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Chapter 35 Agents Affecting Thyroid, Parathyroid, and Pituitary Function
Agents Affecting Thyroid, Parathyroid, and Pituitary Function <ul><li>Goal: maintenance of physiologic stability </li></ul...
Pituitary Gland <ul><li>Consists of: </li></ul><ul><ul><li>Adenohypophysis (anterior pituitary) </li></ul></ul><ul><ul><li...
Hormones secreted by the anterior pituitary (continued)
Pituitary and Thyroid Glands <ul><li>Pituitary gland </li></ul><ul><ul><li>Thyroid-stimulating hormone (TSH) </li></ul></u...
Thyroid Disorders <ul><li>Hyperthyroidism </li></ul><ul><li>Hypothyroidism </li></ul>
Hyperthyroidism <ul><li>Excessive secretion of thyroid hormones </li></ul><ul><ul><li>Increased metabolism   </li></ul></u...
Hyperthyroidism <ul><li>Clinical signs and symptoms </li></ul><ul><ul><li>Skin hot and dry </li></ul></ul><ul><ul><li>Incr...
Antithyroid Drugs <ul><li>Inhibits coupling of iodine </li></ul><ul><ul><li>Prevent T 3  and T 4  formation </li></ul></ul...
Antithyroid Drugs <ul><li>Methimazole and propyithiouracil (PTU) </li></ul><ul><li>Side effects/adverse effects </li></ul>...
Hypothyroidism <ul><li>Decreased secretion of thyroid hormones </li></ul><ul><ul><li>Decreased metabolism   </li></ul></ul...
Hypothyroidism <ul><li>Called  cretinism  in children </li></ul><ul><ul><li>Underdeveloped growth rate </li></ul></ul><ul>...
Hypothyroidism <ul><li>Goal is to replace the thyroid hormone </li></ul><ul><ul><li>Levothyroxine sodium (Synthroid) </li>...
Hypothyroidism <ul><li>Thyroid (levothyroxine sodium) preparations </li></ul><ul><li>Cause interactions </li></ul><ul><ul>...
Client Teaching Tips <ul><li>General client teaching tips for clients with thyroid disorders </li></ul><ul><ul><li>Too hig...
Client Teaching Tips <ul><ul><li>Immediately report chest pain. </li></ul></ul><ul><ul><li>Synthroid takes several weeks t...
Parathyroid Glands <ul><li>Parathyroid </li></ul><ul><ul><li>Pinhead-sized structures located on either side of the thyroi...
Hypoparathyroidism <ul><li>Parathormone deficiency </li></ul><ul><li>Result </li></ul><ul><ul><li>Decreased blood levels o...
Hyperparathyroidism <ul><li>Oversecretion of parathormone </li></ul><ul><li>Result </li></ul><ul><ul><li>Increased blood l...
Pituitary Disorders <ul><li>Hypopituitarism </li></ul><ul><ul><li>Underproduction of pituitary hormones </li></ul></ul><ul...
Pituitary Disorders <ul><li>Hyperpituitarism </li></ul><ul><ul><li>Overproduction of pituitary hormones </li></ul></ul><ul...
Pituitary Disorders <ul><li>Diabetes insipidus </li></ul><ul><ul><li>Caused by a deficiency or total absence of vasopressi...
Antidiuretic Hormone (ADH) <ul><li>Directs the body to retain water and sodium </li></ul><ul><ul><li>Focus is on water ver...
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Chapter 35

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Transcript of "Chapter 35"

  1. 1. Chapter 35 Agents Affecting Thyroid, Parathyroid, and Pituitary Function
  2. 2. Agents Affecting Thyroid, Parathyroid, and Pituitary Function <ul><li>Goal: maintenance of physiologic stability </li></ul><ul><li>Hypothalamus and the pituitary gland </li></ul><ul><ul><li>Form the neuroendocrine system </li></ul></ul><ul><ul><li>Main director is the hypothalamus </li></ul></ul>
  3. 3. Pituitary Gland <ul><li>Consists of: </li></ul><ul><ul><li>Adenohypophysis (anterior pituitary) </li></ul></ul><ul><ul><li>Neurohypophysis (posterior pituitary) </li></ul></ul><ul><li>Linked to the hypothalamus </li></ul><ul><li>Pituitary gland secretes hormones </li></ul>(continues)
  4. 4. Hormones secreted by the anterior pituitary (continued)
  5. 5. Pituitary and Thyroid Glands <ul><li>Pituitary gland </li></ul><ul><ul><li>Thyroid-stimulating hormone (TSH) </li></ul></ul><ul><li>Thyroid gland location: neck </li></ul><ul><ul><li>Produces T 3 and T 4 hormones </li></ul></ul><ul><ul><ul><li>Cellular metabolism </li></ul></ul></ul><ul><ul><li>Produces calcitonin </li></ul></ul><ul><ul><ul><li>Inhibits bone resorption </li></ul></ul></ul>
  6. 6. Thyroid Disorders <ul><li>Hyperthyroidism </li></ul><ul><li>Hypothyroidism </li></ul>
  7. 7. Hyperthyroidism <ul><li>Excessive secretion of thyroid hormones </li></ul><ul><ul><li>Increased metabolism </li></ul></ul>(continues)
  8. 8. Hyperthyroidism <ul><li>Clinical signs and symptoms </li></ul><ul><ul><li>Skin hot and dry </li></ul></ul><ul><ul><li>Increased cardiac and respiratory rates </li></ul></ul><ul><ul><li>Weight loss </li></ul></ul><ul><ul><li>Increased appetite </li></ul></ul><ul><ul><li>Muscle weakness </li></ul></ul><ul><ul><li>Nervousness </li></ul></ul><ul><ul><li>Irritability </li></ul></ul><ul><ul><li>Unable to sleep well </li></ul></ul>(continued)
  9. 9. Antithyroid Drugs <ul><li>Inhibits coupling of iodine </li></ul><ul><ul><li>Prevent T 3 and T 4 formation </li></ul></ul><ul><li>Iodides </li></ul><ul><ul><li>Stop thyrotropin from being active </li></ul></ul><ul><ul><ul><li>Inhibits the production of T 3 and T 4 </li></ul></ul></ul><ul><li>Radioactive isotopes </li></ul><ul><ul><li>Diagnose and treat hyperthyroidism </li></ul></ul><ul><ul><ul><li>Radiation destroys the thyroid gland </li></ul></ul></ul>(continues)
  10. 10. Antithyroid Drugs <ul><li>Methimazole and propyithiouracil (PTU) </li></ul><ul><li>Side effects/adverse effects </li></ul><ul><ul><li>Liver and bone marrow toxicity </li></ul></ul><ul><li>Interactions </li></ul><ul><ul><li>Increased activity of oral anticoagulants </li></ul></ul><ul><ul><li>Additive agranulocytosis when taken with bone marrow depressants </li></ul></ul><ul><li>Therapeutic results </li></ul><ul><ul><li>Normal metabolic rate </li></ul></ul>(continued)
  11. 11. Hypothyroidism <ul><li>Decreased secretion of thyroid hormones </li></ul><ul><ul><li>Decreased metabolism </li></ul></ul><ul><li>Clinical signs and symptoms </li></ul><ul><ul><li>Thickened skin </li></ul></ul><ul><ul><li>Decreased cardiac and respiratory rates </li></ul></ul><ul><ul><li>Weight gain </li></ul></ul><ul><ul><li>Loss of appetite, anorexia </li></ul></ul><ul><ul><li>Muscle weakness </li></ul></ul><ul><ul><li>Lethargy </li></ul></ul>(continues)
  12. 12. Hypothyroidism <ul><li>Called cretinism in children </li></ul><ul><ul><li>Underdeveloped growth rate </li></ul></ul><ul><ul><li>Low metabolic rate </li></ul></ul><ul><ul><li>Mental retardation </li></ul></ul><ul><li>Called myxedema in adults </li></ul><ul><ul><li>Low metabolic rate </li></ul></ul><ul><ul><li>Loss of mental and physical stamina </li></ul></ul><ul><ul><li>Hair loss </li></ul></ul><ul><ul><li>Firm edema </li></ul></ul>(continues) (continued)
  13. 13. Hypothyroidism <ul><li>Goal is to replace the thyroid hormone </li></ul><ul><ul><li>Levothyroxine sodium (Synthroid) </li></ul></ul><ul><li>Widely prescribed synthetic thyroid hormone </li></ul>(continues) (continued)
  14. 14. Hypothyroidism <ul><li>Thyroid (levothyroxine sodium) preparations </li></ul><ul><li>Cause interactions </li></ul><ul><ul><li>Oral anticoagulants: increased anticoagulant effect </li></ul></ul><ul><ul><ul><li>Digitalis: decreased serum levels </li></ul></ul></ul><ul><ul><ul><li>Hypoglycemic agents: decreased effect </li></ul></ul></ul>(continued)
  15. 15. Client Teaching Tips <ul><li>General client teaching tips for clients with thyroid disorders </li></ul><ul><ul><li>Too high of a dose will result in nervousness, irritability, and insomnia </li></ul></ul><ul><ul><li>Keep a log of pulse, weight, and mood status </li></ul></ul><ul><ul><li>Avoid foods high in iodine such as soy, tofu, turnips, seafood, and iodized salt </li></ul></ul>(continues)
  16. 16. Client Teaching Tips <ul><ul><li>Immediately report chest pain. </li></ul></ul><ul><ul><li>Synthroid takes several weeks to months to reach the therapeutic level. </li></ul></ul>(continued)
  17. 17. Parathyroid Glands <ul><li>Parathyroid </li></ul><ul><ul><li>Pinhead-sized structures located on either side of the thyroid gland </li></ul></ul><ul><li>Primary function </li></ul><ul><ul><li>Parathormone secretion </li></ul></ul><ul><ul><ul><li>It promotes bone resorption (breakdown of the bone) </li></ul></ul></ul>
  18. 18. Hypoparathyroidism <ul><li>Parathormone deficiency </li></ul><ul><li>Result </li></ul><ul><ul><li>Decreased blood levels of calcium </li></ul></ul><ul><ul><li>Increased phosphate levels </li></ul></ul><ul><ul><li>Neuromuscular irritability </li></ul></ul><ul><ul><li>Psychiatric disorders </li></ul></ul><ul><li>Treatment </li></ul><ul><ul><li>Replace the calcium </li></ul></ul>
  19. 19. Hyperparathyroidism <ul><li>Oversecretion of parathormone </li></ul><ul><li>Result </li></ul><ul><ul><li>Increased blood levels of calcium </li></ul></ul><ul><ul><li>Decreased phosphate levels </li></ul></ul><ul><ul><li>Kidney stones </li></ul></ul><ul><li>Treatment </li></ul><ul><ul><li>Replace the calcitonin </li></ul></ul><ul><ul><li>Replace the phosphate </li></ul></ul>
  20. 20. Pituitary Disorders <ul><li>Hypopituitarism </li></ul><ul><ul><li>Underproduction of pituitary hormones </li></ul></ul><ul><li>Therapy </li></ul><ul><ul><li>Corticosteroids: a life and death issue </li></ul></ul><ul><ul><li>Thyroid replacement </li></ul></ul><ul><ul><li>Sex hormone replacement </li></ul></ul>(continues)
  21. 21. Pituitary Disorders <ul><li>Hyperpituitarism </li></ul><ul><ul><li>Overproduction of pituitary hormones </li></ul></ul><ul><ul><li>Signs and symptoms: gigantism and acromegaly </li></ul></ul><ul><li>Treatment </li></ul><ul><ul><li>Chemotherapy </li></ul></ul><ul><ul><li>Radiation </li></ul></ul><ul><ul><li>Surgery—inactivation or removal </li></ul></ul>(continues) (continued)
  22. 22. Pituitary Disorders <ul><li>Diabetes insipidus </li></ul><ul><ul><li>Caused by a deficiency or total absence of vasopressin (ADH) </li></ul></ul><ul><ul><li>Signs and symptoms </li></ul></ul><ul><ul><ul><li>Huge urine output (polyuria) </li></ul></ul></ul><ul><ul><ul><li>Increased thirst (polydipsia) </li></ul></ul></ul><ul><ul><ul><li>Hypernatremia (increased sodium) </li></ul></ul></ul><ul><ul><ul><li>Dehydration </li></ul></ul></ul><ul><ul><li>Treatment: antidiuretic hormone </li></ul></ul>(continued)
  23. 23. Antidiuretic Hormone (ADH) <ul><li>Directs the body to retain water and sodium </li></ul><ul><ul><li>Focus is on water versus sodium </li></ul></ul><ul><li>Causes vasoconstriction </li></ul><ul><li>Synthetic ADH drugs </li></ul><ul><ul><li>Lypressin </li></ul></ul><ul><ul><li>Vasopressin </li></ul></ul>
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