PHARM2 - Endocrine Medications

Levothyroxine (Synthroid)

Thyroid Hormone replacement

• Synthetic T4 that is converted into T3

Adverse effects

• Body systems speed up

  • Palpitations

  • tremors

  • N/V/D

• Weight loss

Implications

• Monitor cardiac function

• Assess body’s response

• Long half life

• may result in hyperthyroidism

• Lowers TSH

Methimazole (Tapazol)

Antithyroid

• Interferes with iodine incorporation into thyroid hormone, preventing synthesis

Adverse Effects

• Bone marrow suppression

• Agranulocytosis

Implications

• Monitor CBC + infection

• Watch for fever or sore throat

  • agranulocytosis

Propylthiouracil (PTU)

Antithyroid

• decreases thyroid hormone synthesis

Adverse Effects

• Bone marrow suppression

• Hepatotoxicity

Implications

• Monitor CBC

• Monitor liver

  • pay attention to the liver too

Radioactive Iodine

Used to destroy thyroid tissue

Adverse effects

• can cause permanent hypothyroidism

Somatropin (Genotropin)

Growth hormone replacement

• Synthetic

Indications

• Given in growth-related delay and dwarfism

• Wasting in HIV patients

Adverse effects

• headache

• hypothyroidism

• hyperglycemia

• hypocalcemia

Implications

• gather baseline labs and growth

  • monitor growth, motor skills, and developmental milestones

Vasopressin (Pitressin)

Antidiuretic vasopressor

Indications

• vasidialary shock

• DI

Adverse effects

• HTN

• headache

Implications

• used in the ICU

  • cardiac monitoring

• watch cardiac system

Desmopressin (DDAVP)

Antidiuretic hormone analog

• Mimics ADH to tell kidneys to retain water in DI

Adverse effects

• N/V/D

• Headache

• hyponatremia and water intoxication

Implications

• Monitor for hyponatremia

  • neurological status

• Daily weights

• kidney monitoring

Don’t pee so much

Prednisone

Immediate acting glucocorticoid

• anti-inflammatory immunosuppressant

Given in exacerbations of chronic respiratory illness

Hydrocortisone (corticoid, cortizone)

Short acting glucocorticoid

• Used in steroid-responsive conditions

• Adrenal insufficiency as well

Implications

• Na and H2O retention

  • monitor

• doses may be diluted to better tolerate

  • has both mineral and gluco properties

Fludrocortisone

Mineralcorticoid

• Increases Na and H2O retention

• Increases K excretion

Adverse effects

• HTN

• fluid retention

• hypokalemia

• EKG changes

Implications

• monitor daily weights

• assess hydration

Teaching

• take with food

• do not abruptly stop taking

  • may cause an adrenal crisis

    • body doesn’t produce enough of its own cortisol