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Kuliah Drug Endocrine Ds
Kuliah Drug Endocrine Ds
Disease
Diabetes Insipidus
Deficiency of ADH
Excessive thirst, large volumes of dilute urine
Can occur secondary to brain tumors, head trauma,
infections of the CNS, and surgical ablation or radiation
Nephrogenic DI—relates to failure of the renal tubules to
respond to ADH. Can be related to hypokalemia,
hypercalcemia and to medications (lithium demeocycline)
Excessive thirst
Urinary sp. gr. of 1.001.1.005
Assessment and Diagnostic Findings
Thyrotoxicosis—nervousness, irritable,
apprehensive, palpitations, heat intolerance, skin
flushing, tremors, possibly exophthalmos
Have an increased sensitivity to catecholamines
Can occur after irradiation or presence of a tumor
Management
Cataracts, glaucoma
Hypertension, heart failure
Truncal obesity, moon face, buffalo hump, sodium
retention, hypokalemia, hyperglycemia, negative nitrogen
balance, altered calcium metabolism
Decreased inflammatory responses, impaired wound
healing, increased susceptibility to infections
Osteoporosis, compression fractures
Peptic ulcers, pancreatitis
Thinning of skin, striae, acne
Mood alterations
Medical Management
If pituitary source, may warrant transphenoidal
hypophysectomy
Radiation of pituitary also appropriate
Adrenalectomy may be needed in case of adrenal
hypertrophy
Temporary replacement therapy with hydrocortisone or
Florinef
Adrenal enzyme reducers may be indicated if source if
ectopic and inoperable. Examples include: ketoconazole,
mitotane and metyrapone.
If cause is r/t excessive steroid therapy, tapering slowly to
a minimum dosage may be appropriate.