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Pharm review Ch 30-35, pt 5

Desmopressin used for posterior pituitary deficiencies i.e. diabetes insipidus Somatropin used to stimulate skeletal growth in pts with insufficient growth hormone. Monitored closely for needed dosage changes in pts with acute medical conditions i.e. asthma, migraines, epilepsy, in pts taking somatropin should keep accurate ht and weight chart and expect to see increased growth. Any hormonal therapy must be taken as prescribed and not stopped without physician orders. Hormonal therapy does not cure the hormonal deficiency just replaces the missing hormones. Thyroid replacement drugs use in caution in pts with heart problems and watch for subsequent heart problems, advantage of synthetic thyroid replacement drugs is that you can take them once daily for effectiveness, full therapeutic effects may not happen for 3-4 weeks Cretinism low level of thyroid during youth Myxedema low level of thyroid during adulthood Graves disease high level of thyroid Primary hypothyroid caused by abnormality in thyroid itself Secondary hypothyroid caused by dysfunctional pituitary gland which does not secrete TSH Tertiary hypothyroid when hypothalamus does not secrete TRH which stimulates the pituitary gland to secrete TSH Early signs of hypoglycemia irritability, confusion, sweating, tremor When mixing insulins draw up clear then cloudy Diabetic patient who is NPO and on oral hypoglycemic make sure to ask MD for something to control her blood sugar until she can take meds by mouth again Therapeutic response to oral antidiabetic drugs is fasting glucose of 70-100, for glucose of lower than 50 on conscious patient use oral glucose unconscious pt d50 or glucagon corticosteroids will increase blood sugars so will illness pts taking sulfonylureas for oral antidiabetic meds may have a cross allergy if they have sulfa allergies so consult md before giving rinse mouth after using steroid inhaler

nsaids are contraindicated with use of corticosteroids systemically administered glucocorticoid causes hypokalemia, hyperglycemia, hypernatremia undersecretion of adrenocorticol hormones causes dehydration and weight loss long term corticosteroid therapy causes depressed immune system and slow wound healing estrogen replacement therapy pt should report weight gain of more than 5lbs per week estrogen replacement therapy major adverse effect is thrombophlebitis so dont give to pts with hx of same progesterin (progesterone) is used as a common med for primary amenorrhea dizziness and multiple births are possible side effects of fertility drugs brethine used as a uterine toxolytic drug which reduces uterine contractions SERMs (selective estrogen receptor modulators adverse effects include venous thromboembolism, stop taking 72 hrs before extended immobility Fosamax should be taken in the am with water Risk factor for osteoporosis is thin, white or asian, woman, smoking, low calcium diet, low activity level Estrogen patches associated with a high risk for cardiovascular disease Provera forms of Birth control should be given IM Testosterone is best given by patch to avoid the first pass effect allows for better absorption of med Androgen therapy can cause fluid retention Finasteride (proscar) for tx of BPH poss side effect is hair growth, pregnant woman should not handle this med Before taking any BPH med MD should do a PSA (lab test to detect prostate CA) and a rectal digital exam to check for prostate enlargement including herbal meds Erectile deficiency meds should not be taken with nitrites.