Pituitary and Parathyroid Hormones
TERMS
□ bromocriptine mesylate (Parlodel)
□ corticotropin (Acthar, HP)
□ somatrem (Protropin)
□ vasopressin (Pitressin)
QUICK LOOK AT THE CHAPTER AHEAD
Drugs that affect the anterior and posterior pituitary gland are generally used for replacement therapy for hormone deficiency, diagnosis to determine if there is hypofunction or hyperfunction of pituitary hormones, and drug therapy for specific disorders to produce a therapeutic hormonal response.1
Anterior pituitary hormones include: adrenocorticotropic hormone (ACTH), follicle stimulating hormone, growth hormone (GH), lutenizing hormone, melanocyte-stimulating hormone, prolactin, and thyroid-stimulating hormone. Posterior pituitary hormones include: antidiuretic hormone (ADH) and oxytocin.
ACTH, GH, and ADH are discussed in this chapter. Other drugs that affect the pituitary gland are discussed in Chapter 58.
The parathyroid hormone (PTH) is secreted by the parathyroid gland when calcium levels are low. Calcitonin is a hormone released by specialized cells of the thyroid gland in humans when serum calcium levels increase and there is a reduction of PTH secretion.2 Calcitonin decreases serum calcium by inhibiting bone resorption and, with PTH, assists in finely regulating serum calcium levels.2
Table 48-1 Pituitary and Parathyroid Hormones | |||||||||||||||||||||||||||
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PITUITARY AND PARATHYROID HORMONES CLIENT TEACHINGAdrenocorticotropic Hormone (ACTH)
Notify other health care providers, including dentist or specialist if taking ACTH.
Do not take OTC or herbal remedies without consulting health care provider.
Avoid vaccines during therapy.
Avoid alcohol during therapy.
Do not discontinue abruptly.
Notify health care provider if signs of infection or muscular pain occur.
Carry MedicAlert identification.
Avoid vaccines during therapy.
Do not discontinue abruptly.Growth Hormone (GH)
Keep a journal of growth measurements.
Maintain follow-up care with health care provider that includes laboratory testing and bone age determinations.
Keep a journal of growth measurements.GH Antagonists
Rotate injection sites.
Report symptoms of hyper- or hypoglycemia or irritation at injection site to health care provider.
May take at bedtime or between meals to minimize GI effects.
May take at bedtime or between meals to minimize GI effects.Antiduretic Hormones (ADH)
Report symptoms of water intoxication to health care provider and hold medication if symptoms occur.
Take as directed and maintain follow-up care with health care provider.
Clients with diabetes insipidus should carry MedicAlert identification.
Do not take OTC or herbal remedies without consulting health care provider.
Avoid alcohol while taking ADH.
Report symptoms of water intoxication to health care provider and hold medication if symptoms occur.Lypressin (Diapid) for Treatment of Nocturia
Administer 1 to 2 sprays intranasally when urinary frequency increases.
Bedtime dose can be taken if daily dose doesn’t control nocturia.
Do not inhale medication.
Do not inhale medication.Parathyroid Hormones
Take at bedtime to avoid nausea and flushing.
Take at bedtime to avoid nausea and flushing.Nasal Spray: Calcitonin-Salmon (Miacalcin, Calcimar)
Blow nose before using nasal spray and do not inhale while spraying.
Follow manufacturer’s instructions in assembling and storage of pump.
Blow nose before using nasal spray and do not inhale while spraying.
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