-
"negative feedback mechanism"
maintains normal levels
-
hypothalmic hormone med
- Gonadotropin releasing hormone: causes release of FSH & LH from pituitary
- used to stiumlate ovulation & diagnose pituitary function
-
hypothalmic hormone med: (2)
- growth hormone inhibiting hormone (somatostatin): inhibits release GH
- inhibits GI secretions and motility
- used to treat severe diarrhea
-
pituitary hormones
- controlled by hypothalamus
- include the anterior pituitary (adenohyphysis)
- and posterior pituitary (neurohypophysis)
- and intermediate lobe
-
andenohypophysis includes
- somatotropin (GH)
- Corticotropin or ACTH (in adrenal cortex)
- thyrotropin or TSH (thyroid)
- follicle stiumlating hormone or FSH (ovaries)
- Leutotropic hormone or LTH (lactation)
- Leuenizing hormone or LH (ovaries & testicles)
-
posterior pituitary (neurohypiphysis)
- not a functioning gland *warehouse storage for antidiuretic hormone or ADH or vasopressin (fluid)
- oxycotin (uterine contrations)
-
intermediate lobe
melanocyte hormone or MSH (pigment cells)
-
somatotropin
- growth hormone replacement
- SE: hyperglycemia & hypothyroidism
-
antidiuretic hormone or vasopressin
makes you hold onto pee (water *retain fluid*), dehydrated, brain problems
-
Low ADH or Vasopressin
- diabetes insipidus
- s/sx: excessive fluid loss, polyuria w/ dilute urine, concentrated blood, hypovolemic shock
-
vasopressin
- diagnostic purposes & emergency (vasoconstrictor)
- 1st line in cardiac arrest
-
DDAVP
- desmopressin
- intranasal form for maintaining therapy for ADH
- very powerful
- can lead to water intoxication & hyponatremia
-
too much ADH
- SIADH (Syndrome of Inappropriate Antidiuretic Hormone)
- s/sx of too much fluid retention, minimal concentrated urine, diluted blood resulting in hyponatremia & CNS dysfunction
-
other pituitary meds
used in diagnostic evaluations
-
thyroid gland
- primary function is control rate of cellular metabolism
- hormones: thyroxin (T4) & tri-iodothyronine (T3)
- T4 converted to T3 (more active form)
- thyrocalcitonin regulates calcium
-
hyperthyroidism
- HYPER! (tremors, weight loss, warm & flushed skin, exopthalmus)
- toxic drugs: therefore used short-term
-
propylthiouracil (PTU)
- inhibits production of hormone & conversion of T4 to T3.
- SE: bone marrow suppression that can bottom out WBC-->risk for infections
-
Iodine solutions (SSKI)
- inhibit TSH
- SE: iodine toxicity (metallic taste, etc.)
- stains teeth so drink w/ straw
-
Radioactive iodine
- diagnostic purposes
- destroys the thyroid gland
-
beta blockers
used to control hyperthyroidism symptoms
-
hypothyroidism
- lethargy, weight gain, cool and dry skin, atherosclerosis (fat accumulation)
- levothyroxine (synthroid)-synthetic T4 (drug of choice)
- monitor HR/BP
- take in AM to prevent insomnia
-
parathyroid glands
- maintain calcium level & calcium and phosphorous ratio
- hyperparathyroid-chronic renal failure pt
-
funtions of calcium
- ^ calcium: low neuromuscular activity (hyperparathyrodism) *osteoperosis*
- low calcium: high neuromuscular activity (hypoparthyroidism) *carpopedal spasm and osteoperosis
- treat with TUM's & Vitamin D
-
adrenal cortex
- glucocorticoids (cortisol & cortisol-like) for stress and maintain BG, anti-inflammatory, immunosuppressant effects
- mineral corticoids: aldosterone: retention of sodium and excretion of K
- adrenal androgens: testosterone like hormones; secondary sex characteristics at puberty for M&F
-
adrenal medulla
- norepinephrine (maintain BP)
- epinephrine (adrenalin)-response to stress
-
Addison's disease
- deficiency of adrenal hormones
- s/sx: hypoglycemia, dehydration, hyponatremia, and hyperkalemia, inability to respond to stress
- treat w/ "steroids"
- ADDison's-ADD hormone to treat it
-
glucocoricosteroids
- lower # of WBC, T-cells.
- systemic effects on body esp. w/ high dose or long-term therapy
- hyperglycemia, breakdown of protein-muscle wasting, breakdown of fat-oxidation of fatty acids, "moon face" and "buffalo hump"
-
systemic effects on musculoskeletal (from steroids)
- muscle atrophy
- risk for fractures
- resp. effects:inhibition of broncoconstriction
- GI effects: risk for ulcers since interferes w/ gastric mucosa protection
-
F/E effects of steroids
- increase retention of Na and water
- excretion of K and Ca
- nervous system: slows activity
- endocrine effect: suppression of cortisol-releasing hormone from hypothalamus-in turn suppresses cortisol from adrenal gland
- life threatening
-
general nursing principles r/t steroids
- DO NOT abruptly discontinue
- DO give according to Circadian rhythm
- DO give w/ food
- DO protect from infection/injury
- Do monitor BG
- DO monitor for fluid retention
-
Cushing's Syndrome or Disease
- most commonly bc of the steroids
- excess of adrenal hormone
- s/sx: fluid retention, hyperglycemia, hypertension, "buffalo hump", "moon face", gastric hyperacidity
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