CUSHING'S DISEASE - Mind Map

CUSHING'S DISEASE

PATHOPHYSIOLOGY

a form of secondary hypercortisolism caused specifically by a pituitary tumor.

This tumor secretes ACTH which in turn causes the adrenal glad to secrete cortisol.

The tumor does not respond to negative feedback, so it continues to secrete ACTH, and cortisol continues to be secreted into excessive levels.

DIAGNOSTIC PROCEDURE

24-hour urine free cortiosol (UFC) measurement

Cortisol saliva testing

Blood ACTH

Dexamethasone suppression test

Brain MRI

Inferior petrosal sinus sampling

TREATMENT/MEDICATION

- Surgical removal of the pituitary tumor is the most effective long-term cure
- In some patients, medication can be used to reduce the production of cortisol (this dose not affect the ACTH)
- If the tumor is not able to be removed, radiation therapy can help control the tumor
- If the other treatments do not work, the adrenal gland may be removed

- ketoconazole
- mitotane (Lysodren)
- metyrapone (Metopirone).
- Mifepristone (Korlym, Mifeprex)
- pasireotide (Signifor)
- osilodrostat (Isturisa)

NURSING INTERVENTIONS

Provide a protective environment to prevent falls, fractures, and other injuries to bones and soft tissues.

Assist the patient who is weak in ambulating to prevent falls or colliding into furniture.

Recommend foods high in protein, calcium, and vitamin D to minimize muscle wasting and osteoporosis

Avoid unnecessary exposure to people with infections.

Assess frequently for subtle signs of infections

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