drugs affecting endocrine

Endocrine system

Ductless glands that release hormones directly into the bloodstream

Hormones

Chemicals that regulate metabolism growth development reproduction stress and fluid electrolyte balance

Negative feedback mechanism

High hormone levels suppress further secretion while low levels stimulate production

Growth hormone agonist

Drug that replaces deficient growth hormone

Somatropin

Recombinant growth hormone used for growth hormone deficiency and dwarfism

Somatropin therapeutic action

Stimulates linear bone growth protein synthesis and overall growth

Somatropin adverse effects

Hypothyroidism hyperglycemia edema joint pain nutritional imbalance

Somatropin nursing consideration

Monitor growth chart thyroid function blood glucose and injection compliance

Somatropin route

Administered intramuscularly or subcutaneously only

Growth hormone antagonist

Drug that blocks excess growth hormone effects

Octreotide

Growth hormone antagonist used for acromegaly and gigantism

Pegvisomant

Growth hormone receptor blocker for acromegaly

Bromocriptine

Drug that decreases growth hormone secretion

Growth hormone antagonist adverse effects

Nausea vomiting abdominal pain gallstones headache dizziness glucose changes

Growth hormone antagonist nursing consideration

Monitor growth liver function abdominal pain and blood glucose

Posterior pituitary hormone drugs

Medications affecting antidiuretic hormone function

Diabetes insipidus

Condition of deficient or ineffective ADH causing polyuria and polydipsia

SIADH

Excess ADH secretion causing water retention and dilutional hyponatremia

Desmopressin

Synthetic ADH used for diabetes insipidus nocturnal enuresis and bleeding disorders

Desmopressin action

Increases water reabsorption and decreases urine output

Desmopressin routes

Nasal oral or intravenous administration

Tolvaptan

Oral ADH antagonist used for hyponatremia and SIADH

Tolvaptan action

Increases free water excretion raising serum sodium

Conivaptan

Intravenous ADH antagonist for severe hyponatremia

Conivaptan nursing consideration

Administer in hospital due to risk of rapid sodium correction

Posterior pituitary adverse effects

Water intoxication hyponatremia headache nasal irritation arrhythmias

Posterior pituitary nursing consideration

Monitor intake output serum sodium and signs of water intoxication

Glucocorticoids

Adrenocortical drugs with anti inflammatory and immunosuppressive effects

Prednisone

Common glucocorticoid used for inflammation allergy and autoimmune disease

Dexamethasone

Potent glucocorticoid with anti inflammatory action

Hydrocortisone

Natural cortisol replacement for adrenal insufficiency

Glucocorticoid adverse effects

Immunosuppression hyperglycemia weight gain hypertension osteoporosis GI ulcer

Cushingoid features

Moon face buffalo hump due to excess glucocorticoids

Glucocorticoid nursing consideration

Never stop abruptly taper dose monitor glucose blood pressure weight infection

Mineralocorticoids

Drugs that mimic aldosterone effects

Fludrocortisone

Mineralocorticoid used for adrenal insufficiency and orthostatic hypotension

Mineralocorticoid action

Increases sodium and water retention and potassium excretion

Mineralocorticoid adverse effects

Hypertension edema hypokalemia fluid overload

Mineralocorticoid nursing consideration

Monitor blood pressure weight edema sodium and potassium

Thyroid hormone replacement

Drugs that replace deficient thyroid hormones

Levothyroxine

Synthetic T4 used for hypothyroidism

Liothyronine

Synthetic T3 rarely used due to potency

Levothyroxine action

Replaces T4 to increase metabolism heart rate and energy use

Levothyroxine adverse effects

Signs of hyperthyroidism when overdosed

Levothyroxine nursing consideration

Give on empty stomach in morning avoid calcium iron antacids

Antithyroid drugs

Medications that decrease thyroid hormone production

Methimazole

First line antithyroid drug for hyperthyroidism

Propylthiouracil

Antithyroid drug preferred in pregnancy and thyroid storm

Thioamide action

Inhibits thyroid peroxidase to block T3 and T4 synthesis

Thioamide adverse effects

Agranulocytosis hepatotoxicity hypothyroidism rash GI upset

Antithyroid nursing consideration

Monitor WBC liver function signs of infection and hypothyroidism

Iodine solutions

High dose iodine used for short term thyroid suppression

Potassium iodide

Iodine preparation used preoperatively and for thyroid storm

Iodine solution action

Blocks release of T3 and T4 and reduces thyroid vascularity

Iodism

Iodine toxicity with metallic taste burning mouth salivation rash

Iodine nursing consideration

Dilute in juice use straw avoid long term use monitor thyroid tests

Parathyroid drugs

Medications affecting calcium balance

Hypocalcemia

Low calcium causing muscle cramps tetany seizures arrhythmias

Vitamin D preparations

Drugs that increase intestinal calcium absorption

Calcitriol

Active vitamin D3 used for hypocalcemia

Ergocalciferol

Vitamin D2 used to increase calcium absorption

Calcium supplements

Direct calcium replacement therapy

Calcium carbonate

Oral calcium supplement taken with meals

Calcium gluconate

Intravenous calcium for acute hypocalcemia

PTH analog

Therapy that stimulates bone formation

Teriparatide

Parathyroid hormone analog for severe osteoporosis

Hypercalcemia

Excess calcium causing weakness confusion kidney stones arrhythmias

Bisphosphonates

Drugs that inhibit bone resorption

Alendronate

Bisphosphonate used for osteoporosis and hypercalcemia

Zoledronic acid

Intravenous bisphosphonate for malignancy related hypercalcemia

Calcitonin

Hormone that lowers calcium by inhibiting bone resorption

Antihypercalcemic nursing consideration

Monitor calcium renal function bone pain and GI symptoms