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Topic 7 Drugs affecting the ENDOCRINE SYSTEM

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Topic 7 Drugs affecting the ENDOCRINE SYSTEM How Metabolism is controlled and mediated by hormones Many disorders are due to either over or under secretion of a ... – PowerPoint PPT presentation

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Title: Topic 7 Drugs affecting the ENDOCRINE SYSTEM


1
Topic 7Drugs affecting the ENDOCRINE SYSTEM
2
How Metabolism is controlled and mediated by
hormones
  • Many disorders are due to either over or under
    secretion of a hormones
  • Endocrinology
  • Can potentiate normal hormonal action
  • Inhibit hormonal action.

3
Drugs affecting THYROID gland
  • Thyroid gland produces hormones Thyroxine and
    triiodothyronine which influence growth,
    development and metabolism.
  • Production of these hormones depends on the
    thyroid gland receiving iodine from the body

4
HYPOTHYROIDISM
  • Decrease in thyroid activity caused by
  • 1. Hashimotos thyroiditis (Auto immune
    disorder.)
  • 2. Myxoedema If hypothyroidism not treated
  • 3. Iodine deficiency.
  • 4. Radioactive iodine ingestion.
  • 5. Atrophy of thyroid gland.
  • 6. Surgical removal of all or part of gland.

5
SIGNS AND SYMPTOMS
  • Tiredness
  • Lethargy
  • Weight Gain
  • Intolerance to heat
  • Dry skin
  • Bradycardia
  • Mental impairment

6
HYPOTHROIDISM
  • NURSING IMPLICATIONS.
  • Monitor symptoms related to BMR
  • Monitor heart rate, reporting tachycardia and
    palpitations.
  • Education re life long treatment of deficient
    hormones.
  • Diabetics need to monitor BSL as insulin or oral
    hypoglycaemics may need increasing.

7
HYPERTHROIDISM(Thyrotoxicosis)
  • Overproduction of thyroid hormone.
  • Graves Disease is an example of hyperthyroidism.
    More common in women than in men and occurs
    between 20-40 years of age and often arises after
    emotional or physical stress or infection.

8
SIGNS AND SYMPTOMS
  • Exophthalmos
  • Tremor
  • Nervousness
  • Constant hunger
  • Weight loss
  • Fatigue
  • Heat tolerance
  • Palpitations

9
Drugs for ADRENAL CORTEX problems.
  • 3 Naturally occurring Groups
  • Mineralocorticoids. Electrolyte and water
    balance. Natural occurring is aldosterone.
  • Glucocorticoids. Affect fat, protein and
    carbohydrate metabolism and also have an
    anti-inflammatory effect.
  • Gonadocorticoids, sex hormones.

10
Mineralocorticoids
  • These drugs primarily responsible for regulating
    sodium and potassium in the body.
  • Treat adrenocortical insufficiencies.
  • Potent immunosuppressants, prevent organ
    transplant rejection
  • Lung maturation in premature infants
  • Aldosterone, causes Sodium and Water retention
    increases blood volume and BP
  • Fludrocortisone (Florinef)

11
GLUCOCORTICOIDS
  • Classified according to their duration of action
  • Increases blood glucose, mobilizes fats,
    stimulates protein catabolism, depresses
    immunity, and inflammatory responses.
  • Natural Hydrocortisone
  • Synthetic All others, prednisone

12
Examples
  • Betamethasone
  • Dexamethasone
  • Prednisone
  • Flixotide
  • Betnovate cream

13
Effects
  • Euphoria, psychiatric problems
  • Fluid retention, electrolyte imbalance
  • Delayed wound healing, bruising, acne
  • Fungal infections exacerbated
  • Hyperglycaemia, insomnia
  • Increased appetite, obesity
  • Osteoporosis (long term effect)
  • Cushings syndrome (Metabolic disorder resulting
    from chronic and excessive production of cortisol
    by the adrenal cortex.

14
CUSHINGS SYNDROME
  • SIGNS SYMPTOMS
  • 1. Moon Face
  • 2. Buffalo hump
  • 3. Depression
  • 4. Anxiety
  • 5. Menstrual irregularities
  • 6. Acne

15
Nursing Implications
  • Monitor BP
  • Inhaled steroids, wash mouth
  • IMI deep
  • Not withdrawn immediately, tapered over at least
    2 weeks
  • BSL monitoring
  • Taken with food

16
Gonadocorticoids
  • Oestrogen only preparations
  • Replacement (menopause)
  • Morning after pill
  • Induces uptake of Ca into bone, therapy for
    menopausal women with osteoporosis
  • S.E. breast tenderness, Fluid retention,
    thrombosis

17
Gonadocorticoids
  • Progesterone only preparations
  • Suppress ovarian function
  • Mini pill
  • S.E. similar to Oestrogen only symptoms

18
Gonadocorticoids
  • Oral contraceptives
  • Combination
  • S.E. thromboembolism, heart disease, CVA, liver
    disease

19
Gonadocorticoids
  • Androgens (testosterone),
  • Treat deficiencies.
  • Nandrolone, a anabolic androgen, Produces
    masculinising effect

20
Drugs used in disorders of the PANCREAS
  • When the pancreas no longer secrete sufficient
    effective insulin the glucose cannot enter the
    cells.
  • NIDDM, IDDM, Glucogon.
  • Glucagon acts on the liver to increase blood
    glucose levels by stimulating the breakdown of
    glycogen into glucose, and amino acids and free
    fatty acids

21
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22
INSULIN
  • IVI, S/C, IMI (rare).
  • Short medium or long acting.
  • Observe for Hypoglycemic episodes
  • Requirements may vary with pregnancy, infections,
    stress,
  • Never change type quickly.

23
HYPOGLCEMIA
  • Do you know the signs and symptoms of a hypo ?

24
Oral Hypoglycaemic agents2 types
  • Sulfonylureas, (Daonil)
  • 1 Stimulates insulin secretion
  • 2 inhibits gluconeogenesis (forming glucose
    from amino acids and fatty acids)
  • 3 increases the number of insulin receptors in
    the target cells
  • Biguanide, (Metformin) acts by promoting glucose
    uptake into cells .
  • Used in precaution with renal disorders

25
Nursing Implication
  • Monitor BSL
  • Reduced tolerance to alcohol and need to restrict
    intake
  • Pt to carry medi alert tag
  • Educate family
  • Monitor liver enzymes

26
Drugs used on disorders of the PARATHYROID
  • Calcitonin (Decreases) (thyroid) and parathyroid
    (Increases) blood Calcium.
  • Calcitonin inhibits bone reabsorption
  • S/E dose related nausea and vomiting, local
    inflammation at inj site, alopecia, headache,
    Oesopageal pain,
  • Alendroate (Fosamax), increases Ca level. Avoid
    laying flat ½ hour after ingestion

27
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28
Posterior Pituitary Hormones
  • Antidiuretic Hormone (ADH) Vasopressin
  • Cannot be administered orally.
  • Oxytocin, smooth muscle stimulant, used to
    initiate labour.
  • Oxytocin

29
Identification of Drugs
  • Daonil
  • Actrapid
  • Prednisilone
  • Metformin
  • Syntocinon
  • Thyroxin

30
Identification of Drugs
  • Tolbutamide
  • Gliclazide
  • Dexamethasone
  • Humalin 7030
  • Pulmicourt
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