Chapter 49: Pituitary, Thyroid & Adrenal Disorder Drugs

The discussion extends to posterior pituitary dysfunctions, contrasting the treatment of diabetes insipidus (DI) using antidiuretic hormone (ADH) replacements like desmopressin and vasopressin against the management of Syndrome of Inappropriate Antidiuretic Hormone (SIADH) using vasopressin receptor antagonists (vaptans) and demeclocycline. Significant attention is dedicated to the thyroid gland, outlining the negative feedback mechanisms of T3 and T4, and explaining the use of levothyroxine sodium for hypothyroidism versus thioamides like methimazole and propylthiouracil (PTU) for hyperthyroidism and Graves disease. The summary also covers parathyroid disorders and calcium regulation, describing the administration of calcitriol and vitamin D analogs for hypoparathyroidism, and the use of calcimimetics like cinacalcet for hyperparathyroidism. Finally, the text examines the adrenal cortex, focusing on the pharmacological applications of glucocorticoids and mineralocorticoids. It details the treatment of adrenal insufficiency (Addison disease) with hydrocortisone and fludrocortisone, while emphasizing the critical nursing considerations for corticosteroid therapy, including prednisone and dexamethasone. Key safety protocols are highlighted, such as tapering doses to prevent adrenal crisis, monitoring for Cushing syndrome, and managing adverse effects like hyperglycemia, immunosuppression, and electrolyte imbalances.