Drugs that Affect the Endrocrine System-IN Organ System Pharmacology

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Organ System Pharmacology Drugs that Affect the Endocrine System:

Organ System Pharmacology Drugs that Affect the Endocrine System Prepared and p resented by: Marc Imhotep Cray, M.D. WebPath Pathology: Endocrine Pathology  70 Images Recommended Reading: Management of Diabetes Formative Assessment Practice question set #1

Topics Discussed:

Topics Discussed Endocrine Glands / Hormones Action and Secretion Review Pituitary Drugs Parathyroid and Thyroid Drugs Adrenal Drugs Pancreatic Drugs Reproductive Drugs 2

Functions:

Functions Regulation Control 3 Endocrine Glands / Hormones Action and Secretion Review

Glands:

Glands Exocrine Secrete enzymes Close to organs Endocrine Secrete hormones Transport via bloodstream Require receptors 4

PowerPoint Presentation:

5 Nervous Endocrine Wireless Wired Neurotransmitters Hormones Short Distance Long Distance Closeness Receptor Specificity Rapid Onset Delayed Onset Short Duration Prolonged Duration Rapid Response Regulation versus

Mechanism of Action:

Mechanism of Action 6

Hypothalamus:

Hypothalamus 7

Hypothalamic Control Pituitary:

Hypothalamic Control Pituitary 8

Posterior Pituitary:

Posterior Pituitary 9

Anterior Pituitary:

Anterior Pituitary 10

Anterior Pituitary:

Anterior Pituitary 11

Anterior Pituitary:

Anterior Pituitary 12

Pituitary Hormones:

Pituitary Hormones 13

Thyroid:

Thyroid 14

Thyroid :

Thyroid 15

Hypothyroidism:

Hypothyroidism 16

Hyperthyroidism:

Hyperthyroidism 17 http://library.med.utah.edu/WebPath/ENDOHTML/ENDOIDX.html

Parathyroid:

Parathyroid 18

Parathyroid:

Parathyroid 19

Calcium Regulation:

Calcium Regulation 20

Pancreas:

Pancreas 21

Pancreas:

Pancreas Alpha cells: glucagon Beta cells: insulin 22

Pancreas:

Pancreas 23

Glucose Regulation:

Glucose Regulation 24

Adrenal:

Adrenal 25

Adrenal Medulla:

Adrenal Medulla 26

Adrenal Cortex:

Adrenal Cortex 27

Anterior Pituitary Drugs:

Anterior Pituitary Drugs Inadequate Growth Hormone Dwarfism somatrem ( Protropin ® ) homatropin ( Humatrope ® ) Excessive Growth Hormone Acromegaly Gigantism Surgical removal 1º octreotide ( Sandostatin ®) 28

Posterior Pituitary Drugs:

Posterior Pituitary Drugs Oxytocin ADH Diabetes insipidus Nocturnal enuresis vasopressin ( Pitressin ® ) desmopressin ( Stimate ® ) lypressin ( Diapid ® ) 29

Parathyroid Diseases:

Parathyroid Diseases Hypoparathyroidism Inadequate calcium levels TX: increased dietary calcium Hyperparathyroidism Excessive calcium levels TX: surgical removal 30

Thyroid Disease:

Thyroid Disease Hypothyroidism Hormone replacement levothyroxine ( Synthroid ®) Hyperthyroidism Thyrotoxicosis Surgical removal propylthiouracil (PTU) 31

Adrenal Cortex:

Adrenal Cortex ACTH Hypersecretion Cushing’s Disease Surgical removal Inhibit adrenal secretion ketoconazol ( Nizoral ® ) Symptomatic tx : Antihypertensives ACTH Hyposecretion Addison’s Disease Replacement therapy Cortisone ( Cortistan ® ) Hydrocortisone ( SoluCortef ® ) Fludrocortisone ( Florinef Acetate ® ) 32

Insulin Preparations:

Insulin Preparations Regular Insulin Natural insulin Modified Insulin Increased duration of action NPH (neutral protamin Hagedorn ) Natural plus protamin Lente Attached to zinc to prolong absorption 33

Oral Hypoglycemic Agents:

Oral Hypoglycemic Agents Sulfonylureas  insulin secretion tolbutamide ( Orinase ® ) chlorpropamide ( Diabinese ® ) glipizide (Glucotrol ® ) glyburide ( Micronase ® ) Alpha- glucosidase inhibitors Delay carbohydrate metabolism acarbose ( Precose ® ) miglitol ( Glyset ® ) 34 Biguanides metformin (Glucophage ® )  Glucose synthesis  Glucose uptake Thiazolidinediones Insulin effectiveness troglitazone ( Rezulin ® )

Hyperglycemic Agents:

Hyperglycemic Agents Glucagon  gluconeogenesis D 50 W diazoxide ( Proglycem ®) Inhibits insulin release 35

Estrogens & Progestins:

Estrogens & Progestins Estrogens used for post-menopausal hormone replacement therapy. estradiol ( Estrace ® ) conjugated estrogens ( Premarin ® ) estropipate ( Ogen ® ) Progestin Diminish side effects of estrogen therapy Nausea, fluid retention, breast tenderness medroxyprogesterone acetate (Provera ® ) norethindrone acetate ( Aygestin ® ) 36

Oral Contraceptives:

Oral Contraceptives Combination of estrogen and progestin Loestrin ® , Levora ® , Nordette ® , Ovocon ® , Norinyl ® plus many others Minipill : progestin only Micronor ® , Nor-Q.D. ® , Orvette ® Prime side effect:  risk of thromboembolism 37

Uterine Stimulants & Relaxants:

Uterine Stimulants & Relaxants Stimulants ( Oxytocics )  uterine contraction Indication: Induce labor Postpartum hemorrhage oxytocin (Pitocin ® ) ergonovine ( Ergotrate ® ) Relaxants ( tocolytics ) Relax uterine smooth muscle Beta 2 agonists terbutaline ( Brethine ® ) ritodrine ( Yuptopar ® ) 38

Infertility Agents:

Infertility Agents Promote maturation of ovarian follicles clomiphene ( Clomid ® ) urofollitropin ( Metrodin ® ) 39

Male Reproductive Agents:

Male Reproductive Agents Testosterone Replacement methyltestosterone ( Metandren ® ) fluoxymesterone ( Halotestin ® ) Benign Prostatic Hypertrophy Surgery finasteride ( Proscar ® ) 40

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