PassAssured's Pharmacy Technician Training Systems. Medication Review. Local Hormones. Pharmacy Technician Training Systems Passassured, LLC

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1 Medication Review Local Hormones Pharmacy Technician Training Systems Passassured, LLC p1

2 Medication Review, Local Hormones Click Here for Glossary Index! Definitions Therapeutic Classes Systemic Hormones Antihistamines (Histamine Antagonists) Prostaglandin Antagonists Prostaglandins Systemic Hormones Androgens Click Here to Print Topic Help File (.pdf) (Internet Access is Required for this Feature) Estrogens Progestins Corticosteroids Insulin Oral Hypoglycemics Oxytocics Thyroid hormones (Thyroxine) AntiThyroid Hormones Pass Assured, LLC, Pharmacy Technician Training Systems Copyright Pass Assured, LLC, Web Site - passassured.com -o- p2

3 Definitions Click Here for Glossary Index! Click Here to Print Topic Help File (.pdf) (Internet Access is Required for this Feature) Definitions Local Hormones vs. Systemic Hormones Local hormones are synthesized in various tissue types. Systemic hormones are produced by one specific tissue (gland) Local hormones are released and act locally Systemic hormones act throughout the body Local hormones exert profound changes in the body Systemic hormones have a regulatory effect Histamine Local hormone found in all tissues of the body Causes bronchial constriction, stomach acid secretion, blood vessel dilation, and local edema (swelling), pain, and itching. Prostaglandins A group of local hormones that cause a variety of local reactions Causes uterine and bronchial contractions and relaxation, decreased gastric secretions, pain, and inflammation. Pass Assured, LLC, Pharmacy Technician Training Systems Copyright Pass Assured, LLC, Web Site - passassured.com -o- p3

4 Therapeutic Classes Click Here for Glossary Index! Therapeutic Classes Click Here to Print Topic Help File (.pdf) (Internet Access is Required for this Feature) Antihistamines (Histamine Antagonists) Treatment of allergies, rashes, and hay fever Motion sickness, nausea, and dizziness H2 antagonist is used to treat ulcers and reflux disease Mechanism of Action Inhibits the action of histamine Drowsiness CNC depression Anticholinergic effects Sedating Antihistamines - Type 1, competitively antagonize histamine at the H1 receptor (block histamine). They cross the blood brain barrier making them a CNS drug Diphenhydramine (Benedryl) Chlorpheniramine (Chlor-Trimeton) Hydroxyzine (Atarax, Vistaril) Brompheniramine (Dimetane) Dimenhydrinate (Dramamine) Meclizine (Antivert, Bonine, Dramamine II) used to treat vertigo Clemastine (Tavist) Cyclizine (Marezine) Cyproheptadine (Periactin) Dexchlorpheniramine (Polaramine) Cyproheptadine (also used for appetite stimulation) Promethazine (Phenergan) is used to treat nausea (antiemetic). p4

5 IProchlorperazine (Compazine) is used to treat nausea (antiemetic). Non-Sedating Antihistamines - Type I, do not cross blood brain barrier, no sedation Loratadine (Claritin) Astemizole (Hismanal) Fexofenadine (Allegra) Cetirizine (Zyrtec) Desloratadine (Clarinex) Medpointe (Astelin) nasal spray used for seasonal allergic Claritin-D Allegra-D The "D" is for decongestant (Pseudoephedrine) - may cause heart palpitations. Antihistamine - Type II, competitive blockers of histamine at the H2 receptors, those in the stomach Cimetidine (Tagamet) Ranitidine (Zantac) Famotidine (Pepcid) Nizatidine (Axid) Prostaglandin Antagonists Arthritis Minor pain Fever Inflammation Mechanism of Action Inhibit or reverse the actions of prostaglandins by blocking Cox-1 and Cox-2 enzymes Ulcers Kidney damage Non-steroidal anti-inflammatory drugs (NSAID's): p5

6 Aspirin (Anacin, Ascriptin, Bayer, Bufferin, Ecotrin) Ibuprofen (Motrin) Naproxen (Anaprox, Naprosyn) Indomethacin (Indocin) Diclofenac (Voltaren) Nabumetone (Relafen) Oxaprozin (Daypro) Piroxicam (Feldene) Sulindac (Clinoril) Fenoprofen (Nalfon) Flurbiprofen (Ansaid) Etodolac (Lodine) Diflunisal (Dolobid) Ketoprofen (Orudis, Oruvail) Ketorolac Tromethamine (Toradol) Meclofenamate (Meclomen) Salsalate (Disalcid) Tolmetin (Tolectin) Cox-2 selective drugs Kidney damage Celecoxib (Celebrex) Rofecoxb (Vioxx) no longer available in the US Prostaglandins NSAID ulcer prevention Abortifacient (abortion) Misoprostol (Cytotec) Dinoprostone (Prostin E2) p6

7 Alprostadil (MUSE) Pass Assured, LLC, Pharmacy Technician Training Systems Copyright Pass Assured, LLC, Web Site - passassured.com -o- p7

8 Systemic Hormones Click Here for Glossary Index! Click Here to Print Topic Help File (.pdf) (Internet Access is Required for this Feature) Definitions Systemic Hormones Hormones produced by one specific tissue (gland) Generally, act systemically Have a regulatory function on the body Therapeutic Classes Androgens Male hormones, which are secreted by the testes, are responsible for the characteristic sexual changes in men (sexual organ development, hair growth, muscle development, and deepening of the voice) Testosterone deficiency (hormone replacement) Muscle wasting (severely anemic and cancer patients) Side effects Masculinizing effects Fluoxymesterone (Halotestin) Nandrolone (Durabolin) Testosterone (Androderm, Depotest) Methyltestosterone Estrogens Female hormones, which are secreted by the ovaries and are responsible for development of female sexual characteristics (breast development, body fat distribution, sexual organ p8

9 development, and menstruation) Hormone replacement (menopause): Decrease heart problems Prevent osteoporosis Contraception Cancer chemotherapy Side effects Headaches Blood clots Hormone replacement: Conjugated Estrogens (Premarin) Ethinyl Estradiol (Estinyl) Estropipate (Ogen) Oral contraceptives: Monophasic (combination products) - fixed dosage of estrogen to progestin throughout the cycle. Lo-Ovral Demulen Loestrin Ovcon Levlen Nordette Yasmin Biphasic - Estrogen is same for 21 days, increased progestin for first half of cycle and decreased progestin during second half of cycle Ortho Novum 10/11 Necon 10/11 Triphasic - Estrogen remains the same or varies throughout cycle and progestin varies Ortho Novum 7/7/7 p9

10 Triphasil Tri-Norinyl Tri-Levlen Ortho Tri-Cyclen Progestins Female hormones secreted by the corpus luteum, which cause growth of mammary ducts and prevention of uterine bleeding during pregnancy Hormone replacement (menopause) Contraception Breast changes Changes in weight Hormone replacement: Medroxyprogesterone (Cycrin, Provera) Oral contraceptives: Progestin only products Norethindrone (Nor-QD) Norgestrel (Ovrette) Corticosteroids Hormones secreted by the adrenal gland Inflammation Asthma Cancer Hypoadrenalism p10

11 Stomach upset (take with food or milk to decrease upset) Water retention Increased appetite Agitation Suppression of the body's production of Cortisol Prednisone (Deltasone, Orasone) Methylprednisolone (Medrol) Prednisolone (Prelone) Dexamethasone (Decadron) Hydrocortisone (Anucort - HC, Cortaid, Gynecort, Hytone, Locoid, ProctoCream, Cortifoam, Westcort) Triamcinolone (Aristocort, Azmacort, Kenalog) Betamethasone (Alphatrex, Diprolene, Diprosone, Valisone) Cortisone (Cortone) Insulin Hormone produced by pancreas by the Beta cells Use To replace insulin in patients with Type I or Type II diabetes Mechanism of Action Facilitates the utilization and storage of glucose Type I (IDDM): Patient who does not produce any insulin and requires daily insulin injections for survival Type II (NIDDM): Patient who produces some insulin, but generally not enough to allow proper glucose utilization Hypoglycemia p11

12 Regular - fast acting NPH - Intermediate acting Semilente - Rapid acting Ultralente - Long acting Lente - Intermediate acting Humalog - fast acting Lantus- long acting (once daily dose) Oral Hypoglycemics Use Manage patients with Type II diabetes Mechanism of Action Promote insulin release from the beta cells of the pancreas Increases insulin sensitivity Hypoglycemia Photosensitivity Skin rash AVOID ALCOHOL Glyburide (Micronase, Diabeta) (Sulfonylurea) - second generation oral hypoglycemic agent Glipizide (Glucotrol) - Mechanism of Action - decrease blood glucose by stimulating the release of insulin from pancreas Metformin (Glucophage) - does not stimulate insulin secretion - Mechanism of Action - decrease hepatic (liver) glucose production and increases peripheral glucose utilization (muscle sensitivity to insulin) Troglitazone (Rezulin) - Mechanism of Action - stimulates peripheral glucose utilization, high doses decrease hepatic glucose production Chlorpropamide (Diabinese) - first generation Glimepiride (Amaryl) - second generation Tolazamide (Tolinase) - first generation Tolbutamide (Orinase) - first generation p12

13 Oxytocics Hormones secreted by the pituitary, which stimulate the contraction of uterine smooth muscle Relief from breast enlargement during lactation and control of postpartum uterine bleeding Some Ergot Alkaloids are also used to treat migraine headaches e.g. Ergotamine (Ergostat) Nausea/vomiting Dizziness Increased blood pressure Chest pain Oxytocin (Pitocin) Ergonovine (Ergotrate) Methylergonovine (Methergine) Thyroid hormones (Thyroxine T4) Regulate the rate of many physiological processes including protein synthesis, glucose and carbohydrate metabolism, energy storage, lipid metabolism, nervous system development, and body temperature regulation Treat thyroid hormone deficiency (hypothyroidism) Various Levothyroxine (Synthroid, Levothroid) Thyroglobulin (Proloid) Thyroid Tablets p13

14 Anti-Thyroid Hormones To treat over secretion of thyroid hormones (hyperthyroidism) Mechanism of Action Interfere with thyroid hormone production Methimazole (Tapazole) Propylthiouracil (PTU) Potassium Iodide (SSKI) Pass Assured, LLC, Pharmacy Technician Training Systems Copyright Pass Assured, LLC, Web Site - passassured.com -o- p14