Pharmacology, part 35: Endocrine Medications - Growth Hormone, Antidiuretic Hormone, Corticosteroids

Hi, I'm Cathy with Level Up RN. In this video, we are going to wrap up our coverage of endocrine system medications. Specifically, I'll be covering growth hormone, anti-diuretic hormone, and corticosteroids. At the end of the video. I'm going to give you guys a little quiz to test your knowledge of some of the facts I'll be covering in this video. So definitely stay tuned for that. If you have our Pharmacology Second Edition Flashcards, definitely grab those and follow along with me. And if you are new to our channel, be sure to subscribe because we have hundreds of free videos to help you learn the most important facts and concepts you need to know for nursing school and in your nursing practice.

Let's begin our coverage with somatropin, which mimics are naturally occurring growth hormone. So this supports growth as well as protein synthesis. So we would use somatropin to address growth hormone deficiencies in adults and children. Side effects of somatropin can include hyperglycemia as well as pancreatitis. Some key nursing care points include the fact that we administer this medication through the IM or subcutaneous route. We're going to want to make sure we rotate our injection site so we don't end up with a build up of scar tissue in one place. If we're giving this medication to children, we're going to want to closely monitor their growth rate and their bone age because we want to stop treatment with somatropin prior to epiphyseal closure.

So my way of remembering this drug name and our cool chicken hint here on the card, if you look at somatropin, I think of summer and trophy. So there's a woman named Summer, and she takes somatropin to address her growth hormone deficiency so that she can win a basketball trophy. So obviously, no one's going to give-- there's not a provider out there who's going to give someone somatropin so they can get a basketball trophy. But for the purpose of remembering this drug name and what it's for summer. So Amir spoke a little different summer trophy. So much open, so hopefully that's helpful for you.

Next, let's talk about our anti-diuretic hormones, which include vasopressin and desmopressin. So these medications would be used to treat diabetes insipidus. And if you recall, diabetes insipidus is an endocrine disorder that causes the patient to pee out large amounts of dilute urine. So these medications mimic ADH, which is produced by the posterior pituitary gland. This allows for the reabsorption of water at the kidneys. And this in turn decreases the patient's urine output and increases the patient's urine osmolality. So it really concentrates the urine more. Side effects can include over hydration. So if we have too much ADH, then we can be retaining too much fluid. So over hydration, which can manifest into a pounding headache for the patient. In terms of nursing care, we're going to want to closely monitor the patient's Is & Os, as well as their urine specific gravity.

The way I remember these medications and what they're for and our cool chicken hint here on our flashcard is that vasopressin helps to suppress all that urine. So really it helps to decrease urine output in patients with diabetes insipidus.

Next, let's talk about glucocorticoids. So if someone asked me to list out the five most important drug classes you need to know for nursing school, this would definitely, definitely be on the list. So if you have our flashcard deck, definitely review the bold, red text on the back of this card because there's a lot of important signs and symptoms and key points you need to know for this drug class. So medications that fall within this drug class include prednisone, hydrocortisone, and dexamethasone. You'll notice they all end in that sone. So this drug class can be used for a variety of conditions, including asthma, autoimmune disorders like rheumatoid arthritis, and inflammatory disorders such as Crohn's disease. So the mode of action of glucocorticoids is to decrease inflammation and suppress the body's immune response. Side effects are plentiful. There are a lot of side effects. Some of the more important ones include bone loss, weight gain and fluid retention, hyperglycemia, hypokalemia, peptic ulcer disease, infection, adrenal gland suppression, and GI upset.

So some key points to keep in mind, as the nurse you're going to want to monitor the patient for signs of infection because we are suppressing their immune response. We also want to monitor them for signs of peptic ulcer disease. So this includes coffee ground emesis and tarry stools. We want to educate the patient that periods of stress may require them to take higher doses of prednisone or another glucocorticoid. Also, it's important that the patient know that they should never stop taking prednisone suddenly. They will need to taper this drug very slowly. So they're not going to just suddenly discontinue it. And then they should take vitamin D and calcium supplements because of that risk of bone loss. And then they should avoid NSAIDs as well, because NSAIDs are linked to GI bleeding and peptic ulcer disease, and by taking prednisone, the patient is already predisposed to getting those conditions. So NSAIDs should be off the table.

The last medication class that I'm going to cover in this video is a mineral coracoid, which is fludrocortisone. Fludrocortisone is used to treat adrenal cortical insufficiency such as Addison's disease, and the mode of action of this medication is that it mimics aldosterone. So that causes the reabsorption of salt and water at the kidneys, which helps the patient maintain their blood pressure and their sodium balance.

So the way that I remember this mode of action, if you look at the drug name, fludrocortisone, it starts with that flud, F-L-U-D, and I think fludrocortisone is a steroid that helps to flood your body with more salt and water. So hopefully that will help you remember the mode of action as well.

Side effects can include hypertension, edema, hyperglycemia, hypokalemia, infection, peptic ulcer disease, and adrenal gland suppression. So a lot of the same side effects that we saw with glucocorticoids. So for a patient with Addison's disease, they are often treated with fludrocortisone and a glucocorticoid. It's going to be important to teach our patient to never abruptly discontinue this medication because that can cause an addisonian crisis.

Okay, it's time for quiz. I have three questions for you. Question number one, in a child receiving somatropin for a growth hormone deficiency, when should treatment be stopped? The answer is prior to the epiphyseal closure. Second question, vasopressin is a medication used to treat what disorder? The answer is diabetes insipidus. Question number three, prednisone should never be discontinued abruptly, true or false? The answer is true. We never want to stop those steroids abruptly, we want to taper slowly.

Okay, I hope this video and these quiz questions have been helpful for you. If so, be sure to like this video and leave me a comment, and take care and good luck studying.