MEDICATIONS FOR ENDOCRINE AND METABOLIC DISORDERS
CLASSIFICATIONS INDICATIONS
ADRENOCORTICAL Decrease cortisol
STEROID INHIBITORS production; used to reduce
Aminogluthimide hyperadrenalism caused by
Ketoconazole ectopic adrenocorticotropic
Mitotane hormone secretion by a
tumor that cannot be totally
eradicated
ALPHA – GLUCOSIDASE Slow the digestion of some
INHIBITORS carbohydrates; aftermeal
Acarbose blood glucose peaks are
not as high
ANTIDIURETIC Conserve renal water by
HORMONE increasing urine osmolality
REPLACEMENT AGENTS and decreasing urine flow
Desmopressin rate
Vasopressin
SELECTED
INTERVENTIONS
 Administer in divided
doses to reduce nausea
and vomiting, and
instruct the client to
continue taking the
medication despite
discomfort
 Inform the client to take
safety precautions
because medication
may cause drowsiness
and for orthostatic
hypotension
 Instruct the client to
take the medication
daily and to continue
other measures to
decrease blood glucose
levels
 Advise the client that
insulin may be needed
during times of
increased stress
 Forewarm the client that
possible adverse effects
may include
hypoglycemia
 May be administered
intranasally; instruct the
client to notify the health
care provider if nasal
stuffiness occurs
 I.M. injection must be
administered deep I.M.;
be sure to warm oil-
based medications
 Instruct the client to
report signs of water,
intoxication
(drowsiness, lethargy,
headache, sudden
weight gain, severe
nasal congestion);
caution against
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 adjusting dosage
without consulting his
health care provider.

ANTITHYROID AGENTS Interfere with conversion of  Advise the client to

Methimazole iodine thyroglobulin, report flulike symptoms
Prophythiouracil thereby inhibiting hormone and fever immediately;
synthesis they may be drug-
induced.
 Tell the client to report
signs and symptoms of
hyperthyroidism or
hypothyroidism.
 Caution the client not to
use or eat products
containing iodine, such
as cough medicines,
iodized salt, or shellfish;
tell him to notify his
health care providers if
he is taking products
containing these
substances

BIGUANIDES Keep the liver from  Instruct the client to take

Metformin releasing too much glucose the medication daily and
to continue other
measures (diet,
exercise) to decrease
blood glucose levels.
 Advise the client that
insulin may be needed
during times of
increased stress.
 Forewarm the client that
possible adverse effects
may include
hypoglycemia.

D – PHENYLALANINE Stimulate the release of  Instruct the client to

DERIVATIVES insulin from beta cells administer at least 1 to
Nateglinide 30 minutes before
meals
 Instruct the client to omit
when skipping a meal

ELECTROLYTE Maintain capillary integrity  Administer the amount

REPLACEMENT and normal functioning of prescribed slowly
Calcium gluconate the nervous, muscular and through a large vein to
skeletal systems avoid infiltration, which

2
 may cause severe
necrosis and sloughing
of tissue
 Keep the client on bed
rest at least 1 hour after
drug administration to
prevent orthostatic
hypotension
 Keep the medication at
the bedside with the
necessary I.V.
equipment

GROWTH HORMONE Suppress the release if  Administer with meals to

MEDICATIONS growth hormone and minimize GI distress.
Somatrem prolactin  Instruct the client to
Somatropin report vision problems,
severe nausea or
vomiting and acute
headaches
 Advise the client to limit
his use of alcohol

INSULIN Replace endogenous  Answer five questions

RAPID ACTING
Humulin R; regular insulin
INTERMEDIATE
Humulin N, NPH
LONG ACTING
Humulin L, ultralente insulin
– 70/30 (70% NPH and
30% R), 60/40, 50/50
insulin and maintain blood
glucose levels by regulating
protein, carbohydrate and
fat metabolism
before administering
insulin
1) When dose insulin
peak? Rapid acting
peaks in 2 to 4 hours,
intermediate acting in 6
to 8 hours, long acting
in 16 to 24 hours,
humalog acts within 15
minutes this is the time
that hypoglycemic
reaction may occur
2) What meal covers the
peak time? Glucose or
food is the antidote for
insulin e.g. 7am regular
insulin is covered by
breakfast
3) Is the client receiving
nothing by mouth? If so
question the insulin
order
4) What is the client’s
blood glucose level? If
below 90 mg/dl
questions the insulin

3
 order
5) Where will the shot be
injected? Absorption is
best in the abdomen
 Teach and demonstrate
preparation,
administration
techniques, injection
sites and rotation:
insulin and equipment
care, storage, and
disposal

IODINE CONTAINING Inhibit release if stored  Administer for short

AGENTS thyroid hormone and retard term before
Lugol’s solution hormone synthesis thyroidectomy
Potassium iodide medication has a short
half-life
 Dilute oral iodine
solution in juice or
beverage of choice,
administer through
straw with fluids to
prevent staining of teeth

MINERALOCORTICOIDS Replace hormones, major  Explain that additional

Fludrocortisone effect: sodium-retaining doses may be needed
activity associated with in terms of stress
potassium loss  Instruct the client to
report weight gain and
severe headache

SULFONYLUREAS Reduce blood glucose  Instruct the client to take

Acetohexamide levels by stimulating the medication calmly
Chorpropamide pancreatic insulin and to continue other
Glyburide production and make cell measures (diet,
Glypizide receptor sites more exercise) to decrease
Tolbutamide receptive to circulating blood glucose levels
insulin  Advise the client that
insulin may be needed
during times of
increased stress
 Forewam the client that
possible adverse effects
may include
hypoglycemia

SYNTHETIC Replace adrenocortical;  Inform the client that the

GLUCOCORTICOIDS major activities are medication cannot be
Cortisone metabolic effects on stopped abruptly but

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Dexamethasone carbohydrate, protein, and
Hydrocortisone sodium fat metabolism and anti-
succinate inflammatory and
Methylprednisone immunosuppressive activity
prednisone
THIAZOLIDINEDONES Make muscle cells more
Pioglitazone sensitive insulin,
Rosglitazone maleate decreasing blood glucose
levels
THYROID HORMONE Raise metabolic rate,
Levothyroxine promote gluconeogenesis,
increase use of stored
glycogen, stimulate protein
synthesis, and affect
protein and carbohydrate
metabolism and cell growth
VITAMINS AND Replace therapy for deficit
MINERALS
should be discontinued
gradually to prevent
withdrawal symptoms
and possibly: shock or
death
 Identify signs and
symptoms of cushingoid
effects to report,
including weight gain,
moon face, buffalo
hump, and hirsutism
 Explain that dosage
may need to be
increased during times
of increased stress,
instruct the client to
carry medication or
medical identification
 Instruct the client to take
the medication daily and
to continue other
measures (diet,
exercise) to decrease
blood glucose levels
 Advise the client that
insulin may be needed
during times of
increased stress
 Forewarm the client that
possible adverse effects
may include
hypoglycemia
 Administer in the
morning to avoid
bedtime insomnia
 Instruct the client to
notify his health care
provider of signs and
symptoms of
hypothyroidism and
hyperthyroidism
 Monitor cardiac
response to increased
metabolic rate and
oxygen requirements.
 Observe the client for
symptoms of
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Oral calcium hypercalcemia (nausea,
Vitamin D vomiting, headache,
mental confusion,
anorexia)