Drugs Acting on the Endocrine System

What drug class does somatropin belong to?

Anterior pituitary hormone; Growth Hormone (GH) agonist.

What is somatropin?

A synthetic equivalent of human growth hormone produced via recombinant DNA technology.

How does somatropin work?

It binds to GH receptors on target tissues to replace human GH and stimulate growth.

What does somatropin stimulate in the body?

Linear skeletal growth, growth of internal organs, protein synthesis, and lipolysis.

What pediatric conditions is somatropin used to treat?

Growth failure due to GH deficiency, chronic renal failure, small for gestational age, Turner syndrome, and Prader-Willi syndrome.

What adult conditions can somatropin treat?

Adult GH deficiency, AIDS-related wasting, and short bowel syndrome.

What are common side effects of somatropin?

Injection-site pain or reactions, headache, edema, arthralgia, and myalgia.

What serious metabolic effect can somatropin cause?

Insulin resistance and glucose intolerance (hypoglycemia or hyperglycemia).

What endocrine complications can occur with somatropin?

Hypoadrenalism and hypothyroidism.

What immune-related issue can develop with somatropin therapy?

Development of GH-inactivating antibodies.

What serious gastrointestinal complication can occur with somatropin?

Pancreatitis.

How do glucocorticoids interact with somatropin?

They may counteract its growth-promoting effects.

Why should caution be used with drugs that use the cytochrome P450 system?

Somatropin is metabolized in the liver and may interact with P450-metabolized drugs.

What should patients be taught about somatropin administration?

Proper storage, preparation, and rotating injection sites.

Why should children on somatropin be monitored psychologically?

Sudden growth changes may cause body image issues or psychological trauma.

What is an absolute contraindication for somatropin?

Closed epiphyses (growth plates).

Why is active malignancy a contraindication for somatropin?

It may promote tumor growth.

What growth parameters should nurses monitor with somatropin?

Height and weight.

What lab values should be monitored with somatropin?

Blood glucose levels, thyroid function tests, and liver function tests.

What drug class is desmopressin?

Posterior pituitary hormone; synthetic antidiuretic hormone (ADH) analog.

How does desmopressin work?

It increases kidney tubular permeability to promote water reabsorption and decrease urine formation.

What clotting factor does desmopressin increase?

Factor VIII.

What is desmopressin primarily used to treat?

Neurogenic diabetes insipidus.

What pediatric urinary condition is treated with desmopressin?

Nocturnal enuresis (bedwetting).

What adult urinary condition is treated with desmopressin?

Nocturia due to nocturnal polyuria.

What bleeding disorders can desmopressin treat?

Hemophilia and von Willebrand disease.

What are common side effects of desmopressin?

Headache, dry mouth, nausea, facial flushing, fluid retention, slight increase in blood pressure, and injection-site reactions.

What is the major serious adverse effect of desmopressin?

Water intoxication (dilutional hyponatremia).

Which medications increase the antidiuretic effects of desmopressin?

Carbamazepine and tricyclic antidepressants (TCAs).

How does alcohol interact with desmopressin?

It interacts and may alter its effects.

What special consideration applies to nasal desmopressin?

Proper administration technique and regular evaluation of nasal mucosa in older adults.

Why must children have adult supervision when taking desmopressin?

To ensure adherence to the treatment protocol.

What is a contraindication for desmopressin?

Severe renal dysfunction.

In which patients should desmopressin be used cautiously?

Those with vascular disease, asthma, or hyponatremia.

What must nurses strictly monitor with desmopressin?

Intake and output (I&O) and daily weights.

Which electrolyte is most important to monitor with desmopressin?

Sodium.

What are signs of water intoxication?

Confusion, shortness of breath, altered mental status, seizures, and coma.

What drug class is vasopressin?

Posterior pituitary hormone; synthetic antidiuretic hormone (ADH).

What are the three main actions of vasopressin?

Antidiuretic, hemostatic, and vasopressor.

How does vasopressin increase blood pressure?

It strongly stimulates contraction of blood vessels (vasoconstriction).

What is vasopressin primarily used for in critical care?

To increase blood pressure in adults with vasodilatory shock.

When is vasopressin given in hypotension?

When patients remain hypotensive despite fluids and catecholamines.

What serious fluid-related complication can vasopressin cause?

Water intoxication leading to hyponatremia.

What cardiac complication is associated with vasopressin?

Myocardial ischemia due to potent vasoconstriction.

How do catecholamines interact with vasopressin?

They greatly enhance vasopressor effects, increasing risk of severe hypertension.

What examples of catecholamines may interact with vasopressin?

Dopamine, epinephrine, and norepinephrine.

What is a contraindication for vasopressin?

Severe renal dysfunction.

In which patients must vasopressin be used with extreme caution?

Those with known vascular disease.

What must nurses closely monitor with vasopressin therapy?

Intake and output, daily weights, electrolytes, and blood pressure.

What cardiovascular complications must be monitored with vasopressin?

Severe hypertension, lack of blood pressure response, and myocardial ischemia.

What is the half-life of vasopressin?

Approximately 10 minutes.

How is vasopressin administered in acute care?

Intravenously (IV).