Endocrine System

Thyroid and diabetes meds

What is the endocrine system?

Organs in the body that secrete hormones

What are hormones?

Chemicals responsible for regulating a wide array of bodily functions, such as growth, metbolism, mood, and sleep

What are two major endocrine glands?

Thyroid and pancreas

What are other endocrine glands?

Liver, testes, and ovaries

What does the pancreas do?

Regulates blood sugar by secreting insulin hormone or glucagon hormone

What does insulin hormone do?

Lowers glucose

What does glucagon hormone do?

Increases glucose

What is the thyroid?

Regulates metabolism of body by secreting thyroid hormones

What does the thyroid control?

Controls metabolism, or conversion of calories of consumed food and drink into energy

What are thyroid hormones?

Regulate energy use, body temperature, heart rate, and are crucial for the growth, development, and maintenance of virtually every cell and organ system

What are 3 common diseases or conditions of the endocrine system?

Hyperthyrodism, hypothyrodism, diabetes

What is hyperthyrodism?

Condition where thyroid secretes too much thyroid hormone

What are common symptoms with hyperthyrodism?

Anxiety, diarrhea, insomia, sensitivity to heat, weight loss

What is hypothyrodism?

Condition where thyroid secretes too little thyroid hormone or fails to convert thyroid hormone into active form

What are common symptoms with hypothyrodism?

Problems focusing, constipation, depression, sensitivity to cold, tiredness, weight gain

What is diabetes?

Condition where pancreas secretes too little insulin, or the body doesn’t respond normally to insulin

What does diabetes result in?

Hyperglycemia or high blood sugar

What treats diabetes?

Biguanides, sulfonylureas, thiazolidinediones, SGLT2 inhibitors, DPP-4 inhibitors, meglitinides, GLP-1 agonists, and insulin

What adverse reactions are there with thyroid meds?

At theraputic levels, there is rarely adverse rxns since they help stabilize thyroid levels and help maintain healthy metabolism. However, of course that being excessive with the med may lead to hypo or hyperthyrodism

Patients allergic to poricne products can’t take which thyroid med?

Armour thyroid

HYPOthyroid meds must be taken…

30 to 60 minutes before a meal, since food can decrease absorbtion of oral hypothyroid meds

What meds can’t be taken with hypothyroid meds?

Aluminum, calcium, and magnesium containing products, since theycan affect absorbtion. Must be separated at least 4 hours

What labs are commonly monitored when taking thyroid meds?

TFTs, or thyroid function tests, such as TSH measuring

What are 3 common hypothyroid meds?

Levothyroxine/liothyronine combo, levothyroxine, liothyronine

Brand name levothyroxine/liothyronine combo?

Armour thyroid

Brand name levothyroxine?

Synthroid

Brand name liothyronine?

Cytomel

What are 2 common hyperthyroid meds?

Methimazole and propylthiouracil

Both Methimazole and propylthiouracil are _______ meds.

NIOSH meds, hazardous

Methimazole must be avoided in…

Pregnant women

Brand name methimazole?

Tapazole

Brand name Propylthiouracil?

Propyl-Thyracil

What is diabetes mellitus?

Condition where their blood sugar remains high due to insufficient insulin being produced or lack of response due to existing insulin in body

Diabetes mellitus can cause damage to…

Heart, eyes, kidneys, liver, and other organs

What is diabetes type 1?

Where body procduces little, if any insulin

Type 1 diabetes occurs commonly at what age?

Young age

What is type 1 diabetes called?

Insulin-dependent diabetes since patients will need insulin lifelong

What is type 2 diabetes?

May or may not require insulin

What do type 2 diabetes meds do?

Can either increase insulin in body, or resensitize patient’s body to insulin so blood sugar (glucose) is lowered

When does type 2 diabetes occur?

Later in life

How do biaguanides work?

Decrease sugar (glucose) absorbed in stomach from food and decrease insulin resistance

How do sulfonylureas and meglitinides work?

Signal pancreas to produce more insulin

How do DPP-4 inhibitors and GLP-1 agonists work?

Slow down activation of certain hormones (incretins) to decrease blood glucose levels

How do SGLT2 inhibitors work?

Prevent reabsorbtion of glucose in kidneys, which allows body to excrete excess glucose through urine and lower blood sugar

How do thiazolidinediones work?

Enhance insulin sensitivity so body can take up more sugar from blood

How do insulins work?

Allow glucose to flow from bloodstream to body tissues

Most diabetic meds are considered…

High alert meds, they can drop blood sugar too low if wrong product or strength is dispensed

What is the common biaguanide?

Metformin

Metformin must be taken with…

Food

Metformin may cause…

Lactic acidosis (BW)

Metformin and GLP-1 agonist may cause…

N/V, constipation or diarrhea

Which patients must take metformin carefully?

Kidney disease patients

Brand name metformin?

Glucophage

What are 3 common sulfonylureas?

Glimepiride, glipizide, and glyburide

Sulfonylureas must be avoided in which patient?

Patients with sulfa allergy and patients with kidney disease

Sulfonylureas and insulins cause…

• Weight gain. Increase insulin, therefore increase calories from sugar being absorbed from bloodstream

• Hypoglycemia. even more if combined with other meds

Brand name glimepiride?

Amaryl

Brand name glipizide?

Glucotrol

Brand name glyburide?

Diabeta

What are 2 common dipeptidyl peptidase-4 (DDP-4) inhibitors?

Linagliptin and sitagliptin

Brand name linagliptin?

Tradjenta

Brand name sitagliptin?

Januvia

What are 2 common meglitinides?

Nateglinide and repaglinide

Meglitinides may cause…

hypoglycemia

Meglitinides must be taken…

30 minutes before a meal

Brand name nateglinide?

Starlix

Brand name repaniglide?

Prandin

What are 3 common sodium-glucose co-transporter 2 (SGLT2) inhibtors?

Canagliflozin dapagliflozin, emapagliflozin

Canagliflozin must be taken…

Before first meal of day

Emapagliflozin must be taken…

In the morning

What is a common thiazolidinedione?

Pioglitazone

Pioglitazone is a…

Beers med

What patients must avoid pioglitazone?

Patients with heart failure, since they may cause fluid retention and make it harder for heart to pump

Pioglitazone may cause…

Hypoglycemia, swelling and weight gain

Brand name pioglitazone?

Actos

What are 4 common glucagon-like peptide-1 (GLP1) agonists?

Dulaglutide, liraglutide, semaglutide, and tirzapeptide

Brand name duraglutide?

Trulicity

Brand name Liraglutide?

Victoza

Brand name semaglutide?

Ozempic

Brand name tirzapatide?

Zepbound, mounjaro

Oral semaglutide must be taken…

30 minutes before food

GLP1s may cause…

Weight loss, since they slow stomach emptying so patients eat less

What is the difference between rapid acting and slow acting insulins?

Rapid-acting insulin handles sudden blood sugar spikes from meals, while slow-acting insulin provides a steady, 24-hour background level of insulin

What are 2 common rapid actin insulins?

Insilun aspart and insulin lispro

Brand name insulin aspart?

Novolog

Brand name insulin lispro?

Humalog

What is a common short-acting insulin?

Insulin regular

Brand name insulin regular?

Humulin N, Novolin R

What is a common intermediate acting insulin?

Insulin NPH

Brand name insulin NPH?

Humulin N, novolin R

What are 3 common long acting insulins?

Insulin degludec, insulin determir, insulin glargine

Brand name insulin degludec

Tresiba

Brand name insulin detemir?

Levemir

Brnd name insulin glargine?

Lantus

Any diabetes med may cause…

Hypoglycemia, but the risk varies. Drugs that increase insulin levels have a higher chance of hypoglycemia

What are the diabetes meds that are beers?

Sulgonylureas, thiazolidinediones, rapid and short acting insulins, due to glucose lowering

What labs will be regularly monitored in patients on diabetes meds?

• Blood glucose and A1c, to measure of current therapy is effective and blood sugar is within normal range

• Metabolic (eye, kidneys, heart) to ensure diabetes hasn’t damaged organs

Which diabetes meds must be kept in refrigirator?

Insulins and GLP1 agonists

What must be avoided with diabetes meds?

Alcohol, since it can affect blood sugar levels