NURS 3210 Active Learning Guide Module 10

Somatotropin (Growth Hormone)

• Growth Hormone Deficiency (GHD) in Children:

  • Symptoms include slow growth, short stature, delayed sexual development, immature appearance, and prominent forehead.

• GHD in Adults:

  • Higher body fat, reduced muscle and strength, increased bone fractures, anxiety, depression, fatigue, and sexual dysfunction.

• Excess Growth Hormone:

  • Acromegaly (in Adults): Enlarged bones in the skull, face, and jaw, soft tissue swelling, and skin changes (thick, coarse skin).
  • Gigantism (in Children): Characterized by excessive height and growth of muscles and organs, large hands/feet, and coarse facial features.
  • Additional symptoms include joint pain, headaches, vision problems, and excessive sweating.

Thyroid Hormone

• Hypothyroidism:

  • Symptoms include fatigue, weight gain, sensitivity to cold, constipation, dry skin, and hair changes (brittle hair).
  • Slowed movements, dull facial expressions, hoarse voice, joint/muscle pain, and tingling or pain in the hands are also common.

• Hyperthyroidism (e.g., Graves' Disease):

  • Symptoms include rapid/irregular heartbeat, weight loss despite increased appetite, heat intolerance, and anxiety.
  • Additional issues include muscle weakness, frequent loose bowel movements, sweaty/clammy skin, and goiter or thyroid nodules.

Cortisol

• Addison's Disease (Adrenal Insufficiency):

  • Symptoms include fatigue, muscle weakness, low mood, appetite loss, unintentional weight loss, increased thirst, and dizziness.

• General Effects of Cortisol Deficiency:

  • Systemic impacts can include immunosuppression, hyperglycemia, adrenal suppression, and osteoporosis.

Octreotide and VIPoma

• Mechanism of Action:

  • Octreotide inhibits the secretion of vasoactive intestinal peptide (VIP) to control VIPoma-related diarrhea by decreasing intestinal secretion and motility.

• Monitoring Parameters:

  • Blood glucose levels, liver function tests, electrolyte levels, thyroid function, and signs of gallstones or cholecystitis.

• Blood Glucose Elevation:

  • Octreotide may prevent insulin secretion from the pancreas, causing hyperglycemia requiring monitoring and management.

Importance of Monitoring in Thyroid Drug Use

• Potential Overmedication:
  • Symptoms of palpitations and heat intolerance after extended thyroid drug use warrant immediate monitoring of thyroid hormone levels to assess for hyperthyroidism.### Antidiabetic Agents
• Lispro is a rapid-acting insulin used to control blood sugar levels following meals.
• Glucagon is a hyperglycemic agent indicated for severe hypoglycemia management.
• Humalin 70/30 is a combination insulin (70% NPH, 30% regular insulin) used to provide both basal and prandial coverage.
• Exenatide is an incretin mimetic (GLP-1 receptor agonist) that enhances glucose-dependent insulin release.
• Glipizide is a sulfonylurea, stimulating the pancreas to release more insulin.
• Metformin is a biguanide, improving insulin sensitivity and reducing hepatic glucose production.
• Acarbose is an alpha-glucosidase inhibitor that delays carbohydrate absorption from the intestine.
• Pioglitazone is a thiazolidinedione (TZD) that enhances insulin sensitivity in muscle and fat.
• Sitagliptin is a DPP-4 inhibitor, preventing the breakdown of incretin hormones to decrease glucose levels.
• Regular insulin is a short-acting insulin, while NPH is an intermediate-acting insulin.
• Glargine is a long-acting insulin, providing a steady release of insulin throughout the day.
• Repaglinide is a meglitinide that stimulates insulin secretion but has a rapid onset and short duration.
• Canagliflozin is an SGLT2 inhibitor that enhances urinary glucose excretion.
• D50 is a hyperglycemic agent for severe hypoglycemia management.

Other Endocrine and Reproductive Agents

• Prazosin is an alpha-1 adrenergic blocker used for hypertension.
• Hydrocortisone is a corticosteroid, primarily used in adrenal insufficiency treatment.
• Desmopressin is an antidiuretic hormone analog for conditions like diabetes insipidus.
• Methimazole is an antithyroid agent, inhibiting thyroid hormone synthesis.
• Misoprostol is a prostaglandin E1 analog used to prevent NSAID-induced ulcers and induce labor.
• Norethindrone is a progestin used in hormonal contraceptives.
• Dexamethasone and prednisone are glucocorticoids used for their anti-inflammatory properties.
• Indomethacin is a nonsteroidal anti-inflammatory drug (NSAID) used for pain and inflammation.
• Clomiphene is a selective estrogen receptor modulator (SERM) used for ovulatory dysfunction.
• Sildenafil is a phosphodiesterase-5 inhibitor, enhancing erectile function.
• Fludrocortisone is a mineralocorticoid, beneficial in Addison's disease management.
• Testosterone is an androgen, contributing to male characteristics and reproductive functions.
• Somatropin is a recombinant human growth hormone used for growth disorders.
• Dinoprostone is a prostaglandin E2 analog used for cervical ripening and inducing labor.

Dipeptidyl Peptidase IV Inhibitors (DPP-IV)

• DPP-IV inhibitors, known as gliptins, prolong the action of incretin hormones, improving glycemic control.
• Four main DPP-IV inhibitors include sitagliptin (Januvia), saxagliptin (Onglyza), linagliptin (Tradjenta), and alogliptin (Nesina).

Metformin Management

• Metformin is contraindicated in patients with renal impairment (creatinine clearance < 30 mL/min) due to lactic acidosis risk.
• Other contraindications include alcoholism, metabolic acidosis, hepatic disease, and heart failure.
• Common GI side effects (bloating, cramping, diarrhea) often resolve with continued usage; take with meals and start with low doses to mitigate discomfort.

Birth Control and Antibiotics

• Certain antibiotics can diminish the effectiveness of oral contraceptives; patients should consider additional non-hormonal contraceptive methods during antibiotic treatment.

Anabolic Steroids

• Anabolic steroids are synthetic derivatives of testosterone promoting muscle and bone growth.
• Common misuse includes pursuit of enhanced muscle mass, physical appearance, and athletic performance.
• Adverse effects encompass cardiovascular issues, liver damage, psychiatric disorders, and infertility.

Benign Prostatic Hyperplasia (BPH)

• BPH refers to non-cancerous enlargement of the prostate gland, causing urinary symptoms.
• Effective treatments include alpha-blockers, which relax prostate muscles, and 5-alpha-reductase inhibitors, which reduce prostate size by inhibiting hormone conversion.

Patient Education for Testosterone Therapy

• Apply topical testosterone preparations on clean, dry skin areas such as shoulders or upper arms.
• Always wash hands post-application and avoid close contact with others to prevent unintended transfer.

Antidiabetic Agents

• Lispro: Rapid-acting insulin used for fast reduction of blood glucose levels.
• Regular Insulin: Short-acting insulin prescribed for elevated blood glucose, often given in hospital settings.
• NPH Insulin: Intermediate-acting insulin effective for overnight or long-term blood sugar control.
• Glargine: Long-acting insulin providing a steady release of insulin baseline.
• Metformin: Biguanide class medication improving insulin sensitivity and decreasing hepatic glucose production.
• Glipizide: Sulfonylurea that stimulates insulin release from pancreatic beta cells.
• Exanatide: Incretin mimetic (GLP-1 receptor agonist) enhancing insulin secretion and suppressing glucagon.
• Sitagliptin: DPP-4 inhibitor increasing incretin levels to promote insulin release and reduce blood sugar.
• Pioglitazone: Thiazolidinedione (TZD) that improves insulin sensitivity and regulates glucose metabolism.
• Repaglinide: Meglitinide class drug inducing fast insulin secretion to manage postprandial glucose spikes.
• Acarbose: Alpha-glucosidase inhibitor that delays carbohydrate absorption in the intestine.
• Cangliflozin: SGLT2 inhibitor promoting glucose excretion in urine.
• Glucagon: Hyperglycemic agent for severe hypoglycemia management.

Other Endocrine and Reproductive Agents

• Hydrocortisone: Corticosteroid used for adrenal insufficiency and anti-inflammatory purposes.
• Prazosin: Alpha-1 adrenergic blocker treating hypertension and relieving urinary symptoms of BPH.
• Methimazole: Antithyroid agent used to manage hyperthyroidism by inhibiting thyroid hormone synthesis.
• Desmopressin: Antidiuretic hormone analog used for diabetes insipidus and certain bleeding disorders.
• Norethindrone: Progestin component in hormonal contraceptives for regulating menstrual cycles.
• Oxytocin (Pitocin): Uterotonic agent inducing labor and controlling postpartum hemorrhage.
• Dinoprostone: Prostaglandin E2 analog for cervical ripening and labor induction.
• Octreotide: Somatostatin analog used for acromegaly and IBS-related diarrhea.
• Testosterone: Androgen hormone promoting male secondary sexual characteristics and muscle growth.
• Fluticasone: Corticosteroid with anti-inflammatory effects, commonly inhaled for respiratory conditions.

Hormonal Functions and Mechanisms

• Growth Hormone: Stimulates growth and metabolism; used therapeutically as somatropin for dwarfism.
• Adrenocorticotropic Hormone (ACTH): Promotes adrenal hormone synthesis; diagnostic tool for adrenal insufficiency.
• Cortisol: Manages metabolism and immune response; plays a crucial role in the body's stress response.
• Aldosterone: Regulates sodium and potassium balance, impacting blood pressure and fluid retention.

Drug Use and Patient Education

• Additional non-hormonal contraception should be advised when patients are prescribed certain antibiotics, as they may reduce the effectiveness of oral contraceptives.
• Tocolytics like Nifedipine and Terbutaline are used to suppress premature labor; corticosteroids like Betamethasone aid fetal lung development preterm.
• Patients should apply topical testosterone to clean, dry skin areas and wash hands after application to prevent unintentional transfer.

Conditions and Medications

• BPH: Noncancerous prostate enlargement; treated with alpha-blockers and 5-alpha-reductase inhibitors.
• Priority assessments for uterine stimulants include monitoring uterine contractions, fetal heart rate, and maternal vital signs, particularly during labor induction or augmentation.

Antidiabetic Agents

• Lispro: Rapid-acting insulin used for fast reduction of blood glucose levels.
• Regular Insulin: Short-acting insulin prescribed for elevated blood glucose, often given in hospital settings.
• NPH Insulin: Intermediate-acting insulin effective for overnight or long-term blood sugar control.
• Glargine: Long-acting insulin providing a steady release of insulin baseline.
• Metformin: Biguanide class medication improving insulin sensitivity and decreasing hepatic glucose production.
• Glipizide: Sulfonylurea that stimulates insulin release from pancreatic beta cells.
• Exanatide: Incretin mimetic (GLP-1 receptor agonist) enhancing insulin secretion and suppressing glucagon.
• Sitagliptin: DPP-4 inhibitor increasing incretin levels to promote insulin release and reduce blood sugar.
• Pioglitazone: Thiazolidinedione (TZD) that improves insulin sensitivity and regulates glucose metabolism.
• Repaglinide: Meglitinide class drug inducing fast insulin secretion to manage postprandial glucose spikes.
• Acarbose: Alpha-glucosidase inhibitor that delays carbohydrate absorption in the intestine.
• Cangliflozin: SGLT2 inhibitor promoting glucose excretion in urine.
• Glucagon: Hyperglycemic agent for severe hypoglycemia management.

Other Endocrine and Reproductive Agents

• Hydrocortisone: Corticosteroid used for adrenal insufficiency and anti-inflammatory purposes.
• Prazosin: Alpha-1 adrenergic blocker treating hypertension and relieving urinary symptoms of BPH.
• Methimazole: Antithyroid agent used to manage hyperthyroidism by inhibiting thyroid hormone synthesis.
• Desmopressin: Antidiuretic hormone analog used for diabetes insipidus and certain bleeding disorders.
• Norethindrone: Progestin component in hormonal contraceptives for regulating menstrual cycles.
• Oxytocin (Pitocin): Uterotonic agent inducing labor and controlling postpartum hemorrhage.
• Dinoprostone: Prostaglandin E2 analog for cervical ripening and labor induction.
• Octreotide: Somatostatin analog used for acromegaly and IBS-related diarrhea.
• Testosterone: Androgen hormone promoting male secondary sexual characteristics and muscle growth.
• Fluticasone: Corticosteroid with anti-inflammatory effects, commonly inhaled for respiratory conditions.

Hormonal Functions and Mechanisms

• Growth Hormone: Stimulates growth and metabolism; used therapeutically as somatropin for dwarfism.
• Adrenocorticotropic Hormone (ACTH): Promotes adrenal hormone synthesis; diagnostic tool for adrenal insufficiency.
• Cortisol: Manages metabolism and immune response; plays a crucial role in the body's stress response.
• Aldosterone: Regulates sodium and potassium balance, impacting blood pressure and fluid retention.

Drug Use and Patient Education

• Additional non-hormonal contraception should be advised when patients are prescribed certain antibiotics, as they may reduce the effectiveness of oral contraceptives.
• Tocolytics like Nifedipine and Terbutaline are used to suppress premature labor; corticosteroids like Betamethasone aid fetal lung development preterm.
• Patients should apply topical testosterone to clean, dry skin areas and wash hands after application to prevent unintentional transfer.

Conditions and Medications

• BPH: Noncancerous prostate enlargement; treated with alpha-blockers and 5-alpha-reductase inhibitors.
• Priority assessments for uterine stimulants include monitoring uterine contractions, fetal heart rate, and maternal vital signs, particularly during labor induction or augmentation.

This quiz covers the disease processes and symptoms of both deficiencies and excesses of various hormones, including somatotropin. Learn about the effects of hormonal imbalances on the human body.