What are the treatment options for pituitary-dependent Cushing's disease (PDC)?
Start studying Cushing's syndrome. Learn vocabulary, terms, and more with flashcards, games, and other study tools. ... Depends on the how effective treatment is. ... A patient with pituitary-dependent cushing's disease and adrenal hyperplasia may require which type of treatment.
What are the pharmacological approaches to the treatment of Cushing's syndrome?
Low dose dexamethasone suppression test. 1 mg dexamethasone at 11 pm. Check 8 am serum cortisol level following day: < 5 mcg / dL: normal. 5-10 mcg / dL; suggestive of Cushing's. >10 mcg / dL: likely Cushing's. high dose DST: 32 to 8.2. Plasma cortisol levels suppressed more than 50%, consistent with pituitary origin.
Which drugs target the pituitary?
Low dose dexamethasone suppression test. Dexamethasone (1 mg or 8 mg) is given orally late in the evening or at bedtime, and a plasma cortisol level is obtained at 8 am the next morning. Suppression of cortisol to less than 5 mg/dL indicates that the hypothalamic-pituitary-adrenal axis is functioning properly. Indicators of Cushing syndrome.
What is the pathophysiology of Cushing disease?
Treatment-Medications. Ketoconazole,mitotane, aminoglutethimide, or etomidate to inhibit cortisol production (rarely used) Mifepristone for control of blood glucose levels in patients with endogenous Cushing's syndrome (who are usually not a candidate for surgery) Glucocorticoid replacement after pituitary surgery.
What hormones are used to treat hypothyroidism?
Prolactin. Growth hormone. Luteinizing hormone. Antidiuretic hormone. Melan ocyte-stimulating hormone. Prolactin. Growth hormone. When preparing a client for discharge after a thyroidectomy, the nurse teaches the signs of hypothyroidism. When teaching when to call the primary healthcare provider, what statement made by the client shows ...
How often should I turn my client to prone?
Turn client to prone position at least three times a day. For short periods in the right side-lying position. With the residual limb elevated for a total of three days. Turn client to prone position at least three times a day.
Is ketones in urine?
Ketones in the blood but not in the urine. Glucose in the urine but not in the blood. Urine and blood positive for glucose and ketones. Urine negative for ketones and positive glucose in the blood. Urine negative for ketones and positive glucose in the blood.
What is the best medication for Cushing's syndrome?
Cyproheptadine is effective for the treatment of pituitary Cushing's syndrome. Mitotane is prescribed for the treatment of adrenal Cushing's syndrome. Cabergoline and bromocriptine mesylate are effective for the treatment of hyperpituitarism.
Which hormone is produced by the anterior pituitary gland?
Prolactin is a hormone produced by the anterior pituitary gland that targets the ovaries and mammary glands in women and testes in men. Calcitonin is a hormone produced by the thyroid gland that interacts with bone tissue. A client with type 1 diabetes is admitted to the hospital for major surgery.
What is the cause of diabetes insipidus?
Diabetes insipidus is the result of decreased levels of antidiuretic hormone and is not associated with cortisol and ACTH levels. Adrenal Cushing's syndrome is caused by chronic steroid use, so the client will have increased urine cortisol and decreased ACTH levels.
How does cortisol affect protein synthesis?
Cortisol maintains the blood glucose concentration by stimulating the liver for gluconeogenesis. Gluconeogenesis involves formation of glucose from amino acids and fatty acids. Cortisol mobilizes free fatty acids and inhibits protein synthesis.
What is the reaction of ketoacidosis?
Hypoglycemia reaction. Ketoacidosis occurs when insulin is lacking and carbohydrates cannot be used for energy; this increases the breakdown of protein and fat, causing deep, rapid respirations (Kussmaul respirations), decreased alertness, decreased circulatory volume, metabolic acidosis, and an acetone breath.
What is the term for a breakdown of protein and fat?
Tap card to see definition 👆. Ketoacidosis occurs when insulin is lacking and carbohydrates cannot be used for energy; this increases the breakdown of protein and fat, causing deep, rapid respirations (Kussmaul respirations), decreased alertness, decreased circulatory volume, metabolic acidosis, and an acetone breath.
Which hormone regulates the blood levels of calcium and phosphorus?
Adrenocorticotropic hormone. Parathyroid hormone (PTH), or parathormone, regulates the blood levels of calcium and phosphorus. Luteinizing hormone (LH) stimulates the production of sex hormones, promotes the growth of reproductive organs, and also stimulates reproductive processes.
What drugs are used to treat Cushing's syndrome?
Drugs used to suppress cortisol secretion are mostly inhibitors of steroidogenesis. Ketoconazole, fluconazole aminoglutethimide, metyrapone, mitotane and etomidate are in that category.
What is Cushing's syndrome?
Cushing's syndrome is a complex endocrine condition with potential serious complications if untreated or inadequately treated.
What is the third category of drugs?
A third category of drugs is glucocorticoid receptor antagonists.
Is Mifepristone a glucocorticoid antagonist?
A third category of drugs is glucocorticoid receptor antagonists. Mifepristone is currently being tested in clinical trials in patients with persistent or recurrent Cushing's disease and in patients with metastatic adrenal cortical carcinoma or ectopic ACTH syndrome not amenable to surgery.
Is Cushing's syndrome a complex endocrine condition?
Cushing's syndrome is a complex endocrine condition with potential serious complications if untreated or inadequately treated. Transsphenoidal surgery with resection of a pituitary adenoma is successful in 75 - 80% of patients, but approximately 20 - 25% show persistence of Cushing's, and a similar …. Drugs in the medical treatment of Cushing's ...