NCLEX Meds Endocrine System Part 3 Other Drugs


Part 1 Endocrine System Drugs – Insulin
Part 2 NCLEX Endocrine Medications Oral Hypoglycemics

For Insulin Overdose

The Drug: Glucagon

Expected Action: Increases glycogenolysis, Decreases glycogenesis, Increases gluconeogenesis

Therapeutic Uses: Hypoglycemia 2º insulin overdose, ò GI motility while undergoing radiological procedures of stomach / intestines

Adverse Effects: GI distress (turn on left side to ò risk of aspiration)

Pregnancy: ?

Pheochromocytoma d/t catecholamine stimulating effects
Ineffective for starvation-related hypoglycemia because depleted glycogen stores.

Education: Provide food as soon as patient is able to eat.


Thyroid Hormones

Drug: levothyroxine (Synthroid) Others: liothyronine, liotrix

Expected Action:

Synthetic thyroxine leads to increased metabolic rate, protein synthesis, cardiac output, renal perfusion, oxygen use, body temperature, blood volume, and growth processes.

Therapeutic Uses:

Hypothyroidism (all forms), Emergency treatment of myxedema coma by IV

Adverse Effects: Hyperthyroidism (anxiety, tachycardia, palpitations, increased appetite, heat intolerance, fever, diaphoresis, and weight loss)

Contraindications/Precautions: Pregnancy (A), Thyrotoxicosis and MI, CAUTION with Cardiovascular problems and pregnancy


Levothyroxine breaks down vitamin K ’ ñ Warfarin effects
Many antiseizure and antidepressant meds like carbamazepine, phenytoin, phenobarbital, sertraline ñ levothyroxine metabolism
Binding agents (iron, calcium, antacids, cholestyramine)and sucralfate ò levothyroxine absorption


Antithyroid Medication

Drug: propylthiouracil — Others: methimazole (Tapazole)

Expected Action: Block thyroid hormone synthesis // Prevent oxidation of Iodine // V T4 leads to T3

Therapeutic Uses: Grave’s disease, Adjunct to thyroid irradiation, Produce euthyroid state prior to thyroid removal, Emergency thyrotoxicosis treatment

Adverse Effects:

Overmedication leads to hypothyroidism which can cause (drowsiness, weight gain, edema, bradycardia, cold intolerance, dry skin)

Agranulocytosis Monitor for early signs (fever, pharyngitis) Tx: Neupogen

Contraindications/Precautions: Pregnancy (D), USE CAUTION: Marrow depression or immunosuppression

Interactions: increased anticoagulant effects

Education: Take at consistent time and with meals (decreases GI distress), Hyperthyroidism may get β-adrenergic blocker (propranolol) to decrease tremors


Radioactive Iodine (I131)

Drug: Radioactive iodine

Expected Action: Destroys thyroid cells at high doses

Therapeutic Uses: Hyperthyroidism (ñ dose), Thyroid cancer (ñ dose), ò doses: Thyroid function studies

Adverse Effects: Marrow suppression (anemia, leukopenia, thrombocytopenia), Radiation sickness: Hematemesis, epistaxis, intense nausea, vomiting

Contraindications/Precautions: Pregnancy (X), childbearing age, lactation

Interactions: Reduced uptake with antithyroid meds

Education: Take on empty stomach, Void frequently // Limit contact to ½ hr/day/person // ñ fluids, dispose of body wastes per protocol, avoid coughing and expectorating


Nonradioactive Iodine

Drug: strong iodine solution (Lugol’s solution) — Others: sodium iodide, potassium iodide

Expected Action: increases iodide levels leads to decreased uptake (by thyroid), V thyroid hormone production, and block release of thyroid hormones into blood stream.

Therapeutic Uses: Development of euthyroid state and ò size prior to removal, Emergency treatment of thyrotoxicosis

Adverse Effects: Iodism symptoms d/t corrosive property (metallic taste, stomatitis, sore teeth and gums, gastric distress). – drink through straw // take ĉ food // OD prevention

Contraindications/Precautions: Pregnancy (D)

Interactions: Foods high in iodine (fish, salt) leads to Risk for iodism

Education: Dilute Lugol’s solution with juice to improve taste.


Growth Hormones (Anterior Pituitary)

Drug: Somatropin — Others: Somatrem (Protropin)

Expected Action Stimulate overall growth, production of proteins, and ò use of glucose

Therapeutic Uses: Growth hormone deficiencies, Bulking up so you can hit the long ball…

Adverse Effects: Hyperglycemia (polyphagia, polydipsia, polyuria)

Contraindications/Precautions: Pregnancy(C), Caution: Diabetes leads Risk for hyperglycemia, D/c Tx before epiphyseal closure

Interactions: Glucocorticoids can counteract growth-promoting effects

Education: IM or SC (less painful)


Antidiuretic Hormone

Drug: vasopressin (Pitressin) — Others: desmopressin (DDAVP)

Expected Action: Promote H2O reabsorption in kidneys (desmopressin preferred), Vasoconstriction due to smooth muscle contraction (vasopressin)

Therapeutic Uses: Diabetes insipidus, Cardiac arrest

Contraindications/Precautions: Pregnancy (X), CAD or decreased peripheral circulation (risk for gangrene)

Education: Monitor site carefully; extravasation can cause gangrene.

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