Endocrine Disorder Chart Pharm

ENDOCRINE DISORDER CHART Hormone Excess or deficit Signs/Symptoms Electrolyte Issues Labs/ Diagnostics (if applicable) (if applicable) Treatment/Diet Growth Hormone Deficit = dwarfism Deficit: Body is still proportional just small. Deficit: Tx with growth hormone replacement therapy. Med: Somatropin; ADR: hyperglycemia, hypothyroidism. Growth Hormone Excess = gigantism/acr omegaly Excess: Too much GH prior to puberty = gigantism, increase in height 7-8 feet. Fatal due to heart failure. If too much after puberty = acromegaly; sx of bone and tissue enlargement, muscle weakness. Excess: Gigantism treat with GH inhibitor. Med: octreotide (also used for GI problems) Anitdiuretic hormone (ADH) Deficit = Diabetes Insipidus (pituitary problem) Sx: excessive fluid loss from polyuria with dilute urine and concentrated blood. Acromegaly treatment normally involves surgical removal of pituitary. Hypernatremi a due diabetes insipidus. Tx: replacement hormone Meds: Vasopressin: natural hormone in injectable form for diagnostic purposes or emergency (also used for GI bleeding due to esophageal varices b/c it’s also a potent vasoconstrictor) Desmopressin: synthetic hormone, given intranasal form for maintenance therapy. ADRs: HTN, angina, headache, abdominal cramping. Anitdiuretic hormone (ADH) Excess= SIADH (Syndrome of Inappropriate Antidiuretic hormone) Sx: hyponatremia and CNS dysfunction (confusion and seizures due low sodium) Hyponatremia Tx: Correct underlying issue; head injury, pituitary tumor or certain ling cancers. Meds: Samsca: 1X dose, 2nd dose only if needed (must euvolemic and hyponatremic) ** Seizure Pre-caution** Mech: Reabsorbs Na+ in kidney while excreting water. Nur. Cons: Monitor I&O, VS, cont. seizure precautions and sodium levels, NO fluid restriction. ENDOCRINE DISORDER CHART Hormone Excess or deficit Excess = Signs/Symptoms Sx: tremors, Electrolyte Issues Labs/ Diagnostics (if applicable) (if applicable) Treatment/Diet Tx: Anti-thyroid drugs (short term due to toxicity). Primary ADR of any anti-thyroid med is Thyroid Hyperthyroidi sm; Too much metabolism nervousness, weight loss, tachycardia, warm and flushed skin, intolerance to heat, GI distress, exophthalmus. hypothyroidism. Meds: propylthiouracil (PTU): inhibits production of hormones Iodide solutions (Lugol’s solution; SSKI): Inhibit release of stored hormones. SE of iodine toxicity Radioactive iodine: for pts that are not good surgical candidates or for diagnostic purposes. Beta blockers: control symptoms to stabilize patient Thyroid Deficit= hypothyroidis m; Too little metabolism Sx: Lethargy, weight gain, brady cardia, cool and dry skin, intolerance to cold, constipation, atherosclerosis. Tx: Involves thyroid replacement therapy. ADR: Hyperthyroidism. Monitor: HR/BP during therapy. Teach patient to check resting pulse. Only needs periodic thyroid function study once a year. Note: Meds are light sensitive; don’t switch meds. Taken on an empty stomach (30 min before eating) and in the morning to prevent insomnia Meds: Levothyroxine: synthetic T4 (Most common) Liothyroine: synthetic T3 (More potent) Liotrix Parathyroid Parathyroid Deficit: Too little calcium = too little neuromuscula r activity Sx: Symptoms of hyperneuromuscul ar activity (spasms); also, osteoporosis and bone fractures, possibly bleeding difficulties. Hypocalcemia Excessive: Hyperparathyr oidism Sx: hyponeuromuscula r activity (weakness); also, osteoporosis as result of pulling of calcium from bones into blood; kidney stones & calcium deposits. Hypercalcemia Treat with calcium replacement as well as vitamin D3 replacement. OTC calcium- Tums Vitamin D3 analog- calcitriol, zemplar Tx: **Most commonly used to treat with surgery (parathyroidectomy) but may use drugs which antagonize PTH Meds: (to lower calcium in blood) Calcitonin-salmon Etidronate Plicamycin Cinacalcet ADRs: hypocalcemia and bleeding abnormailities ENDOCRINE DISORDER CHART Hormone Excess or Signs/Symptoms Electrolyte Labs/ Treatment/Diet deficit Issues (if applicable) Adrenal Gland Adrenal Gland EXCESS = CUSHIING SYNDROME DEFICIT = ADDISON’S DISEASE Pheochrom ocytoma *Adrenal Tumor Diagnostics (if applicable) Sx: fluid retention, hyperglycemia, HTN, thin extremities with muscle wasting, “buffalo hump”, “moon face” with reddened cheeks, gastric hyperacidity. Glucose monitoring Tx: primarily by adjustment in steroid therapy if that is cause, or Adrenalectomy if primary disease. Do not stop abruptly. Sx: hypoglycemia, dehydration, hyponatremia, hyperkalemia, inability to respond to stress Glucose montioring Tx: Hormone replacement therapy with cortisol like drugs: “steroids” Sx: High blood pressure, headache, profuse sweating, tachycardia, SOB. Meds: Glucocorticosteroids Prednisolone Dexamethasone Solu-Medrol Treatment: Surgical removal of the tumor, targeted treatment with radiation or chemo.