All Study Guides Pharmacology for Nurses Unit 27
💊 Pharmacology for Nurses Unit 27 – Thyroid & Parathyroid MedicationThyroid and parathyroid glands play crucial roles in regulating metabolism and calcium levels. Disorders of these glands can lead to significant health issues, affecting various body systems. Understanding the function and treatment of these glands is essential for nurses.
Medications for thyroid and parathyroid disorders aim to restore hormonal balance and manage symptoms. From levothyroxine for hypothyroidism to calcium supplements for hypoparathyroidism, nurses must be familiar with these treatments to provide effective care and patient education.
Key Concepts
Thyroid gland secretes hormones that regulate metabolism, growth, and development
Parathyroid glands secrete parathyroid hormone (PTH) which regulates calcium levels in the body
Hypothyroidism occurs when the thyroid gland produces insufficient thyroid hormones
Hyperthyroidism results from excessive production of thyroid hormones
Medications used to treat thyroid disorders include levothyroxine, methimazole, and propylthiouracil
Hyperparathyroidism is characterized by elevated levels of PTH and hypercalcemia
Hypoparathyroidism is a condition of decreased PTH secretion and hypocalcemia
Nurses play a crucial role in monitoring patients' response to thyroid and parathyroid medications
Anatomy and Physiology Review
Thyroid gland is a butterfly-shaped endocrine gland located in the neck
Consists of two lobes connected by an isthmus
Thyroid follicular cells produce and secrete thyroid hormones (T3 and T4)
Synthesis of thyroid hormones requires iodine
Thyroid hormones regulate basal metabolic rate, growth, and development
Parathyroid glands are four small glands embedded in the posterior surface of the thyroid gland
Parathyroid glands secrete PTH in response to low serum calcium levels
PTH increases serum calcium levels by promoting bone resorption, renal calcium reabsorption, and intestinal calcium absorption
Negative feedback mechanisms regulate the secretion of thyroid hormones and PTH
Types of Thyroid Disorders
Hypothyroidism is a condition of insufficient thyroid hormone production
Causes include autoimmune disorders (Hashimoto's thyroiditis), iodine deficiency, and surgical removal of the thyroid gland
Symptoms include fatigue, weight gain, cold intolerance, and dry skin
Hyperthyroidism is characterized by excessive thyroid hormone production
Causes include Graves' disease, toxic multinodular goiter, and thyroiditis
Symptoms include weight loss, heat intolerance, palpitations, and anxiety
Goiter refers to an enlarged thyroid gland, which can be associated with both hypothyroidism and hyperthyroidism
Thyroid nodules are solid or fluid-filled lumps within the thyroid gland
Most thyroid nodules are benign, but some may be malignant (thyroid cancer)
Thyroiditis is inflammation of the thyroid gland, which can cause transient hyperthyroidism followed by hypothyroidism
Thyroid Medications
Levothyroxine is a synthetic form of T4 used to treat hypothyroidism
Administered orally, typically once daily on an empty stomach
Dosage is adjusted based on thyroid function tests (TSH, free T4)
Methimazole and propylthiouracil (PTU) are antithyroid medications used to treat hyperthyroidism
Inhibit the synthesis of thyroid hormones by blocking the enzyme thyroid peroxidase
Methimazole is preferred due to a lower risk of hepatotoxicity compared to PTU
Radioactive iodine (I-131) is used to treat hyperthyroidism and thyroid cancer
Concentrated in thyroid cells, causing localized destruction of the gland
Beta-blockers (propranolol) are used to manage symptomatic hyperthyroidism
Alleviate symptoms such as palpitations, tremors, and anxiety
Parathyroid Disorders
Hyperparathyroidism is a condition of excessive PTH secretion
Primary hyperparathyroidism is caused by parathyroid adenomas or hyperplasia
Secondary hyperparathyroidism occurs in response to chronic hypocalcemia (renal failure, vitamin D deficiency)
Symptoms include bone pain, kidney stones, abdominal pain, and fatigue
Hypoparathyroidism is characterized by insufficient PTH secretion
Causes include surgical removal of parathyroid glands, autoimmune disorders, and genetic mutations
Symptoms include muscle cramps, tingling sensations, and seizures due to hypocalcemia
Pseudohypoparathyroidism is a rare genetic disorder characterized by resistance to PTH
Results in hypocalcemia and hyperphosphatemia despite normal or elevated PTH levels
Parathyroid Medications
Calcium supplements are used to treat hypocalcemia in hypoparathyroidism
Administered orally in divided doses to maintain serum calcium levels within the normal range
Vitamin D analogs (calcitriol) are used in conjunction with calcium supplements to enhance intestinal calcium absorption
Calcitriol is the active form of vitamin D and directly stimulates calcium absorption
Cinacalcet is a calcimimetic medication used to treat secondary hyperparathyroidism in patients with chronic kidney disease
Activates calcium-sensing receptors on parathyroid cells, suppressing PTH secretion
Bisphosphonates (alendronate) may be used to treat bone loss associated with hyperparathyroidism
Inhibit bone resorption and increase bone mineral density
Nursing Considerations
Monitor thyroid function tests (TSH, free T4) regularly in patients taking thyroid medications
Assess for signs and symptoms of hypothyroidism or hyperthyroidism
Educate patients on the importance of taking thyroid medications consistently and at the prescribed times
Monitor serum calcium and phosphate levels in patients with parathyroid disorders
Assess for signs and symptoms of hypocalcemia or hypercalcemia
Encourage patients with hypoparathyroidism to maintain an adequate intake of calcium and vitamin D through diet and supplements
Assess patients taking cinacalcet for signs of hypocalcemia (muscle cramps, tingling sensations)
Collaborate with healthcare providers to adjust medication dosages based on laboratory results and clinical response
Patient Education and Monitoring
Teach patients about the signs and symptoms of thyroid and parathyroid disorders
Emphasize the importance of reporting any new or worsening symptoms to their healthcare provider
Instruct patients on the proper administration of thyroid and parathyroid medications
Levothyroxine should be taken on an empty stomach, at least 30 minutes before breakfast
Calcium supplements should be taken in divided doses throughout the day
Encourage patients to maintain a balanced diet rich in calcium and vitamin D
Recommend dietary sources of calcium (dairy products, leafy greens) and vitamin D (fatty fish, fortified foods)
Advise patients to inform their healthcare provider about any new medications or supplements they are taking
Some medications (calcium carbonate, iron supplements) can interfere with the absorption of thyroid hormones
Emphasize the importance of regular follow-up visits to monitor thyroid and parathyroid function
Laboratory tests and clinical assessments help ensure optimal management of thyroid and parathyroid disorders