Endocrine

• Oral antihyperglycemics


  Medications used to improve insulin sensitivity, stimulate insulin secretion from the pancreas, or reduce glucose production in the liver
• Oral antihyperglycemics do not provide insulin replacement
• Oral antihyperglycemics can exacerbate risk of DKA in patients with DM1
• Oral antihyperglycemics can't be used for DM1 because they don't produce insulin
• 15-15 rule for diabetes

  15 grams of fast acting carbs, wait 15 mins & check blood sugar again, keep repeating if sugar under 70, helps quickly raise sugar when having hypoglycemic episode
• Cushing's disease medications


  Periactin interferes with ACTH, ketoconazole & mifepristone (antifungals) decreases cortisol production
• Addison's disease medications


  Hormone replacement therapy, Glucocorticoid & mineralocorticoid replacement
• Symptoms of thyroid storm

  • high fever, agitation, delirium, congestive heart failure, loss of consciousness, persistent thirst, itchiness, loss of interest in sex, nervousness, anxiety, hyperactivity, mood swings, difficulty sleeping, feeling tired all the time, sensitivity to heat, muscle weakness, diarrhea, frequent urination
• Symptoms of hypothyroidism


  • fatigue, weight gain, cold intolerance, joint pain, depression, difficulty concentration/memory problems, menstrual problems/irregularities, brady, goiter (enlarged thyroid gland)
• Symptoms of myxedema coma

  • decreased mental status, hypothermia, brady, hypotension, hypoglycemia, weakness, lethargy, confusion, loss of consciousness, feeling cold, low body temp, edema (face, tongue, lower extremities), difficulty breathing
• Pediatric diabetes management


  • DM 2 (faster beta cell decline & early progression to complications), more likely to develop DM 1, less able to identify s/s of hypo/hyperglycemia, needs help calculating and administering meds, care plans at school
• Adult diabetes management


  • more typically DM 2, lifestyle changes, nutrition consult, screen for diabetes complications
• Levothyroxine (synthroid)


  Medication used to treat hypothyroidism, taken in the morning on an empty stomach 30 mins to an hour before giving meds, many things can impact absorption or be contraindicated, can be taken by pregnant women (dose increased)
• Methimazole & PTU


  Medications used to treat hyperthyroidism, need time to work
• levothyroxine (Synthroid)


  A medication that should not be taken with certain supplements
• Supplements that should not be taken with levothyroxine (Synthroid)


  • Antacids
  • Bile acid sequestrantes
  • Ion exchange resists
  • Iron supplements
  • Calcium
• Hormone replacement therapy


  Treatment for Addison's disease that involves replacing the missing hormones with synthetic versions, including glucocorticoids and mineralocorticoids.
• Mineralocorticoid replacement


  Treatment for Addison's disease that involves replacing the missing aldosterone, a mineralocorticoid hormone that helps regulate electrolyte and fluid balance in the body.
• Glucocorticoid replacement


  Treatment for Addison's disease that involves replacing the missing cortisol, a glucocorticoid hormone that helps regulate metabolism, immune response, and stress response.
• Antifungals


  Ketoconazole & mifepristone
• Antifungals (ketoconazole & mifepristone)


  Decreases cortisol & prevents unexpected rise in secretion in Cushings
• Oral antihyperglycemic examples

  • Metformin
  • Sulfonylureas
  • DPP-4 inhibitors