Deck 15: Drugs for the Endocrine System

Question 1

List examples of oral hypoglycemics used for diabetes treatment and explain how they work.

Answer 1

Hypoglycemic drugs are commonly used in type 2 diabetes to reduce the blood sugar. This group of drugs can be classified into various classes, each having a specific action of its own.
Oral hypoglycemics can be classified into three types:
1. First-generation sulfonylureas
How they work: These affect the blood glucose by causing the beta cells of the islets of Langerhans to secrete more insulin.
Examples of this type are Orinase, Tolinase and Diabinese.
2. Second-generation sulfonylureas
How they work: The second-generation sulfonylureas work in similar manner to the first-generation, but they are considered to be more potent than the first-generation type.
Examples of this type are Glipizide (Glucotrol), Glimepiride (Amaryl), Glyburide (DiaBeta, Micronase).
3. Miscellaneous oral hypoglycemics
These include:
i. Meglitinides such as Repaglinide (Prandin) and Nateglinide (Starlix).
How they work: Their mode of action like the sulfonylureas.
ii. Alpha-glucosidase inhibitors like Acarbose (Precose) and miglitol (Glyset).
How they work : They act by lowering the blood glucose blocking enzymes that cause breakdown of carbohydrates and absorb glucose. This slows down the carbohydrate breakdown and glucose absorption mechanisms.
iii. Thiazolidinediones like Pioglitazone (Actos) and Rosiglitazone (Avandia).
How they work : They increase the flow of glucose into the muscles, fat and liver, which in turn, stimulates insulin activity.
iv. DPP-4 inhibitors like Sitagliptin (Januvia) and linagliptin (Tradjenta).
How they work : They stimulate insulin release and reduce glucose secreted by the liver.

Question 2

Complete the following statements by filling in the blanks.
Diabetes insipidus is caused by a lack of the _______________ hormone.

Answer 2

The hormone that acts to regulate the water balance in the body by controlling the loss of water in the urine is known as Anti-diuretic hormone (ADH). The ADH consists of two compounds: exogenous and endogenous.
The endogenous compound is known as ADH while on the other side exogenously administered synthetic drug is known as vasopressin. In the condition where the person doesn't consist of ADH the collecting ducts of nephron become virtually impermeable to water.
In that situation all the water gets excreted into the urine and the person suffer from a medical condition known as Diabetes Insipidus. In this water is lost from the body in large volume since the frequency of urination gets increased. This condition is described in the medical terminology as polyuria.
The treatment of the rare medical condition Diabetes Insipidus (DI) might involve replacement therapy by the use of synthetic vasopressin. The vasopressin injection is available in the trade name of Pitressin Synthetic and Desmopressin is available in acetate form in an abbreviated name DDAVP.
Hence, the condition Diabetes Insipidus (DI) is caused by the lack of the hormone
.

Question 3

Answer the following questions in the spaces provided.
When combining Humulin N insulin and Humulin R insulin in the same syringe, which insulin should be drawn up first ______________________________________________________
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Answer 3

The drug Humulin N is an example of intermediate-acting insulin. The Humulin N consists of protamine which is a protein that prolongs the action of insulin. The onset of action of Humulin N is within 1 to 2 hours of administration and the action of drug reaches peak level within 4 to 12 hours.
The duration of action i.e. action of Humulin N lasts for 18-24 hours. This means that this insulin exerts its therapeutic effect till 18 hours of administering the insulin. This is the reason that Humulin N is categorized as intermediate acting preparations.
Regular human insulin is also known as Humulin R and is the only preparation that is found to be compatible with all other human insulin's. It is possible to draw two different types of insulin in the same syringe if one of the types is regular insulin. Therefore regular insulin should be drawn first.

Question 4

Case Studies
Corticosteroids have been prescribed for a patient as a hormone replacement. The patient's adrenal cortex does not function properly. What condition do you suspect the patient may have What are other conditions that may require corticosteroids What are the side effects you should watch the patient for
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Question 5

Define each of the terms listed below.
Glycogen _________________________________________________________________

Question 6

Complete the following statements by filling in the blanks.
Addison's disease is caused by a long-term lack of _______________ hormones.

Question 7

Match these drugs to their uses.
ACTH
a. replacement of pituitary hormone that stimulates production of corticosteroids
b. inflammatory diseases, allergic reaction, replacement of corticosteroids
c. diabetes insipidus
d. diabetes mellitus

Question 8

Critical Thinking
Patients with diabetes who are on insulin must live with the risk of insulin overdose or underdose. Decide which of these two problems is signaled by each set of symptoms below. Give the usual treatment for each.

Question 9

Recognize the symptoms of hyperglycemia and hypoglycemia and explain how they are treated.

Question 10

The following drugs are used in the management of diabetes mellitus. Next to each drug, place the letter that tells what drug group it belongs to, as follows:

Ultralente

Question 11

Match these drugs to their uses.
vasopressin tannate
a. replacement of pituitary hormone that stimulates production of corticosteroids
b. inflammatory diseases, allergic reaction, replacement of corticosteroids
c. diabetes insipidus
d. diabetes mellitus

Question 12

Critical Thinking
Patients with diabetes who are on insulin must live with the risk of insulin overdose or underdose. Decide which of these two problems is signaled by each set of symptoms below. Give the usual treatment for each.

Question 13

Match these hormones to their functions
Somatotropin
a. prepare the body to cope with stress
b. keeps the kidneys from excreting too much urine
c. regulates growth
d. supress inflammation
e. regulates the amount of calcium in the blood

Question 14

The following drugs are used in the management of diabetes mellitus. Next to each drug, place the letter that tells what drug group it belongs to, as follows:

_________ NPH

Question 15

Match these drugs to their uses.
Solu-Medrol, prednisone, Florinef
a. replacement of pituitary hormone that stimulates production of corticosteroids
b. inflammatory diseases, allergic reaction, replacement of corticosteroids
c. diabetes insipidus
d. diabetes mellitus

Question 16

Obtain a current copy of the PDR from your school, nursing unit, or clinic. Use it to answer the following questions in a notebook or on file cards.
Use the PDR to find another product name for each drug in the Representative Hormones and Hormonelike Drugs table in this chapter.

Question 17

State what factors affect the insulin needs of a patient with diabetes mellitus.

Question 18

The following drugs are used in the management of diabetes mellitus. Next to each drug, place the letter that tells what drug group it belongs to, as follows:

_________ Diabinese

Question 19

Match these drugs to their uses.
rosiglitazone, Dymelor, Januvia
a. replacement of pituitary hormone that stimulates production of corticosteroids
b. inflammatory diseases, allergic reaction, replacement of corticosteroids
c. diabetes insipidus
d. diabetes mellitus

Question 20

Obtain a current copy of the PDR from your school, nursing unit, or clinic. Use it to answer the following questions in a notebook or on file cards.
In Section 3 of the PDR , Product Category Index, find Hypoglycemic Agents/Diabetes Agents. Make a list of all the oral hypoglycemic agents you see listed there.

Question 21

Match these hormones to their functions
Parathyroid hormone
a. prepare the body to cope with stress
b. keeps the kidneys from excreting too much urine
c. regulates growth
d. supress inflammation
e. regulates the amount of calcium in the blood

Question 22

The following drugs are used in the management of diabetes mellitus. Next to each drug, place the letter that tells what drug group it belongs to, as follows:

_________ Regular insulin

Question 23

Drug Calculations
The physician orders Novolin R Regular U-100 insulin 8 U with Novolin N U-100 insulin 20 U subcutaneously before breakfast. Describe the setup procedure and prepare to administer _______________ units to your patient.

Question 24

List the hormones produced by the seven major glands.

Question 25

Describe the procedure for administering regular and intermediate acting insulin in one syringe.

Question 26

The following drugs are used in the management of diabetes mellitus. Next to each drug, place the letter that tells what drug group it belongs to, as follows:

_________ Humulin N

Question 27

Drug Calculations
The physician orders metformin ( Glucophage ) 2500 mg orally daily. Available are 1000-mg tablets. You will administer _______________ tablets to your patient.

Question 28

Define each of the terms listed below.
Tetany ____________________________________________________________________

Question 29

Match these hormones to their functions
Corticosteroids
a. prepare the body to cope with stress
b. keeps the kidneys from excreting too much urine
c. regulates growth
d. supress inflammation
e. regulates the amount of calcium in the blood

Question 30

The following drugs are used in the management of diabetes mellitus. Next to each drug, place the letter that tells what drug group it belongs to, as follows:

_________ Tolbutamide

Question 31

Drug Calculations
The physician orders levothyroxine sodium ( Synthroid ) 0.5 mg orally daily. Available are 25-mcg tablets. You will give your patient _______________ tablets.

Question 32

State the action of each of these hormones or hormone like drugs: somatotropic hormone, thyroxine, parathyroid, corticosteroids, epinephrine (adrenaline) and norepinephrine, insulin, adrenocorticotropic hormone, and antidiuretic hormone.

Question 33

List at least three uses of corticosteroids.

Question 34

The following drugs are used in the management of diabetes mellitus. Next to each drug, place the letter that tells what drug group it belongs to, as follows:

_________ Humulin R

Question 35

Drug Calculations
The physician orders prednisone ( Deltasone ) 15 mg orally bid. Available are 10-mg tablets. You will give your patient _______________ tablets.

Question 36

Define each of the terms listed below.
Glycosuria ________________________________________________________________

Question 37

Match these hormones to their functions
Epinephrine and norepinephrine
a. prepare the body to cope with stress
b. keeps the kidneys from excreting too much urine
c. regulates growth
d. supress inflammation
e. regulates the amount of calcium in the blood

Question 38

The following drugs are used in the management of diabetes mellitus. Next to each drug, place the letter that tells what drug group it belongs to, as follows:

_________ Semilente

Question 39

Drug Calculations
The physician orders metformin ( Glucophage ) 2 g orally daily. Available are 1000-mg tablets. You will administer _______________ tablets to your patient.

Question 40

State which hormones are lacking in the condition of diabetes mellitus, diabetes insipidus, Addison's disease, and hypothyroidism, and give examples of drugs used for replacement in each case.

Question 41

Identify five possible side effects of long-term corticosteroid therapy.

Question 42

The following drugs are used in the management of diabetes mellitus. Next to each drug, place the letter that tells what drug group it belongs to, as follows:

_________ Lantus

Question 43

Circle the correct letter.
When a patient is taking levothyroxine sodium ( Synthroid ), which of the following side effects should you monitor for

A) Weight gain, moon face, muscle weakness
B) Nausea, vomiting, dizziness
C) Palpitations, weight loss, tachycardia
D) Tremor, abdominal cramps, drowsiness

Question 44

Define each of the terms listed below.
Hypoglycemia _____________________________________________________________

Question 45

Match these hormones to their functions
ADH
a. prepare the body to cope with stress
b. keeps the kidneys from excreting too much urine
c. regulates growth
d. supress inflammation
e. regulates the amount of calcium in the blood

Question 46

Answer the following questions in the spaces provided.
What is the main action of the oral hypoglycemics ______________________________
___________________________________________________________________________________
___________________________________________________________________________________

Question 47

Circle the correct letter.
Which of the following directions should you follow when administering insulin

A) Use an insulin syringe to draw up the insulin.
B) Keep the insulin in the refrigerator.
C) Shake the vial of insulin to make sure it is mixed.
D) Massage the site after the insulin is administered.

Question 48

State the correct medical terms in referring to parts of the endocrine system and symptoms of hormone imbalances.

Question 49

Solve calculations on drug for the endocrine system.

Question 50

Answer the following questions in the spaces provided.
What are three factors that bring about changes in the diabetic patient's need for insulin
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Question 51

Circle the correct letter.
LO 15-2) A patient asks you why prednisone ( Deltasone ) has been prescribed. What is the most appropriate answer to give the patient

A) Regulate growth
B) Regulate the blood sugar
C) Replace the deficient hormone
D) Suppress inflammation

Question 52

Define each of the terms listed below.
Insulin ___________________________________________________________________

Question 53

Complete the following statements by filling in the blanks.
The gland that traps iodine while producing its hormone is the _______________ gland.

Question 54

Answer the following questions in the spaces provided.
What is the difference between glucocorticoids and mineralocorticoids _____________
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Question 55

Circle the correct letter.
How long does it take for Humalog insulin to start working in the body

A) 15 minutes
B) 30 minutes
C) 1 hour
D) 4 hours

Question 56

List the types of insulin available for treatment of diabetes mellitus, and give examples of each group.

Question 57

Complete the following statements by filling in the blanks.
The glands that sit on top of the kidneys are the _______________ glands.

Question 58

Answer the following questions in the spaces provided.
List all the uses you can think of for corticosteroids. ____________________________
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Question 59

Circle the correct letter.

A) Euphoria, insomnia
B) Delayed wound healing, muscle weakness
C) GI upset, diarrhea or constipation
D) Headache, palpitations

Question 60

Define each of the terms listed below.
Glucagon _________________________________________________________________

Question 61

Complete the following statements by filling in the blanks.
Diabetes mellitus is caused by a lack of the hormone _______________.

Question 62

Answer the following questions in the spaces provided.
Now list the possible side effects of long-term use of corticosteroids. ______________
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Question 63

Case Studies
A patient with diabetes mellitus received Novolin R Regular U-100 6 U subcutaneously at 0700. At 0900, he begins to experience shakiness, nervousness, heart palpitations, and blurred vision. What should you do What is the usual treatment
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