Endocrine (Pituitary)
What does endogenous growth hormone do in the body?
-- Regulates growth in muscles and bones
What endogenous hormone does Somatropin mimic?
-- Growth hormone
What pt population requires caution when using Vasopressin?
-- Renal issues
What should you monitor when infusing Vasopressin IV?
-- IV site for infiltration
How is Desmopressin used in the pediatric population?
-- Nocturnal polyuria (severe bed wetting)
What endogenous hormone does Vasopression mimic?
-- ADH (Anti-diuretic hormone)
What does ADH (anti-diuretic hormone) do in the body?
-- Chemical produced in the brain that causes the kidneys to release less water/sodium, decreasing the amount of urine produced
What is diabetes insipidus?
-- Rare disorder that causes the body to make too much urine. (Most people make 1-3 quarts of urine a day, people with DI can make up to 20 quarts of urine in a day)!
-- Works on Vasopressin receptors in the kidney increasing the concentration of urine.
When giving Desmopressin, what labs should you monitor?
-- Serum sodium concentration (Hyponatremia)!
What class of drugs is known to reduce growth?
-- Octreotide
-- ACROMEGALY, Thyrotrophinomas, and carcinoid syndrome, stool or fistula output deduction in pts with high-output secretory diarrhea, and ESOPHAGEAL VARICES
--Terminology:
- Acromegaly: A disorder that occurs when your body makes too much growth hormone (GH).
-Thyrothrophinomas: A rare type of pituitary adenoma, a benign tumor that develops in the pituitary gland
- Carcinoid syndrome: Occurs when a rare cancerous tumor called a carcinoid tumor secretes certain chemicals into your bloodstream, causing a variety of S/S's.
-- Esophageal varices: These are enlarged veins in the esophagus. They're often due to blocked blood flow through the portal vein. The portal vein carries blood from the intestine, pancreas, and spleen to the liver.
What is a major effect of Vasopressin?
- Fluid volume excess
How does Desmopressin help pts with bleeding disorders?
-- Helps the clotting cascade to improve homeostasis, Hemophilia A, and Von Willebrand
What is Somatropin used for in kids and in adults?
-- Kids: Children with growth hormone deficiency or insufficiency, poor growth due to renal failure, children born small for gestational age with poor growth past 2 years of age. Most of the time they are the population that will use Somatropin!
-- Adults: The approved uses include AIDs related wasting and growth hormone deficiency (usually due to a pituitary tumor).
What AEs would you expect to see in a pt taking Somatropin?
-- H/A
-- Hyperglycemia (esp. in diabetics)
-- Hypothyroid
-- Muscle pain
What are other indications for Vasopression?
-- Vasopressin used for bleeding (esp. GI), asystole, and shock from massive vasodilation.
How does Octreotide help pts with Acromegaly?
-- Inhibits the release of thyroid-simulating hormone, growth hormone, insulin, and glucagon (Too much growth hormone)!
--Termonoligy: Glucagon= a hormone that raises blood sugar (glucose), made in the pancreas. When blood sugars are low, glucagon tells the liver to send sugar into the blood, which goes to the cells for energy.
How does Vasopressin help pts with DI?
-- To prevent or control polydipsia, polyuria, and dehydration caused by lack of ENDOGENOUS ADH.
--Terminology:
- Polydipsia: abnormal, great thirst as a symptom of disease (such as diabetes).
- Polyuria: production of abnormally large amounts of dilute urine.