Learn and understand each hormone and function first, then each disease and drug Renin angiotensin aldosterone system.

🧬 Endocrine System – Function

• Endocrine glands release hormones into the bloodstream.
• Hormones then travel to cells in other parts of the body.
• Endocrine hormones help regulate:
• 🧠 Mood
• 📈 Growth & development
• 🫀 Organ function
• 🔥 Metabolism
• 👶 Reproduction

🧠 Pituitary Gland (GH)

The master gland is the Pituitary and Hypothalamus is the secretary.

📍 Located at the base of the brain; has two lobes:

• Anterior lobe → secretes hormones that stimulate other glands (thyroid, adrenals, gonads).
• Posterior lobe → secretes two neurohormones: ADH & Oxytocin.

🔹 Anterior Pituitary Hormones

🔹 Posterior Pituitary Hormones

💡 Memory Tip:

Pituitary gland looks like a D!ck, the anterior part has all the good stuff, cause the eyaculation goes to the front. Not controlled by neurons. The the d!ck.!, is control by blood.

The posterior part of you body is you medulla spine, so the posterior only has two hormones, and is controlled by the neurons.

• Posterior = 2 hormones → ADH & Oxytocin.
• Anterior = “all the rest.”

🌱 Growth Hormone Therapy

👉 This way, you can see deficiency vs excess clearly separated.

Prader william hyperfagia, prevent cause obesity they eat to much

Anterior galnd, posterior neuronal. Thyroid disorders.

Afib ⇒ more cloths

Thyroids

The hypothalamus releases Thyrotropin-Releasing Hormone (TRH), which stimulates the anterior pituitary to secrete Thyroid-Stimulating Hormone (TSH).

Thyroid gland produce T3 and T4 hormones that regulate protein synthesis, enzyme activity, and mitochondrial oxidation.

TSH stimulates the release of T4 and T3 Too much (T4 and T3) Hyperthyroidism, too little (T4 and T3) Hypothyroidism.

HYPOTHYROIDISM MEDICATION

Levothyroxine Sodium (Synthroid)

Drug of choice for hypothyroidism – increases T3 and T4 levels

• Increases metabolism and oxygen consumption
• Promotes body growth
• Treats simple goiters and Hashimoto’s thyroiditis
• Long term treatment, pt’s won’t be cure.

Contraindications

• thyrotoxicosis → Already too much thyroid hormone; levothyroxine would make it worse, risk of thyroid storm.
• Myocardial Infarction (MI) → Increases heart workload and oxygen demand; can worsen heart damage or cause arrhythmias.
• Severe Renal Disease → Kidneys can’t clear drug properly; risk of imbalance and worsening heart issues.
• Adrenal Insufficiency → Speeds up cortisol metabolism; without cortisol replacement, can trigger adrenal crisis.

Side Effects / Adverse Reactions (Think in someone skinny and active and nervous)

To much thyroid hormones leads to Hyperthyroidism signs and symptoms.

• GI: N/V diarrhea, cramps
• CNS: Nervousness, insomnia, weight loss, tremors, headache
• Cardio: Tachycardia, palpitations, hypertension, dysrhythmias, angina
• Serious: Thyroid crisis, angina pectoris, atrial fibrillation

HYPERTHYROIDISM MEDICATION

Thyrotoxicosis vs. Thyroid Storm

• Thyrotoxicosis = Too much thyroid hormone in the body → speeds up metabolism.
• Thyroid Storm = Extreme, sudden worsening of thyrotoxicosis → life-threatening emergency.

Onset:

• Thyrotoxicosis: Gradual.
• Thyroid Storm: Sudden, rapid.

Symptoms:

• Thyrotoxicosis: Fast heart rate, weight loss, heat intolerance, sweating, nervousness, tremors, bulging eyes (Graves’).
• Thyroid Storm: Severe tachycardia, very high fever, agitation/delirium, nausea, vomiting, diarrhea, heart failure, shock.

Nursing Care:

• Thyrotoxicosis: Monitor vitals and labs, ensure medication adherence, patient teaching.
• Thyroid Storm: ICU care, antithyroid meds, beta-blockers, IV fluids, cooling, cardiac monitoring.

PARATHYROID GLAND

Parathyroid hormone (PTH): Increases calcium levels in the blood. Main role: Keeps calcium levels normal in the blood by acting on the bones, kidneys, and GI tract. If the parathyroid glands don’t make enough PTH (hypoparathyroidism), calcium levels drop → muscle cramps, tingling, tetany, seizures. DRUG: Calcitriol (active form of Vitamin D): Increases calcium levels in the blood.

CALCITRIOL = Parathyroid hormone replacer.

• Helps the intestines absorb calcium from food.
• Promotes release of calcium from bone to blood when levels are too low.

Side Effects:

• GI: N/ V, diarrhea
• CNS: Headache, dizziness, drowsiness, lethargy
• Other: Metallic taste, dry mouth (xerostomia)

Hyperparathyroidism

Treatment: CALCITONIN

• Synthetic calcitonin (lowers calcium by moving it from blood back into bone)

ADRENAL GLANDS

Kidneys (sense low blood pressure or low sodium) → release Renin → acts on Angiotensinogen from the Liver → forms Angiotensin I → converted in the Lungs by ACE into Angiotensin II → Angiotensin II causes vasoconstriction of Blood Vessels (raising BP) and stimulates the Adrenal Cortex → Adrenal Cortex releases Aldosterone → Aldosterone acts on the Kidneys to retain sodium and water and excrete potassium → this increases Blood Volume and Blood Pressure back to normal.

Glucocorticoids – Prednisone (Deltasone)

Prednisone is a synthetic glucocorticoid, and it basically mimics cortisol, the natural hormone made by the adrenal cortex.

🔹 Normal cortisol → regulates stress response, suppresses inflammation, controls metabolism, and maintains blood pressure.

🔹 Prednisone → prescribed when the body doesn't produce enough cortisol (Addison's disease, adrenal insufficiency) or when enhanced anti-inflammatory/immunosuppressive effects are needed (asthma, rheumatoid arthritis, lupus, allergic reactions, transplant patients).

Action

• Suppresses inflammation
• Used for autoimmune disorders, allergies, asthma, and as immunosuppressant

Drug Interactions

• ↑ Effect of aspirin & NSAIDs → ↑ risk of GI bleeding/ulcers
• ↑ Effect of barbiturates, phenytoin, rifampin, ephedrine, theophylline
• ↓ Effect of anticonvulsants & antidiabetics (can raise blood sugar)
• With digoxin → ↑ risk of dysrhythmias & digoxin toxicity (due to hypokalemia)
• With furosemide (loop diuretic) → ↑ risk of low potassium (hypokalemia)

Side Effects / Adverse Reactions (CUCHSING SYNDROME)

• Metabolic: Increased appetite, weight gain, fluid & sodium retention → edema, hypertension
• CNS: Headache, flushing, mood changes, depression, psychosis
• Cardio: Tachycardia, hypertension, edema
• Endocrine: Hyperglycemia (↑ blood sugar), adrenal suppression
• Musculoskeletal: Muscle wasting, osteoporosis
• GI: Peptic ulcers (↑ risk with NSAIDs), false positive TB test
• Eyes: Glaucoma, cataracts possible with long-term use

Glucocorticoid Inhibitor – Mitotane

Use / Indications

• Prescribed to reduce cortisol levels in conditions such as:
• Cushing syndrome (too much cortisol, often from long-term steroid use or adrenal adenoma)
• Ectopic ACTH-producing tumors (e.g., some lung cancers)
• Adrenal hyperplasia (overgrowth of adrenal tissue → excess cortisol)

Action

• Adrenolytic agent → directly suppresses adrenal cortex activity and reduces cortisol production.

Mineralocorticoid – Fludrocortisone

• Oral mineralocorticoid

Uses:

• Adrenocortical insufficiency
• Addison’s disease (adrenal glands fail to produce cortisol and aldosterone)

Action:

• Mimics aldosterone → promotes sodium and water retention and potassium excretion
• Helps maintain blood pressure and fluid balance

Nursing Considerations:

• Monitor blood pressure, weight, and electrolytes (Na⁺ ↑, K⁺ ↓).
• Watch for signs of fluid overload (edema, hypertension).
• Teach patients to report weakness, irregular heartbeat, or swelling.
• Usually given with a glucocorticoid (like hydrocortisone) to fully replace adrenal function.

NOTES: Hydrocortisone is a glucocorticoid, similar to Prednisone the belong to the same family

Fludrocortisone is used when the adrenal cortex isn’t producing enough multiple hormones (not just cortisol). There's a need to manage sodium/water balance, not just inflammation