Hormone Study Guide Pharmacology Nursing

7/22/2019 Hormone Study Guide Pharmacology Nursing

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Lecture 11

Hormones -

Role in body, use of each, side effects of each, nsg implications and teaching

Why do you give hormones? To replace when there is an inadequate amount.

Adrenal cortex hormone- GlucocorticoidsCommon drug (PO) - Prednisone

Role of hormone in body

Anti-inflammatory - Prevent release of certain enzymes during vasoconstriction

potentiates vasoconstriction

Carb & protein metabolism- help to provide energy we need for fight or flight

Fat metabolism- mobilize fatty acids and increase plasma levels of fatty acids

(defensive mechanism). Role of stress and weight control

Maintains BP- Potentiating vasoconstriction (keeps BP up)

Use of hormone as a drug

Replaces in body when there is inadequate amount

Allergic reactions (anti-inflammatory)

Collagen disorders

Inflammatory reactions

Respiratory diseases (asthma)

S/E -

Euphoria (intense feelings)

Anxiety

Restlessness, insomnia

Hirsutism (facial hair)


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Adverse effects -

Lowered resistance

Decreased growth in kids

Depression

Weight Gain GI problems

Teaching -

Take before 9AM with food

If they stop taking the drug you need to wean off of it

Warn about changes in appearance (extra fat on face - moon face, hirsutism)

ANY S/S of infections (fever)... Why? Because the drug masks the symptoms

of diseases. Report S/S of GI problems - ex. soft bleeding in stool

Adrenal cortex hormone- Mineralocoricoids

- Fludrocortisone (type of mineralcoricoids)(Primarily aldosterone)

Role of hormone in body

Sodium and H20 reabsorption - Causes us to retain sodium (where sodium goes water

follows)

BP control

Potassium levels- if we are saving sodium we are getting rid of K+

Maintains PH

NSG implications -

Contraindicated with CHF, HTN - why? It causes H20 and sodium retention

which will make your CHF and HTN worse.

Monitor weight and BP


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Monitor NA+ and K+ levels

Put them on Low Na diet

Make sure they supplement K+ into their diet. Perhaps with KCl (very salty)

Anti-adrenalDrug is taken when adrenal gland is putting out too much hormone

Common drug - aminogluethimide

Treats Cushings Syndrome -

Watch for Hypotension - lowers BP, at risk for falls

Body is unable to respond to stress. Be aware that the pt needs to be off this

drug before surgery.

Highly recommend pt wear bracelet so that if there is an emergency and they go

to the ER for surgery the healthcare professionals are aware.

Thyroid hormoneThyroid gland deals mostly with metabolism

Role of drug in body - to treat hypothyroidism

Use as a drug

Treats hypothyroidism - not enough thyroid hormone in the body Prevent and treat goiter - enlarged thyroid gland

Replacement of thyroid hormone after thyroidectomy

Used for diagnostic tests


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NSG implications -

Assessment of elderly patients - more sensitive to effects of drug

Report heat intolerance, increased pulse, chest pain or nervousness (all signs

of hyperthyroidism ...they are taking too high of a dose)

Patient teaching -

Daily dose should be given 1-1.5 hours before breakfast.

If you miss a dose dont double up, take it the next day.

Tell patient taking the drug is a lifelong therapy

Needs to take BP and pulse regularly Tell them to HOLD the medication if P is >100

Is the thyroid hormone drug working?

- Rather than looking at lab values monitor for mental and physical happiness.

- Monitor for thyroid stimulating hormone (TSH):

If TSH is highthe patient needs more thyroid hormone drug.

If TSH is lowthe patient has enough thyroid hormone in the body

Anti -thyroid hormoneThyroid gland deals mostly with metabolism

Common drug - thioamides

Role of drug in body - to treat hyperthyroidism

NSG implications -


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Monitor thyroid function

Use cautiously in pregnant women

Can cause adverse bone marrow (anemic, cant fight infection)

Teaching -

Restrict iodized salts, restrict seafood diet (yes to freshwater fish), avoid tofu

and soy products cause they have a lot of iodine

Report to healthcare prof about fevers, skin problems, sore throat (these are

signs of bone marrow toxicity)

Take meds with snack to prevent GI problems

Female hormonesEstrogen & Progestin

Estrogen

Use as a drug

Deficiency of estrogen in women

Used to treat breast cancer for post-menopausal women with estrogen negative

tumors

Advances prostate cancer

Prevent osteoporosis in post menopausal women

CAUTION!

- High doses of Estrogen can increase your chances of getting endometrialcancer, use low doses for long term use and pair with progesterone to reduce

chances.

- Contraindicated with pregnancy. Can cause deformability in baby.

- Contraindicated for breast feeding. Estrogen inhibits lactation.

Administration:


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PO

vag supp, vag cream

IM

Progestin

Use as a drug

Hormone deficiency r/t amenorrhea (menopause) or dysmenorrhea (painful periods)

Endometriosis (cells from the uterine wall grow outside the uterus)

Treatment of endometrial cancer, breast cancer, renal cancer, prostate cancer.

S/E -

Fluid retention

Thrombophlebitis


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Administration routes:

patches, vag ring

progestin only IM q3 months (depo-provera)

Contraindicated:

known drug allergy

pregnancy

high risk or had thromboembolic events

S/E -

Headaches

Weight gain

Hypertension Thrombophelitis - pulm embolism, stroke, MI

Patient Teaching -

Antibiotics, barbiturates (sleep anxiety drugs) , TB meds ... all decrease the

effectiveness of contraceptions

Contraceptions themselves decrease the effectiveness of:

beta blockers hypnotics,

hypoglycemic agents (diabetic meds),

oral anticoagulants,

theophylline (respiratory meds),

vitamins

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Hormone Study Guide Pharmacology Nursing