Endocrine Medications — Hormone Therapies, Antidiabetic Agents, and NCLEX Pharmacology Review | Chapter 44: Saunders NCLEX-PN Review

Endocrine Medications — Hormone Therapies, Antidiabetic Agents, and NCLEX Pharmacology Review | Chapter 44: Saunders NCLEX-PN Review

Chapter 44 of Saunders Comprehensive Review for the NCLEX-PN® Examination (7th Edition) by Linda Anne Silvestri and Angela E. Silvestri provides a complete review of medications used in managing endocrine disorders, from hormone replacements to advanced antidiabetic therapies. This chapter emphasizes NCLEX-priority drug safety, adverse effect monitoring, and patient teaching to support effective and safe pharmacologic care.

Watch the video above for a focused review, then read the detailed breakdown below. For more NCLEX-PN pharmacology study tools, subscribe to Last Minute Lecture on YouTube.

Book cover

Pituitary Medications

  • Growth Hormone: Somatropin — used for GH deficiency; monitor growth, watch for joint pain and hyperglycemia.
  • Antidiuretic Hormones: Desmopressin, vasopressin — treat diabetes insipidus; monitor for water intoxication and hyponatremia.

Thyroid Medications

  • Hypothyroidism: Levothyroxine — take on an empty stomach in the morning; monitor TSH and T4, avoid switching brands.
  • Hyperthyroidism: Methimazole, propylthiouracil — monitor for agranulocytosis; advise infection precautions.
  • Iodine Solutions: Lugol’s iodine — used pre-thyroidectomy to reduce gland vascularity.

Parathyroid Medications

  • Hypoparathyroidism: Calcium supplements, vitamin D.
  • Hyperparathyroidism: Bisphosphonates (alendronate) and calcitonin — teach upright posture after oral dosing to prevent esophageal irritation.

Adrenal Medications

  • Mineralocorticoids: Fludrocortisone — monitor BP, electrolytes, fluid retention.
  • Glucocorticoids: Prednisone, hydrocortisone — taper doses to avoid adrenal crisis; monitor for hyperglycemia, osteoporosis, and infection.

Reproductive Hormones & Fertility Medications

  • Estrogens, progestins, and androgens — contraindicated in certain cancers, thromboembolic disorders.
  • Contraceptives — oral, patch, ring, injections, implants; teach about drug interactions (e.g., antibiotics) and adherence.
  • Fertility Agents — Clomiphene, gonadotropins; monitor for ovarian hyperstimulation and multiple pregnancies.

Insulin Therapy

  • Understand onset, peak, and duration of rapid-, short-, intermediate-, and long-acting insulins.
  • Mixing guidelines — clear before cloudy (regular before NPH).
  • Rotate injection sites to prevent lipodystrophy; store insulin properly.

Oral Antidiabetic Agents

  • Metformin — risk of lactic acidosis; withhold before/after contrast dye procedures.
  • Sulfonylureas, meglitinides — risk of hypoglycemia.
  • DPP-4 inhibitors, SGLT-2 inhibitors — monitor for GI effects, dehydration, urinary infections.

Injectable Antidiabetic Agents

  • GLP-1 agonists (exenatide, liraglutide) — give before meals; store in refrigerator.
  • Pramlintide — amylin analog; administer with insulin but in separate injection; monitor for hypoglycemia.

Emergency Hypoglycemia Treatment

Glucagon — given IM, SC, or IV for severe hypoglycemia; teach caregivers proper administration and follow with a complex carbohydrate once conscious.

NCLEX Safety Tips

  • Check labs before initiating endocrine medications.
  • Educate on side effects and when to notify the provider.
  • Review proper timing and storage of hormone and antidiabetic agents.
  • Always consider drug interactions that may alter therapeutic effects.

Conclusion

Endocrine pharmacology requires precision in dosing, thorough patient education, and vigilant monitoring for adverse effects. This chapter equips NCLEX-PN candidates to safely administer hormone therapies, antidiabetic agents, and other endocrine medications.

If you found this breakdown helpful, be sure to subscribe to Last Minute Lecture for more chapter-by-chapter textbook summaries and academic study guides.

Explore the full playlist for Saunders Comprehensive Review for the NCLEX-PN® Examination (7th Edition) here: Complete NCLEX-PN Review Playlist

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