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Exam 4 Pharm Study Guide DCN

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Pituitary
What does endogenous growth hormone do in the body?
 Regulates growth in muscles and bones
What endogenous hormone does Somatropin mimic?
 Mimics growth hormone
What is Somatropin used for in kids and adults?
 Kids: children with growth hormone deficiency, poor growth due to renal failure,
children born small with poor growth past 2 years of age
 Adults: used in AIDS-related to waiting/growth hormone deficiency
What class of drugs is known to reduce growth?
 Octreotide
What adverse effects would you expect to see in a patient taking Somatropin?
 Injection site reactions
 Headache
 Nausea
How does Octreotide help patients with acromegaly?
 Inhibits growth hormone release
 Reduce symptoms/complications of acromegaly
What are the indications for Octreotide?
 Acromegaly
 Carcinoid syndrome
 Diarrhea and flushing episodes
What endogenous hormone does Vasopressin mimic?
 Antidiuretic hormone (ADH)
 Indicated for diabetes insipidus/ dehydrated due to lack of endogenous ADH
What does ADH (anti-diuretic hormone) do in the body?
 Regulates water balance by increasing water reabsorption in the kidneys
 Constricts blood vessels, increasing blood pressure
What is diabetes insipidus?
 Excessive thirst and excretion of large amounts of diluted urine
 Caused by insufficient production or response to ADH

How does Vasopressin help patients with DI?

,  Mimics ADH, reducing urine output and controlling thirst
What are other indications for Vasopressin?
 GI bleeding
 Vasodilatory shock
 Esophageal variceal bleeding
 Cardiac arrest (as an alternative to epinephrine)
What is a major effect of vasopressin?
 Vasoconstriction, leading to increased blood pressure
What patient population requires caution when using vasopressin?
 Pts with renal issues
What should you monitor when infusing vasopressin IV?
 Monitor IV site for infiltration
How is Desmopressin related to vasopressin?
 It’s a synthetic vasopressin with a longer duration and fewer vasoconstrictive effects
 Works on vasopressin receptors in the kidney, increasing urine concentration
 Helps with clotting cascade to improve hemostasis
How is Desmopressin used in the pediatric population?
 Treatment of primary nocturnal enuresis (bedwetting)
 Management of central diabetes insipidus
How does desmopressin help patients with bleeding disorders?
 Increases levels of von Willebrand factor and factor VIII
 Used in the treatment of mild hemophilia A and von Willebrand disease
When giving Desmopressin, what labs should you monitor?
 Electrolyte levels (especially sodium)
 Blood pressure
 Coagulation parameters (factor VIII and von Willebrand factor levels)




Thyroid

, How important are the thyroid hormones? Explain
 Influence heart, skeletal muscles, liver, kidneys, growth, brain function, bone growth
 Deficiency of thyroid hormones is incompatible with life
What pituitary hormone stimulates the production of T3 and T4?
 Thyroid-stimulating hormone (TSH)
If T3 and T4 levels are high, what happens to TSH?
 TSH levels decrease (negative feedback mechanism)
What are the signs and symptoms of hyperthyroidism?
 Weight Loss  Anxiety, Nervousness, Irritability,
 Heat Intolerance Insomnia, Tremors
  Appetite   Hair, Nail Growth
 HR  Sweating
 Diarrhea
What are the signs and symptoms of hypothyroidism?
 Weight Gain  Fatigue, Depression, Impaired
 Appetite Memory, “Mental Fog”
 Cold Intolerance  Hair Loss, Thin Nails
 HR  Dry Skin
 Constipation
What is levothyroxine used to treat?
 Hypothyroidism
What are the differences between generic levothyroxine and Synthroid?
 Both are bioequivalent but may have different fillers and dyes
 Levothyroxine = generic form
 Synthroid= brand name
 DO NOT SUBSTITUTE GENERIC
What is the best time to take thyroid medicine?
 In the AM
 On empty stomach
o 30-60 min before food

How long will a patient stay on Synthroid?
 Typically for lifelong
What labs should be monitored when a patient is taking Synthroid?

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