chapter 30 pituitary drugs copyright © 2014 by mosby, an imprint of elsevier inc

Chapter 30

Pituitary Drugs

Copyright © 2014 by Mosby, an imprint of Elsevier Inc.

Hypothalamus Part of the CNS

Pituitary gland Anterior pituitary (adenohypophysis) Posterior pituitary (neurohypophysis)

Together, they govern all bodily functions Hormones Negative feedback loop

Neuroendocrine System:Pituitary Hormones

Copyright © 2014 by Mosby, an imprint of Elsevier Inc. 2

Anterior pituitary drugs cosyntropin menotropins bromocriptine pergonal

Posterior pituitary drugs vasopressin desmopressin pitocin

Pituitary Drugs

somatropin somatrem octreotide thyrotropin


Differs depending on the drug Either augments or antagonizes the natural

effects of the pituitary hormones

Mechanism of Action


Classroom Response Question

Which effect does the nurse expect to see in a patient receiving hydrocortisone (Solu-Cortef) ?

A.Increase in inflammatory leukocyte function

B.Reduction of scar tissue formation

C.Renal excretion of sodium

D.Hypotension


cosyntropin (Cortrosyn) Stimulates release of cortisol from adrenal cortex Antiinflammatory effect Used in the diagnosis of adrenocortical insufficiency

Indications


Somatropin and somatrem Recombinantly made growth hormone (GH) Stimulate skeletal growth in patients with deficient

GH, such as hypopituitary dwarfism Also used for wasting associated with human

immunodeficiency virus infection (HIV)

Indications (cont’d)


octreotide (Sandostatin) Carcinoid tumors secrete VIP (vasoactive intestinal

polypeptide) VIP causes profuse, watery diarrhea Octreotide reduces this severe diarrhea, flushing, and

potentially life-threatening hypotension that may occur with a carcinoid crisis

Also used for the treatment of esophageal varices




When administering octreotide (Sandostatin) to a patient, it is most important for the nurse to assess which parameter?

A.Urine output

B.Blood sugar

C.Liver function tests

D.Electrocardiogram


Vasopressin and desmopressin Used in the treatment of diabetes insipidus Because of their vasoconstrictor properties, they are

useful in the treatment of various types of bleeding, in particular gastrointestinal hemorrhage

Desmopressin is useful in the treatment of hemophilia A and type I von Willebrand’s disease because of its effects on various blood-clotting factors




A patient will be receiving somatropin. The nurse expects that the patient has which disorder?

A.Adrenocortical insufficiency

B.Hypopituitary dwarfism

C.Esophageal varices

D.Septic shock


Adverse effects are specific to the individual drugs

Adverse Effects


Obtain thorough nursing assessment and medication history

Assess for contraindications specific to each drug

Assess medication history for possible interactions

Nursing Implications


octreotide (Sandostatin) May impair gallbladder function—instruct patient to

report abdominal pain Use with caution in patients with renal impairment Monitor glucose levels in patients with diabetes, and

even in those who do not have diabetes Can be given IV, IM, or subcut

Nursing Implications (cont’d)


Provide specific instructions for nasal spray forms of vasopressin

Rotate injection sites Do not discontinue drugs abruptly Do not take over-the-counter products without

checking with health care provider Parents of children who are receiving growth

hormones should keep a journal reflecting the child’s growth



Monitor for therapeutic responses Somatropin should increase growth in children Desmopressin and vasopressin should reduce severe

thirst and decrease urinary output Octreotide should reduce symptoms of carcinoid crisis

Monitor for adverse effects




A patient is in pulseless cardiac arrest. Which medication does the nurse anticipate administering?

A.vasopressin

B.desmopressin

C.cosyntropin

D.somatropin


chapter 30 pituitary drugs copyright © 2014 by mosby, an imprint of elsevier inc

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