Endocrine & Mental Health: Key Conditions & Treatments

Diabetes Mellitus Essentials

• Type 1: Autoimmune, insulin-dependent, early onset.
• Type 2: Insulin resistance, gradual onset, linked to diet/weight.
• Diagnosis: Fasting glucose >126 mg/dL, HbA1c.
• Metformin: Hold before contrast dye; risk of lactic acidosis.

Hypoglycemia vs. Hyperglycemia

• Hypoglycemia (<70 mg/dL): Shaky, sweaty, confused, hungry.
• Hyperglycemia: Headache, nausea, fruity breath.
• Treatment: Juice/glucose if conscious; glucagon or D50 if unconscious.

Insulin Types and Administration

• Rapid-acting (Lispro): Onset 10–15 min, eat immediately after injection.
• Short-acting (Regular): Onset 30–60 min.
• Intermediate-acting (NPH): Peak 4–12 hr (cloudy appearance).
• Long-acting (Glargine): No peak, lasts 24 hr.
• Mixing Insulin: Clear (Regular) before Cloudy (NPH).

Oral Antidiabetic Medications

• Metformin: Decreases hepatic glucose production, common GI upset.
• Sulfonylureas: Increases insulin release (avoid with sulfa allergy).
• Meglitinides: Short-acting insulin secretagogues.

Thyroid Disorder Symptoms & Diagnosis

• Hypothyroidism: Weight gain, lethargy, cold intolerance, constipation.
• Hyperthyroidism: Weight loss, anxiety, heat intolerance, exophthalmos.
• Laboratory Tests: TSH, T3, T4 levels.
• Myxedema Coma: Severe hypothyroidism.
• Graves’ Disease: Severe hyperthyroidism.

Thyroid Disorder Treatments

• Levothyroxine: Lifelong therapy, take in the morning on an empty stomach.
• Hyperthyroidism Treatment: Propylthiouracil (PTU), Methimazole, radioactive iodine.
• Monitoring: Monitor for signs of over- or under-treatment.

Corticosteroid Uses and Risks

• Uses: Anti-inflammatory, autoimmune conditions.
• Risks: Hyperglycemia, increased infection risk, osteoporosis, mood swings.
• Important: Never stop abruptly.
• Monitoring: Blood glucose (BG), blood pressure (BP), intake & output (I&O), signs of infection.

Understanding Anxiety Disorders

• Types: Generalized Anxiety Disorder (GAD), Panic Disorder, Phobias, Obsessive-Compulsive Disorder (OCD).
• Treatment: SSRIs (Selective Serotonin Reuptake Inhibitors) + psychotherapy.
• Phobias: Cognitive Behavioral Therapy (CBT) + medications.

Antianxiety Medications

• Benzodiazepines: Risk of dependence, fast-acting.
• SSRIs: First-line treatment, effects take 2–4 weeks.
• Hydroxyzine: Sedating antihistamine for acute anxiety.

Depression and Bipolar Disorder

• Depression: Persistent low mood, sleep/appetite changes, low energy.
• Bipolar Disorder: Cycles of mania (increased energy/euphoria) and depression.
• Treatment: Medications + psychotherapy.

Antidepressant Medication Classes

• SSRIs: First-line, monitor for increased suicide risk in young adults.
• MAOIs (Monoamine Oxidase Inhibitors): Avoid tyramine-rich foods to prevent hypertensive crisis.
• TCAs (Tricyclic Antidepressants): Cardiac risk, anticholinergic side effects.
• SNRIs (Serotonin-Norepinephrine Reuptake Inhibitors): Boost serotonin and norepinephrine.

Lithium: Mood Stabilizer Details

• Function: Mood stabilizer for bipolar disorder.
• Therapeutic Range: 0.4–1.2 mEq/L.
• Toxicity Symptoms: Nausea, tremors, confusion, ataxia.
• Patient Education: Maintain adequate hydration and sodium intake.

Antipsychotic Medications: Types & Side Effects

• Typical Antipsychotics: Dopamine blockers, higher risk of Extrapyramidal Symptoms (EPS).
• Atypical Antipsychotics: Affect dopamine and serotonin, lower risk of EPS.
• Side Effects: Weight gain, diabetes, tardive dyskinesia, Neuroleptic Malignant Syndrome (NMS).
• Monitoring: Complete Blood Count (CBC), liver function tests.

💡 EPS = tremors, rigidity. NMS = high fever, rigidity, altered mental status (deadly).