Pharm Session 13:

Non diabetic hormones and medications




What is the medication that mimics Oxytocin

  • Pitocin


Patients taking an antidiuretic are at risk for fluid overload. What patient would be at a high risk

Posterior Pituitary


  • Oxytocin
    • Pitocin is used to induce labor.
  • ADH – Antidiuretic hormone
    • Diabetes insipidus
      • too little ADH
      • can be genetic or injury to pituitary
      • Low specific gravity, bp high tirst
      • Need ADH meds


Anterior Pituitary


  • DDAVP (Desmopressin)
    • Antidiuretic hormones, for DI (deficiency of ADH) or a deficiency of Vasopressin
    • Nasal route, blow nose before administration
    • only works Neurogenic DI not Nephro-
    • so could be used after head injury and surgery
    • can be used for enuresis too which is bed wetting
    • Complications: water intoxication (imbalance of electrolytes and causes drowsiness headache convulsions and coma)
    • cardiac patients are at a high risk for s/s from fluid overload
  • Vasopressin
    • Antidiuretic Hormone
    • for DI from too little ADH and severe vasodilated shock
    • only excrete unbound water
    • alters renal permeability to reabsorb more water.
    • Decreases urine output and increases BP.
    • can cause an MI in a person with a cardiac pathology
    • Monitor BP, HR and ECG in cardiac patients
  • GH
    • promotes growth of bone and MM
    • GH turns into IGF 1
    • grow tall if the person is young and still growing
    • GH deficiency – these people are normal proportions just small. (treat with GH while young)
    • Acromegaly – when there is an increase in GH after growth is over, this causes bones to grow thicker ie. hands, face, big boggy heart. Self esteem issues.
  • Octreotide (sandostatin)
    • treats acromegaly by suppressing GH release
    • SE: GI, and gallstones (decrease renal function)
    • Assess for Frequency consistency of stools and bowel sounds
    • analog of hormone somatostatin
    • also suppresses Insulin and glucagon, really slow the person down
  • Pegvisomant (somavert)
    • GH receptor antagonist (binds the GH site so that GH cannot do its job)
    • Newest drug class for GH suppression
    • Well tolerated
    • sq injection monthly after loading dose
  • Prolactin
    • Makes milk
    • suppresses ovulation, but do not use this as contraceptive


Thyroid medication


hormones made here regulate metabolism, Heart function and growth/development

Dwarfism and cretinism may result if these hormones are absent


thyroid hormones – TRH ->  TSH ->  T3 and T4

TSH stimulates thyroid to release T3 and T4


T3 – active not bound form, and can cross membranes

T4 – is bound and converts to T3 to be used. There is much more T4 than T3.


Goiter can come from a lot of different pathologies. Including hypo 95% or goiters and hyperthyroidism 5%


Hypothyroidism – T3+4 Low and TSH HIGH. Myxedema

  • liothyronine – T3 analog
  • levothyroxine – T4 analog
  • there are also natural products that are from the ground up cow thyroid


Hyperthyroidism – T3+4 high and TSH low. Thyrotoxicosis

  • Graves disease can cause this
  • exophthalmos
  • Too much T3+4


  • levothyroxine (synthroid) T4 analog
    • this is T4 and gets converted by the body into T3
    • The dose is very patient dependent and there are MANY pill quantities. this also means that a Generic drug which can be plus or minus 20% of the drug, may cause the patient to be getting too much or too little of the drug.
    • Long H life of a week
    • daily dosing
    • takes about a month to get to the therapeutic effects
  • liothyronine (Cytomel) T3
    • shorter H life
    • more money
    • faster onset


  • Propylthiouracil (PTU)
    • used to treat thyroid storm
    • SE: agranulocytosis (discontinue drug if too low WBC count
  • radioactive Iodine-131
    • for hyperthyroidism and thyroid cancer.  
    • emits gamma and beta particles
    • 8 day H life
    • blocks hormone synthesis
    • needs synthroid after treatment for life (hypothyroid for life)
    • destroys the thyroid gland
    • Lugol’s solution – surgery prep, thyrotoxic crisis, it is an antiseptic


Effective hyperthyroidism results in decrease in palpitations


Adrenal Gland hormones

  • inner medulla stress
  • outer cortex stress, sex and salt
  • Classes
    • Catecholamines – Epinephrine, and norepinephrine
    • corticosteroids – Glucocorticoids work on glucose (cortisol), and mineralocorticoids work on the minerals and salts such as aldosterone
    • Androgens
  • these will be for Addison’s Dx and to suppress inflammation


glucocorticoids aka corticosteroids (hydrocortisone, and prednisone)

  • Always taper these meds if on for more than a week
    • glu, lipid, and protein increase blood levels
    • increase glu production and decrease the cellular uptake of glu
    • DO not take for long periods
    • increases cap permeability


  • hydrocortisone
    • synthetic cortisol, corticosteroid
    • for adrenocortical insufficiency
    • Altered glucose metabolism at the normal dose, shown by increased GLU levels.
      • HYPERGLYCEMIA, watch closely in DM patients
    • Can cause cushing’s syndrome or adrenal suppression if too much is given
    • Taper dose once the treatment is done.


  • Prednisone
    • steroidal Antiinflammatory, intermediate immune modifier
    • Taper the med
    • MAKE SURE THE PATIENT knows how to taper and understand the instructions
    • will go into an adrenal crisis if they do not taper and will look like a person with cushing’s disease
    • Cushing’s Dx test – Dexamethasone suppression test
      • Dexamethasone 1 mg at 2300, the measure the plasma cortisol at 0800. if the ACTH is suppressed




addison’s Dx patient need replacement and it comes from extreme adrenal stress. These patients need mineral and glucocorticoids.


  • Fludrocortisone (florinef)
    • for addison’s Dx
    • weight gain from edema so watch I and O’s
    • monitor K, BP and NA
    • geven IM in a Addisonian Crisis



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