effects |
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antidiuretic effectiveness
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reduction in large volumes of urine output associated with diabetes insipidus
cardiac arrest survival |
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adrenal hormone replacement
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hydrocortisone (Hydrocortone, Solu-Cortef)
other: prednisone (Deltasone) dexamethasone (Decadron) mineral corticoids: fldrocortisone (Florinef) |
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adrenal hormone MOA
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mimic effect of natural hormones
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adrenal hormone use
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acute and chronic replacement therapy for adrenocortical insuffieciency (Addison's disease)
Nonendocrine disorders include cancer, inflammation, allergic reactions |
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hydrocortisone adverse (glucocorticoid)
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osteoporosis
adrenal suppression PUD GI discomfort infection |
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fludrocortisone (mineralocorticoid) adverse
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retention of sodium and water- leads to hypertension, edema, HF and hypokalemia
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hydrocortisone interactions
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NSAIDS
alcohol oral anticoagulants potassium depleting agents vaccines and toxoids- may reduce antibody response |
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fludrocortisone interactions
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barbiturates
phenytoin insulin , sulfonylureas- antidiabetic effects are decreased when used with fludrocortisone |
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adrenal hormone replacement contraindications
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viral, bacterial infection
recent MI, gastric ulcer, hypertension, kidney disorder, osteoporosis, DM, hypothyroidism, myasenthia gravis, glaucoma, seizure disorders |
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adrenal hormone replacement nursing admin
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monitor for indcation of acute adrenal insufficiency ( fever, muscle, joint pain, weakness, fatigue
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adrenal hormone replacement effectiveness
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relief of effects of adrenocortical deficiency, weakness, hypoglycemia, hyperkalemia, fatigue, minimal adverse effects
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