Endocrine Drugs

What is the primary action of glucocorticoid medications like prednisone?

They stimulate gluconeogenesis and alter the normal immune response.

Glucocorticoids increase the formation and storage of _____ in muscle tissue.

fat

How do mineralocorticoids, such as fludrocortisone acetate, affect electrolyte balance in the distal convoluted tubules?

They increase sodium reabsorption while increasing potassium and hydrogen excretion.

Why should a single daily dose of a glucocorticoid be administered before 9 a.m.?

To mimic the body's natural circadian rhythm of cortisol secretion.

Abrupt withdrawal of glucocorticoids can precipitate which life-threatening condition?

Addisonian crisis

Which endocrine medication class is indicated for the treatment of Addison disease, Crohn disease, and COPD?

Glucocorticoids

What early psychological symptom often indicates the onset of steroid psychosis?

Nightmares

Which herbal supplement can cause insomnia when taken concurrently with corticosteroids?

Ginseng

Which medication is classified as a mineralocorticoid used specifically for adrenal insufficiency?

Fludrocortisone acetate

Type of Insulin: Lispro

Classification: Rapid-acting insulin with an onset of 15–30 minutes.

What is the peak action time for regular (short-acting) insulin?

1 to 5 hours

Which type of insulin is white and cloudy and has a duration of action of approximately 16 hours?

Isophane (NPH)

Type of Insulin: Glargine

Classification: Long-acting insulin with a continuous effect and no peak.

What is the primary mechanism of action for all insulin types?

They increase glucose transport across cell membranes and enhance the conversion of glucose to glycogen.

Which is the only type of insulin that can be administered intravenously?

Regular insulin

What localized skin condition is prevented by rotating insulin injection sites?

Lipohypertrophy

Which herbal supplement might interfere with the management of diabetes mellitus and requires close blood glucose monitoring?

Ginkgo biloba (type of tree leaf) → raises blood glucose

What is the mechanism of action for Sulfonylureas like glipizide?

They stimulate the release of insulin from the pancreatic beta cells.

Which oral hypoglycemic medication decreases glucose production by the liver without affecting pancreatic beta cells?

Metformin

Metformin is contraindicated in clients with which physiological impairment?

Renal impairment

What is the primary action of Alpha-glucosidase inhibitors such as acarbose?

They delay the digestion of carbohydrates in the gastrointestinal tract.

Which class of antidiabetic drugs decreases insulin resistance and inhibits gluconeogenesis?

Thiazolidinediones

When should a client take Meglitinides like repaglinide relative to meals?

Immediately before each meal, skipping the dose if the meal is skipped.

What is the mechanism of action for Incretin mimetics such as exenatide?

They enhance the action of incretin hormones to stimulate insulin release and decrease glucagon.

Which endocrine hormone stimulates the liver to change glycogen to glucose to reverse severe hypoglycemia?

Glucagon

What is the expected onset of action for Glucagon when administered subcutaneously or intramuscularly?

8 to 10 minutes

How do antithyroid medications like methimazole and propylthiouracil (PTU) function?

They inhibit the oxidation of iodine and the synthesis of thyroid hormone.

What is the specific purpose of administering an iodine solution (Lugol's) 2 weeks prior to thyroid surgery?

To decrease the vascularity of the thyroid gland and inhibit hormone release.

Which antithyroid treatment works by permanently destroying thyroid tissue?

Radioactive iodine

Clients receiving Radioactive iodine (131I) must be on radiation precautions for how many days due to radioactive body fluids?

3 days

What is the primary action of thyroid replacement medications like levothyroxine?

They increase the metabolic rate of body tissues.

Why should thyroid replacement medications be taken in the morning?

To prevent insomnia and mimic the natural release of thyroid hormones.

Which electrolyte imbalance increases the risk of digitalis toxicity in clients taking diuretics?

Hypokalemia

How do bisphosphonates like alendronate treat osteoporosis?

They inhibit osteocytic activity and bone resorption.

What specific administration instruction is required for alendronate to prevent esophagitis?

Take in the morning with 6–8 ounces of water and remain upright for 30 minutes.

Which hormone acts as an antiestrogen by competing with estrogen at receptor sites on malignant cells?

Tamoxifen

What is the mechanism of action for hormonal contraceptives containing ethinyl estradiol?

They inhibit the release of follicle-stimulating hormone (FSH) to prevent ovulation.

Which progestin injection provides effective contraception for 12 weeks?

Medroxyprogesterone acetate

How does finasteride treat benign prostatic hyperplasia (BPH)?

It inhibits 5-alpha-reductase to slow prostatic growth.

Why is it critical that pregnant women do not handle crushed finasteride tablets?

The medication is absorbed through the skin and can cause harm to a male fetus.

Which class of drugs is contraindicated for use with erectile dysfunction medications like sildenafil due to the risk of fatal hypotension?

Nitrates

Sildenafil and vardenafil should be avoided with which type of fruit juice due to increased drug levels?

Grapefruit juice

What endocrine-related side effect is common with the use of spironolactone?

Hyperkalemia

Which endocrine medication is a hormone from the pineal gland used to treat insomnia?

Melatonin

What is the mechanism of action for the hormone replacement therapy used in Acromegaly?

Dopamine agonists or somatostatin analogs are used to suppress growth hormone secretion.

How does the nurse evaluate the effectiveness of desmopressin in a client with Diabetes Insipidus?

By observing a decrease in urine output and an increase in urine specific gravity.

What is the primary action of Calcitonin in the treatment of hypercalcemia?

It decreases serum calcium levels by inhibiting bone resorption.

Which vitamin facilitates the absorption of calcium from the GI tract?

Vitamin D (Ergocalciferol)

What metabolic risk is associated with the long-term use of high-dose glucocorticoids?

Osteoporosis and pathological fractures.

Sulfonylureas can only be effective if the client has some degree of _____ function.

pancreatic beta-cell

Which oral antidiabetic drug should be withheld 48 hours before and after procedures requiring contrast dye?

Metformin

What is the primary adverse effect of all insulin and insulin-secretagogue therapies?

Hypoglycemia

Which intermediate-acting insulin has a peak between 4 and 12 hours?

Isophane (NPH)

What is the mechanism of action for Testosterone inhibitors used in BPH?

They reduce the size of the prostate by inhibiting the conversion of testosterone to its active form.

Which type of contraceptive implant provides pregnancy prevention for up to 5 years?

Levonorgestrel

What is the action of hormone injections like methoxyprogesterone on the reproductive cycle?

They prevent ovulation by maintaining high levels of progestin.

Which medication is a progestin used specifically to manage abnormal uterine bleeding or as part of estrogen replacement therapy?

Medroxyprogesterone acetate

Which herb can relieve hot flashes but may increase the hypotensive effects of antihypertensives?

Black cohosh

How does the drug radioactive iodine differ from potassium iodide (SSKI) in treating hyperthyroidism?

Radioactive iodine destroys thyroid tissue, while SSKI reduces vascularity and inhibits hormone release.

What is the duration of action for rapid-acting insulins like Aspart?

3 to 5 hours

Which herbal supplement may falsely elevate digoxin levels and potentiate steroids and estrogens?

Ginseng

What is the primary therapeutic use of sodium polystyrene sulfonate?

It is a cation exchange resin used to lower serum potassium levels.

Which class of drugs used for ADHD, like methylphenidate, may alter insulin needs in diabetic clients?

Stimulants

How do Gliptins (DPP-4 inhibitors) like sitagliptin work to lower blood glucose?

They enhance the action of incretin hormones by preventing their breakdown.

Which oral hypoglycemic class includes pioglitazone and requires regular liver function studies?

Thiazolidinediones

Clients on long-term glucocorticoid therapy should be monitored for which metabolic syndrome?

Cushing syndrome

Why is regular insulin often administered 20–30 minutes before a meal?

To align its 30–60 minute onset with the postprandial rise in blood glucose.

What is the effect of St. John's wort on hormonal contraceptives?

It decreases the effectiveness of the contraceptive.

Which hormone treatment is used for palliation in advanced breast cancer as an androgen?

Testolactone

What is the expected duration of a single dose of Glucagon?

12 to 27 minutes

How should the nurse mix regular and NPH insulin in a single syringe?

Draw up the clear (regular) insulin first, then the cloudy (NPH) insulin.

Which endocrine medication is indicated for the prevention of postmenopausal osteoporosis and Paget disease?

Alendronate

What metabolic effect does licorice have when combined with corticosteroids?

It potentiates the effect of the corticosteroids.

Which thyroid medication is a synthetic T3 hormone?

Liothyronine sodium

How do alpha-1 adrenergic blockers like terazosin assist in Men's health?

They decrease urinary urgency and hesitancy in prostatic hyperplasia by relaxing smooth muscle.

What is the primary action of the drug Bromocriptine in the context of Parkinson's or endocrine disorders?

It is a dopamine receptor agonist that stimulates postsynaptic dopamine receptors.

Which antidiabetic drug class can cause resumption of ovulation in perimenopausal women?

Thiazolidinediones

What is the primary hormonal deficiency in Diabetes Insipidus?

Antidiuretic hormone (ADH)

Which mineral is restricted when taking Vitamin D (Ergocalciferol) to avoid toxicity?

Magnesium (found in antacids)

What clinical manifestation of thyroid replacement overdose should the nurse teach the client to report?

Angina or palpitations.