Endocrine
9.1 Metabolic Regulation Introduction
Open Resources for Nursing (Open RN)
Learning Objectives
- Understand the classifications and actions of endocrine system drugs
- Give examples of when, how, and to whom endocrine system drugs may be administered
- Identify the side effects and special considerations associated with endocrine system drug therapy
- Identify the considerations and implications of using endocrine system medications across the lifespan
- Apply evidence-based concepts when using the nursing process and clinical reasoning related to medications that affect the endocrine system
- Identify indications, side effects, and potential drug interactions associated with the use of herbal supplements
Key Terms
Have you ever wondered how your body controls functions such as digestion, metabolism, and the stress response? The endocrine system is always working behind the scenes, regulating various organs by releasing hormones and using feedback loops. This chapter will discuss medications that affect three of the major endocrine glands: the adrenal glands, the pancreas, and the thyroid. But before we get started with discussing medications, let’s review some key endocrine system concepts to understand the mechanism of action of endocrine medications.
A lab test used to assess long-term blood glucose levels over 3 months. The general A1C target level is less than 7%.
A blood glucose level below 70 mg/dL; severe hypoglycemia refers to a blood glucose level below 40.
Neuroendocrine tissue composed of postganglionic sympathetic nervous system (SNS) neurons that are stimulated by the autonomic nervous system to secrete hormones epinephrine and norepinephrine.
Abnormally low blood calcium levels caused by parathyroid hormone deficiency, which may develop following thyroid surgery. Low blood calcium can cause muscle twitching, cramping, spasms, or convulsions; severe deficits can paralyze muscles, including those involved in breathing, and can be fatal.
A mineralocorticoid, released by the adrenal cortex, that controls fluid and electrolyte balance through the regulation of sodium and potassium.
The hypothalamus stimulates the release of ACTH from the pituitary, which then stimulates the adrenal cortex to produce the hormone cortisol and steroid hormones important for the regulation of the stress response, blood pressure and blood volume, nutrient uptake and storage, fluid and electrolyte balance, and inflammation.
ADH is released by the posterior pituitary in response to stimuli from osmoreceptors indicating high blood osmolarity. Its effect is to cause increased water reabsorption by the kidneys. As more water is reabsorbed by the kidneys, the greater the amount of water that is returned to the blood, thus causing a decrease in blood osmolarity. ADH is also known as vasopressin because, in very high concentrations, it causes constriction of blood vessels, which increases blood pressure by increasing peripheral resistance.
The “command center” of the endocrine system that secretes several hormones that directly produce responses in target tissues, as well as hormones that regulate the synthesis and secretion of hormones of other glands. In addition, the hypothalamus–pituitary complex coordinates the messages of the endocrine and nervous systems.
Long-acting (insulin glargine or insulin detemir) or intermediate-acting (NPH) insulin.
Abnormally low blood levels of thyroid hormones T3 and T4 in the bloodstream.
The concentration of solutes (such as sodium and glucose) in the blood.
A hormone that facilitates the uptake of glucose into skeletal and adipose body cells.
A disease characterized by underproduction of ADH that causes chronic dehydration.
Hormones released by the adrenal cortex that regulate body minerals, especially sodium and potassium, that are essential for fluid and electrolyte balance. Aldosterone is the major mineralocorticoid.
Gland that secretes digestive enzymes.
Characterized by the inhibition of further secretion of a hormone in response to adequate levels of that hormone.
The pattern in which the body responds in different ways to stress: The alarm reaction (otherwise known as the “fight or flight response,” the stage of resistance, and the stage of exhaustion).
Released in response to stimuli from the nervous system. For example, the activation of the release of epinephrine and norepinephrine in the fight-or-flight response is stimulated by the sympathetic nervous system.
Stimulated by insulin, the metabolism of glucose for generation of ATP.
Specialized cells within the hypothalamus that are sensitive to the concentration of sodium ions and other solutes in the bloodstream.
Chemical signals sent by the endocrine organs and transported via the bloodstream throughout the body where they bind to receptors on target cells and induce a characteristic response.
The hormone released by parathyroid glands; involved in the regulation of blood calcium levels.
Changes in blood levels of non-hormone chemicals that cause an endocrine gland to release or inhibit a hormone to maintain homeostasis. For example, high blood sugar causes the pancreas to release insulin.
During or relating to the eating of food.
Elevated blood sugar.
Hormones that turn on or off the function of other endocrine glands, including ACTH, FSH, LH, and TSH.
An autoimmune disease that affects the beta cells of the pancreas so they do not produce insulin; thus, synthetic insulin must be administered by injection or infusion.
Abnormally elevated blood level of thyroid hormones T3 and T4, often caused by a pituitary tumor, thyroid tumor, or autoimmune reaction in which antibodies overstimulate the follicle cells of the thyroid gland
A condition where the body’s cells become resistant to the effects of insulin. Over time, the beta cells become exhausted and if blood glucose levels cannot be controlled through a healthy diet and exercise, then oral diabetic medication must be implemented and eventually insulin administration may be required.