Pharmacodynamic of Somatropin (humatrope)?

(What does it do?)

1. Stimulates cell growth and cellular mitosis, promotes the use of fatty acids for energy.

2. Equivalent to pituitary GH.

1. Long term replacement for children who have growth failure due to inadequate GH.

2. Given when epiphysis is not closed.

3. Idiopathic short stature.

1. Children with closed epiphyses.

2. Pts with intracranial tumors.

3. Pediatric pts with endocrine disorders (can develop slipped-capital epiphysis).

4. Caution in renal and hepatic disorders.

5. Diabetics may be hyperglycemic.

HA, joint and back pain, muscle aches, rhinitis.

Peripheral edema.

HTN.

Hyperglycemia.

Antibodies to GH.

Hypothyroidism.

Insulin resistance.

1. Take ht and wt before beginning therapy.

2. Monitor thyroid, blood glucose and levels of GH during therapy.

3. Pts on dialysis should dose according to their schedule.

4. Monitor nutritional balance.

5. Drug given only by injection - teach proper technique.

6. Refridgerate reconstitute - its stable for 14 days.

7. Reconstitute with bacteriostatic water.

Pharmacodynamics for Desmopressin (DDAVP)?

(How does it work?)

- Interacts with V1 and V2 receptors which have a presser response and an antidiuretic response.

- V2 receptors are foud on the renal tubule and can mediate antidiuretics by stimulating resorption in the collecting tubules.

- Release or increase in circulating levels of factor VIII.

Can be administered intranasally, orally, IV or SQ.

Drug has a long half life.

1. Diabetes Insipidus.

2. Primary nocturnal enuresis.

3. Trauma induced bleeding.

4. Hemophilia A and von Willebrand disease. 

1. Hypersensitivity.

2. Intranasal may not be appropriate for pt with impaired LOC.

3. Caution in pts with CAD or HTN.

4. Caution in pts with fluid and electrolyte imbalances - cystic fibrosis, renal disease as they can experience hyponatremia.

- Mild abdominal pain and cramps, HA, nasal congestion, nausea, rhinitis and facial flushing.

- Injections associated with erythema, burning, pain or swelling.

- Hyponatremia

- Changes in BP, either high or low.

- Pregnancy catagory B - should not breast feed.

- Establish baseline for wt, BP and electrolyte & urine specific gravity.

- Ptotect medication from excessive heat or freezing - should refridgerate intranasal and parenteral solutions.

- Limit fluid intake 1 hr before and 8 hrs after dose to decrease risk of hyponatremia and water intoxication.

- Monitor urine volume and osmolality, as well as pt electrolyte levels.

- Alcohol can alter therapeutic response.