My Handy Drug Table - Endocrine

DRUG CLASS and THERAPEUTI ROUTE SIDE ADVERSE EFFECTS NURSING

MOA C ROLE EFFECTS (Underline= most common) IMPLICATIONS/PA
(Red= life threatening) TIENT
EDUCATION/NOTE
S
Lispro Insulin  Antidiabetics  Control of SQ  Endo: HYPOGLYCEMIA  Assess for
 ↓ blood glucose hyperglycemia IV  Local: lipodystrophy, hypoglycemia
 Stims uptake of pruritus, erythema, swelling.  Watch for changes in
glucose in skel.  Misc: allergic reactions wt.
muscle including ANAPHYLAXIS  Monitor blood
glucose q6h
Regular  Antidiabetics  Control SQ  Endo: HYPOGLYCEMIA  Assess for
Insulin  ↓ blood glucose hyperglycemia IV  Local: lipodystrophy, hypoglycemia
 Stims glucose pruritus, erythema, swelling  Watch for changes in
uptake in skel.  Misc: allergic reactions wt.
muscle including ANAPHYLAXIS.  Monitor blood
glucose q6h
NPH Insulin  Antidiabetics  Control SQ  Endo: HYPOGLYCEMIA  Instruct proper
 ↓ blood glucose hyperglycemia  Local: erythema, technique
 Stims glucose lipodystrophy, pruritis,  Instruct about S&S of
uptake in skel. swelling. hyper/hypoglycemia
muscle  Misc: allergic reactions and what to do
including ANAPHYLAXIS.

Insulin  Antidiabetics  Control SQ  Endo: HYPOGLYCEMIA  Asses for S&S of

Glargine  ↓ blood glucose hyperglycemia  Local: lipodystrophy, hypoglycemia
 Stims glucose pruritus, erythema, swelling  Watch for changes in
uptake in skel.  Misc: allergic reactions wt.
muscle including ANAPHYLAXIS.  Monitor blood
glucose q6h
Metformin  Biguanides Maintain blood PO  Abdominal  Metallic taste  Low cost
 ↓hepatic glucose glucose bloating  Anorexia  Promote weight loss
 My Handy Drug Table - Endocrine
production  Diarrhea  Headache  Monitor serum glucose
 ↓ intestinal  Nausea  Dizziness  Monitor for DKA
glucose  Vomiting  Agitation  After 3months, other
absorption  Fatigue antidiabetics may be
 ↑ sensitivity to explored
insulin

Glipizide  Sulfonylureas  ↓ blood sugar PO  Abdominal  CNS: dizziness, drowsiness,  Observe for
 Hypoglycemic in diabetic pain headache, weakness. hypoglycemia
agents patients  Diarrhea  GI: constipation, cramps,  Monitor serum glucose
 ↓ blood sugar by  Flatulence diarrhea, drug-induced  Asses @risk patients for
↑ the release of  Photosensiti hepatitis, dyspepsia, ↑ allergy to sulfonamides
insulin from the vity appetite, nausea, vomiting.
pancreas  hypoglycemi  Derm:, rashes.
 ↑ sensitivity @ a  F and E: hyponatremia.
receptor site  Hemat: APLASTIC ANEMIA,
 ↓hepatic glucose agranulocytosis, hemolytic
production anemia, leukopenia,
pancytopenia,
thrombocytopenia
Rosiglitazone  Thiazolidinediones  ↓ insulin PO  CNS: STROKE  Observe for
 Improves resistance with  CV: HF, MYOCARDIAL hypoglycemia
sensitivity to glycemic control INFARCTION, edema  Asses for edema HF
insulin w/o  EENT: new onset and  Monitor serum
hypoglycemia worsening diabetic macular glucose
 Used in Type II edema
diabetic patients  Derm: urticaria
 GI: hepatitis, ↑ liver enzymes
 Hemat: anemia
 Metab:↑ total cholesterol, LDL
and HDL, weight gain
 Misc: ANGIOEDEMA, fractures
(arm, hand, foot) in female
 My Handy Drug Table - Endocrine
patients

Repaglinide  Meglitinides  ↓ blood PO  CNS: dizziness  Requires functional

 Stims insulin from glucose  Resp: bronchitis, coughing, pancreatic beta cells
pancreatic beta upper respiratory infection  Observe for
cells  GI: diarrhea. Endo: hypoglycemia
HYPOGLYCEMIA  Monitor serum glucose
 MS: arthropathy, back pain  Take @ same time
 Misc: flu symptoms. daily

Acarbose  𝛼-glucosidase  Lowers blood PO  Epidermal  abdominal pain  Observe for

inhibitors glucose in thinning  diarrhea hypoglycemia
 ↓ blood glucose diabetic  Dry skin  flatulence  Monitor serum glucose
by inhibiting patients-  Hypopigme  ↑ transaminases  Take @ same time
alpha- glucosidase especially ntation daily
in GI tract postprandial hyperglycem
 Delays and hyperglycemia ia
reduces glucose
absorption
Exenatide  Glucagonlike  ↑ control of SQ  Diarrhea  CV: dizziness, headache,  Monitor for
peptide-1 blood glucose  Nausea jitteriness, weakness pancreatitis
receptor agonist  vomiting  GI: PANCREATITIS, dyspepsia,  Observe for
 ↑ insulin gastrointestinal reflux hypoglycemia
synthesis&  Endo: THYROID T-CELL  Monitor renal
release TUMORS (extended-release), function
hypoglycemia  Monitor serum
 GU: acute renal failure glucose
 Derm: hyperhidrosis
 Metab: ↓appetite, weight
loss.

Sitagliptin  Dipeptidyl  ↑ control of PO  CNS: headache  Monitor for

peptidase-4 blood glucose  GI: PANCREATITIS, nausea, pancreatitis
 My Handy Drug Table - Endocrine
(DDP-4) diarrhea  Assess for rash
inhibitors  GU: acute renal failure  Take missed doses
 ↑ insulin  Resp: upper respiratory tract STAT
release infection, nasopharyngitis  Stop if pancreatitis/
 ↓ glucagon  MS: arthralgia, back pain, rash occur
secretion myalgia
 ↓ glucose  Misc: allergic reactions
production including ANAPHYLAXIS,
ANGIOEDEMA, EXFOLIATIVE
SKIN CONDITIONS (STEVENS-
JOHNSON SYNDROME), rash,
urticaria.

Glucagon  Hormone  ↑ blood IV  Nausea  CV: hypotension  Asses for

 Stims hepatic glucose IM  vomiting  Misc: hypersensitivity hypoglycemia
production of  Relax GI musc. reactions including  Assess neurological
glucose from  Facilitate ANAPHYLAXIS. status
glycogen stores radiography  Assess nutrition
 Relax musc. Of exam  Asses nausea &
GI tract vomiting
  Monitor serum
glucose
Dextrose 50%  Caloric sources  Provides PO  Endo: inappropriate insulin  Assess hydration
 Provides calories IV secretion (long-term use)  Assess nutrition
calories  Prevention  F and E: fluid overload,  Monitor serum
and treatment hypokalemia, glucose, potassium,
of hypomagnesemia, and phosphate
hypoglycemia hypophosphatemia  Monitor IV site
 Local: local pain/irritation at
IV site (hypertonic solution)
 Metab: glycosuria,
hyperglycemia.
 My Handy Drug Table - Endocrine
Levothyroxin  Hormones  Replacement PO  Usually only seen when  Assess apical pulse
e  Replace/ in IV excessive doses cause and BP
supplement hypothyroidis IM iatrogenic hyperthyroidism  Assess for
thyroid m to restore  CNS: headache, insomnia, tachyarrhythmias
hormones balance irritability and chest pain.
 ↑ metabolic  Suppression  CV: angina pectoris,  Monitor thyroid func
rate of body of thyroid arrhythmias, tachycardia
tissues cancer  GI: abdominal cramps,
 ↑ utilization & diarrhea, vomiting
mobilization  Derm: sweating. Endo:
glycogen stores hyperthyroidism, menstrual
 Promote cell irregularities
growth
 Metab: heat intolerance,
 Aid in
weight loss
development of
 MS: accelerated bone
CNS/Brain
maturation in children

Liothyronine  Hormones  Replacement PO  Usually only seen when  Assess apical pulse
 Replace/ in IV excessive doses cause and BP
supplement hypothyroidis iatrogenic hyperthyroidism  Assess for
thyroid m to restore  CNS: insomnia, irritability, tachyarrhythmias
hormones balance headache and chest pain
 ↑ metabolic  CV: arrhythmias, tachycardia,  Monitor thyroid func.
rate of body angina pectoris
tissues  GI: abdominal cramps,
 ↑ utilization & diarrhea, vomiting
mobilization  Derm: hyperhidrosis
glycogen stores
 Endo: hyperthyroidism,
 Promote cell
menstrual irregularities
growth
 Metab: weight loss, heat
 Aid in
intolerance
development of
 My Handy Drug Table - Endocrine
CNS/Brain  MS: accelerated bone
maturation in children.

Radioactive  Damages/  Differentiate Grave’s

iodine destroys thyroid disease from other
tissue forms of thyroiditis
  Treatment of choice
for non-pregnant
adults
 Delayed response up
to 3 months
Non-  Inhibit synthesis  Used before surgery
radioactive of T3 and T4  Used to treat crisis
iodine  Block release of  Maximal effect 1-2
T3 and T4 from wks
circulation
 ↓vascularity of
thyroid gland