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Questions and Answers
Which of the following is the drug of choice for hypothyroidism?
Which of the following is the drug of choice for hypothyroidism?
What are the signs and symptoms of hypothyroidism?
What are the signs and symptoms of hypothyroidism?
Which of the following is a side effect of levothyroxine?
Which of the following is a side effect of levothyroxine?
Which of the following is a contraindication to the use of levothyroxine?
Which of the following is a contraindication to the use of levothyroxine?
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Which of the following is a common side effect of prednisone?
Which of the following is a common side effect of prednisone?
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What is the action of propylthiouracil?
What is the action of propylthiouracil?
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What is the action of calcitriol?
What is the action of calcitriol?
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Hypothyroidism is a condition where the thyroid gland produces too much thyroid hormone.
Hypothyroidism is a condition where the thyroid gland produces too much thyroid hormone.
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Hyperthyroidism is a condition where the thyroid gland produces too little thyroid hormone.
Hyperthyroidism is a condition where the thyroid gland produces too little thyroid hormone.
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Levothyroxine is an antithyroid drug.
Levothyroxine is an antithyroid drug.
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Propylthiouracil is a thyroid hormone replacement drug.
Propylthiouracil is a thyroid hormone replacement drug.
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Which of the following disorders is characterized by a deficiency of parathyroid hormone?
Which of the following disorders is characterized by a deficiency of parathyroid hormone?
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Calcitriol is a vitamin D analog.
Calcitriol is a vitamin D analog.
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The parathyroid gland is responsible for regulating blood glucose levels.
The parathyroid gland is responsible for regulating blood glucose levels.
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Prednisone is an antithyroid drug.
Prednisone is an antithyroid drug.
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Fludrocortisone is a mineralocorticoid drug.
Fludrocortisone is a mineralocorticoid drug.
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Glucocorticoids must be tapered off gradually to avoid adrenal crisis.
Glucocorticoids must be tapered off gradually to avoid adrenal crisis.
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Prednisone promotes potassium loss.
Prednisone promotes potassium loss.
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Hypokalemia is a common side effect of prednisone.
Hypokalemia is a common side effect of prednisone.
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What is the drug of choice for hypothyroidism?
What is the drug of choice for hypothyroidism?
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What is a sign or symptom of hyperthyroidism?
What is a sign or symptom of hyperthyroidism?
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Which of the following is a contraindication to the use of prednisone?
Which of the following is a contraindication to the use of prednisone?
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Which of the following medications is a vitamin D analog used to treat hypoparathyroidism?
Which of the following medications is a vitamin D analog used to treat hypoparathyroidism?
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Which of the following is a sign or symptom of hypocalcemia?
Which of the following is a sign or symptom of hypocalcemia?
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Hypokalemia can cause irregular heart rate.
Hypokalemia can cause irregular heart rate.
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The ______ gland produces epinephrine and norepinephrine.
The ______ gland produces epinephrine and norepinephrine.
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The adrenal cortex produces ______ and ______.
The adrenal cortex produces ______ and ______.
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What is the action of glucocorticoids?
What is the action of glucocorticoids?
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What is the action of mineralocorticoids?
What is the action of mineralocorticoids?
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Match each hormone with its corresponding gland:
Match each hormone with its corresponding gland:
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What is the cause of Addison's disease?
What is the cause of Addison's disease?
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What is the cause of Cushing's syndrome?
What is the cause of Cushing's syndrome?
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What is the purpose of a medical alert tag?
What is the purpose of a medical alert tag?
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What are the signs and symptoms of hypokalemia?
What are the signs and symptoms of hypokalemia?
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Study Notes
Endocrine Drugs: Thyroid, Parathyroid, and Adrenal
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Thyroid Hormone Replacement (Levothyroxine):
- Action: Increases metabolic rate, oxygen consumption, and body growth (increases T3 and T4).
- Uses: Treatment of hypothyroidism, including myxedema (severe hypothyroidism in adults) and cretinism (severe hypothyroidism in children).
- Signs and Symptoms of Hypothyroidism: Lethargy, memory impairment, slow thinking, cold intolerance, dry skin, constipation, weight gain.
- Side Effects/Adverse Reactions: GI distress, tremors/nervousness/insomnia, weight loss, tachycardia, hypertension, palpitations, osteoporosis, thyroid storm.
- Interactions: Increased effects of anticoagulants, TCAs, vasopressors, decongestants; decreased effects of antidiabetic drugs, digoxin. Food should be taken 30-60 minutes before food.
- Contraindications: Severe renal disease, cardiovascular disease, hypertension, diabetes.
Hyperthyroidism:
- Increase in circulating T4 and T3 levels: Causes Graves' disease (thyrotoxicosis).
- Signs and Symptoms: Tachycardia, palpitations, excessive perspiration, heat intolerance, nervousness, irritability, exophthalmos (bulging eyes), weight loss.
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Treatment:
- Antithyroid drugs (e.g., propylthiouracil): Inhibit thyroid hormone synthesis or release.
- Surgical removal of a portion of the thyroid gland (subtotal thyroidectomy).
- Radioactive iodine therapy.
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Hyperthyroidism - Propylthiouracil:
- Action: Reduces excessive secretion of thyroid hormones (T3 and T4)
- Uses: Hyperthyroidism treatment. May take a week to work.
- May need beta blocker (e.g., propranolol): To control blood pressure and heart rate.
- Interactions: Increased effects of anticoagulants; decreased effects of antidiabetics; digoxin and lithium increase action of thyroid drugs.
- Side Effects/Adverse Reactions: Sore throat, rash, fever.
Hypoparathyroidism (Calcitriol):
- Parathyroid Disorders: Parathyroid hormone deficiency; low calcium levels associated with chronic kidney disease (CRF); decreased bone resorption.
- Treatment: Calcitriol (Vitamin D analog).
- Action: Promotes calcium absorption from the gastrointestinal (GI) tract, decreases bone resorption, enhances calcium reabsorption in the kidneys. Net effect is to increase serum calcium levels.
- Side Effects: Fatigue, weakness, somnolence, nausea/vomiting (N/V), diarrhea, cramps, dizziness, or drowsiness, anorexia (loss of appetite).
- Adverse Reactions: Hypercalcemia (high calcium), arrhythmias, hypertension (high blood pressure).
- Contraindications/Interactions: Cardiac disease, renal calculi (kidney stones), malabsorption syndromes.
- Digoxin, verapamil; can increase calcium with thiazide diuretics and calcium supplements.
- Assessment: Serum calcium level; signs/symptoms of hypocalcemia (e.g., twitching/tingling of mouth, fingers, carpopedal spasms).
- Interventions: Monitor serum calcium levels, teach client to report symptoms, and use Chvostek and Trousseau signs to assess.
Adrenal Glands:
- Adrenal Medulla: Produces epinephrine and norepinephrine (catecholamines).
- Adrenal Cortex: Produces glucocorticoids (e.g., cortisol), mineralocorticoids (e.g., aldosterone).
- Glucocorticoid hyposecretion (e.g., Addison's disease).
- Glucocorticoid hypersecretion (e.g., Cushing's syndrome).
- Mineralocorticoids: Promote sodium and water retention; potassium excretion. Controlled by the renin-angiotensin system.
Prednisone (Glucocorticosteroid):
- Action: Affects inflammatory response; carbohydrate, protein, and fat metabolism; and muscle and blood cell activities.
- Use: Inflammation, ulcerative colitis, glomerulonephritis; autoimmune disorders; drug reactions; anaphylaxis; asthma; prevent organ rejection.
- Side Effects: Nausea, diarrhea, abdominal distension, increased appetite; sweating; headache; mood changes; depression; cataracts; amenorrhea (loss of menstruation).
- Adverse Reactions: Petechiae (tiny red spots), thin skin, ecchymosis (bruising), osteoporosis, tachycardia, hypertension, hyperglycemia, abnormal fat deposits, muscle wasting, edema, sodium/fluid retention, potassium loss, circulatory collapse, thrombophlebitis, embolism.
- Contraindications: Allergy, psychosis, fungal infection, peptic ulcer disease. (Cautions: Diabetes, renal disease, CHF, MI, hypertension, osteoporosis, seizures, cataracts, glaucoma).
- Interactions: Decreased effects of anticonvulsants, antidiabetics, digoxin (higher possibility of digoxin toxicity).
Fludrocortisone:
- Oral mineralocorticoid: Replaces aldosterone, increasing water/sodium retention, and excretes potassium.
- Use: Adrenocortical insufficiency, Addison's disease.
- Mechanism of Action: Controlled by the renin-angiotensin system.
Nursing Process/Assessment - General
- Baseline vital signs; labs (sodium, potassium, blood glucose for adrenal); weight; urine output; medical/medication history (diabetes, glaucoma, cataracts, peptic ulcer, psych issues).
Nursing Interventions - General
- Monitor vital signs, weight, and lung sounds.
- Monitor electrolytes (especially potassium).
- Monitor for signs/symptoms of electrolyte imbalance (hypokalemia).
- Teach client to increase potassium in diet.
- Teach client to report adverse reactions.
- Do not stop medication abruptly; taper off.
- Teach side effects of medication and when to contact healthcare provider.
Practice Questions and Answers:
- (Detailed answers for practice questions are summarized in the bullet points related to the specific conditions.)
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Description
Test your knowledge on endocrine drugs focusing on thyroid hormone replacement, hyperthyroidism, and their effects on the body. Understand the actions, uses, side effects, and interactions of these medications, as well as the signs of hypothyroidism. This quiz is perfect for students in pharmacology or medical studies.
