8/11/2019 growth hormones & thyroid hormones.docx

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ENDOCRINE: Pituitary and Thyroid

Anterior PituitaryStimulant DrugsSomatropin (Genotropin,Serostim, Nutropin)

Anterior PituitaryInhibitor DrugsOctreotide(Sandostatin)

Posterior PituitaryDrugsDesmopressin(DDAVP)Vasopressin(Pitressin)

Thyroid HormoneReplacement DrugsT4 Replacement:Levothyroxine(Levothroid,Synthroid)T3 Replacement:Liothyronine

(Cytomel, Triostat)

Anti-thyroid DrugsMethimazole (Tapazole)Propylthiouracil (PTU)

IodinePotassium Iodide(SSKI)

Expected Action Stimulate overall growth,production of proteins, and

use of glucose

Inhibits growthhormone, promotesF&E reabsorption.

Promote H2Oreabsorption in kidneys(desmopressinpreferred)Vasoconstriction due tosmooth musclecontraction(vasopressin)

Synthetic thyroxinemetabolic rate, proteinsynthesis, CO, renalperfusion, O2use, bodytemp, blood volume, &growth processes

Block thyroid hormonesynthesis/prevent oxidation ofiodine

Blocks release ofthyroid hormones intobloodstream

Therapeutic Use Growth hormonereplacement; growth hormonedeficiencies, AIDS wastingsyndrome and short bowel

syndrome

Tx of acromegaly andsevere diarrhea andflushing episodesassociated with

metastatic tumors.

Tx of DI and nocturnalenuresis, normalizesurinary water excretion;cardiac arrest

Tx of hypothyroidism,myxedema & cretinism

Tx of hyperthyroidism, Gravesdisease or thyrotoxicosis

For tx ofhyperthyroidism to the vascularity of thethyroid gland

Adverse Effects HA, hyperglycemia,hypothyroidism, and ketosis

Dysrhythmias, heartfailure, HA, hyper &hypoglycemia, GIcomplaints, fatigue &dizziness, cholelithiasis

Water intoxication(overhydration), ie: HA,restlessness,drowsiness

Insomnia & weight loss;serious effects: HTN,tachycardia, & CVcollapse

Rash and leucopenia; rare butserious effects include:agranulocytosis & pancytopenia

Metallic taste,stomatitis

Contraindiations/Precautions/Interactions

For tx of growth failure afterclosure of the epiphysealplatesGlucocorticoids cancounteract growth-promotingeffects

In pts with DI that iscaused by renal failureas it can worsen fluidretention and overload;potent vasoconstrictor,use with caution in pts

w/ known CAD or HTN& in pts at risk forhyponatremia or thrombi

Known cardiovasculardisease

Immunosuppressed/bone marrowdepressionIncrease anticoagulant effects

Pregnancy

Teaching IM or SC (less painful) Monitor I&O, monitorsite carefully;extravasation can causegangrene

Monitor forthyrotoxicosis &replacement is life-long

Monitor CBC w/ diff andprothrombin time for bone marrowsuppression, monitor TSH levels;teach pt. to report any unsualbruising or bleeding, avoidshellfish and iodine products; take@ consistent time & w/ meals

Maximum effect after15 days.Dilute & administerthrough straw aftermeals to preventteeth discoloration