Neuroendocrine System: Pituitary Hormones Hypothalamus Part of the CNS Pituitary gland Anterior...
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Transcript of Neuroendocrine System: Pituitary Hormones Hypothalamus Part of the CNS Pituitary gland Anterior...
Neuroendocrine System:Pituitary HormonesHypothalamus
Part of the CNSPituitary gland
Anterior pituitary (adenohypophysis)Posterior pituitary (neurohypophysis)
Together, govern all bodily functionsHormonesNegative feedback loop
Pituitary DrugsAnterior pituitary drugs
corticotropinsomatotropin
Posterior pituitary drugsvasopressin
somatremsomatrem octreotideoctreotide
desmopressindesmopressin
UsesReplacement therapy to make up for
hormone deficiencyDrug 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
Mechanism of Action
Differs depending on the drugEither augments or antagonizes the natural
effects of the pituitary hormones
Indicationscorticotropin
Stimulation of release of cortisol from adrenal cortex
Used to diagnose, but not treat, adrenocortical insufficiency
Multiple sclerosisCorticotropin insufficiency caused by long-term
corticosteroid use
Indications (cont’d)somatropin and somatrem
Recombinantly made growth hormone (GH)Stimulate skeletal growth in patients with
deficient GH, such as hypopituitary dwarfism
Indications (cont’d)octreotide (Sandostatin)
Carcinoid tumors secrete VIP (vasoactive intestinal polypeptide)
VIP causes profuse, watery diarrheaOctreotide reduces this severe diarrhea,
flushing, and potentially life-threatening hypotension that may occur with a carcinoid crisis
Unlabeled use: Control bleeding in esophageal varices
Indications (cont’d)vasopressin and desmopressin
Used in the treatment of diabetes insipidusUsed in the treatment of various types of
bleeding, especially GI bleedingdesmopressin is useful for:
Hemophilia A Type I von Willebrand’s disease
Adverse EffectsCorticotropin: Sodium retention, hypokalemia, hyperpigmentation, convulsions, euphoria, psychosis
Vasopressin: High BP, headache, flushing
Nursing ImplicationsObtain thorough nursing assessment,
medication historyAssess for contraindications specific to
each drugAssess medication history for possible
interactions
Nursing Implications (cont’d)corticotropin
IM, SC, IV forms, and gel and repository formsFollow directions carefully for administrationMaintain adequate hydrationSodium and potassium intake should be
decreasedAvoid vaccinations during drug therapy
Nursing Implications (cont’d)Provide specific instructions for nasal spray
forms of lypressin and vasopressinRotate injection sitesDrugs should not be discontinued abruptlyDo not take OTC products without checking
with health care provider
Nursing Implications (cont’d)Parents of children who are receiving
growth hormones should keep a journal reflecting the child’s growth
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 childrenDesmopressin, vasopressin should reduce severe thirst
and decrease urinary outputOctreotide should reduce symptoms of carcinoid crisis
Monitor for adverse effects