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Pharmacology in Nursing Pituitary Drugs

Pharmacology in Nursing Pituitary Drugs. Neuroendocrine System: Pituitary Hormones. Hypothalamus Part of the CNS Pituitary gland Anterior pituitary (adenohypophysis) Posterior pituitary (neurohypophysis) Together, govern all bodily functions Hormones Negative feedback loop.

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Pharmacology in Nursing Pituitary Drugs

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  1. Pharmacology in NursingPituitary Drugs

  2. Neuroendocrine System:Pituitary Hormones • Hypothalamus • Part of the CNS • Pituitary gland • Anterior pituitary (adenohypophysis) • Posterior pituitary (neurohypophysis) • Together, govern all bodily functions • Hormones • Negative feedback loop

  3. Pituitary Drugs • Anterior pituitary drugs • corticotropin • somatotropin • Posterior pituitary drugs • vasopressin • somatrem • octreotide • desmopressin

  4. Uses • Replacement therapy to make up for hormone deficiency • Drug therapy to produce a specific hormone response when a hormone deficiency is present • Diagnostic aids to determine hypofunction or hyperfunction of a specific hormonal function

  5. Mechanism of Action • Differs depending on the drug • Either augments or antagonizes the natural effects of the pituitary hormones

  6. Indications • corticotropin • Stimulation of release of cortisol from adrenal cortex • Used to diagnose, but not treat, adrenocortical insufficiency • Multiple sclerosis • Corticotropin insufficiency caused by long-term corticosteroid use

  7. Indications (cont’d) • somatropin and somatrem • Recombinantly made growth hormone (GH) • Stimulate skeletal growth in patients with deficient GH, such as hypopituitary dwarfism

  8. Indications (cont’d) • octreotide (Sandostatin) • Carcinoid tumors secrete VIP (vasoactive intestinal polypeptide) • VIP causes profuse, watery diarrhea • Octreotide reduces this severe diarrhea, flushing, and potentially life-threatening hypotension that may occur with a carcinoid crisis • Unlabeled use: Control bleeding in esophageal varices

  9. Indications (cont’d) • vasopressin and desmopressin • Used in the treatment of diabetes insipidus • Used in the treatment of various types of bleeding, especially GI bleeding • desmopressin is useful for: • Hemophilia A • Type I von Willebrand’s disease

  10. Adverse Effects Corticotropin: Sodium retention, hypokalemia, hyperpigmentation, convulsions, euphoria, psychosis Vasopressin: High BP, headache, flushing

  11. Nursing Implications • Obtain thorough nursing assessment, medication history • Assess for contraindications specific to each drug • Assess medication history for possible interactions

  12. Nursing Implications (cont’d) • corticotropin • IM, SC, IV forms, and gel and repository forms • Follow directions carefully for administration • Maintain adequate hydration • Sodium and potassium intake should be decreased • Avoid vaccinations during drug therapy

  13. Nursing Implications (cont’d) • Provide specific instructions for nasal spray forms of lypressin and vasopressin • Rotate injection sites • Drugs should not be discontinued abruptly • Do not take OTC products without checking with health care provider

  14. Nursing Implications (cont’d) • Parents of children who are receiving growth hormones should keep a journal reflecting the child’s growth

  15. Nursing Implications (cont’d) • Monitor for therapeutic responses • Corticotropin should eliminate pain associated with inflammation and produce increased comfort and muscle strength in patients with multiple sclerosis • Somatropin should increase growth in children • Desmopressin, vasopressin should reduce severe thirst and decrease urinary output • Octreotide should reduce symptoms of carcinoid crisis • Monitor for adverse effects

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