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Pharmacology Mdm. Azlina Sem 5 > Endocrine 1 > Flashcards

Endocrine 1 Flashcards

1
Q

Endocrine system definition

A

consist of various glands that secrete hormones
- regulate metabolism, growth development and puberty, tissue function and determines mood

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2
Q

Endocrine consist of ?

A

-PINEAL GLAND
-HYPOTHALAMUS
-PITUITARY GLAND
-PARATHYOID GLAND
-THYROID GLAND
-THYMUS
-ADRENAL GLAND
-PANCREAS
-GONAD(OVARIES)
-GONAD (TESTES)

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3
Q

Areas of pituitary gland

A

Posterior
-produces oxytocin and antidiuretic hormone (ADH)

Anterior
 produces thyroid-stimulating hormone (TSH)
 growth hormone (GH)
 adrenocorticotropin (ACTH)
 follicle-stimulating hormone (FSH)

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4
Q

Anterior pituitary

A
  • Primarily regulates other
    endocrine glands
  • TSH stimulates the thyroid gland to release its hormones , increase metabolic rate
  • Growth hormone (GH)
  • lower glucose usage
  • increase consumption of fats as an energy source
  • ACTH stimulates the adrenal gland to release its hormones
  • FSH & LH stimulates maturation
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5
Q

Posterior pituitary

A
  • Oxytocin (the natural form of pitocin)
  • stimulates gravid uterus
  • causes “let down” of milk from the breast.
  • ADH (vasopressin) causes the kidney to retain water
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6
Q

Pancreas function

A
  • key gland in the folds of duodenum
  • secretes several key digestive enzymes
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7
Q

Islet of langerhans

A
  • specialized tissues in which the endocrine functions of the pancreas occurs
  • include 3 types of cells: alpha (ª) beta (ɓ) delta (ḍ)
  • each secretes an important hormone
    ALPHA CELLS (a)
  • release glucagon, essential for
    controlling blood glucose levels
    BETA CELLS (b)
  • release insulin (antagonistic to glucagon)
  • Insulin increase the rate which various body cells take up glucose
  • insulin lowers the blood glucose level
    DELTA CELLS (d)
  • produce somatostatin, which inhibits both glucagon and insulin
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8
Q

Adrenal Medulla

A

secretes catecholamine hormones norepinephrine and epinephrine
- closely related to the
sympathetic component of autonomic nervous system

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9
Q

3 steroid hormones that secreted by adrenal cortex

A
  • gluticocorticoids
  • mineralocorticoid
  • androgenic hormones
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10
Q

Gluticocorticoids

A
  • accounts for 95% of adrenal cortex hormone production
  • the level of glucose in blood
  • Released in response to stress, injury or serious infection
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11
Q

Mineralocorticoid

A

work to regulate the concentration of potassium and sodium in the body

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12
Q

Sodium can be retained by the kidney, resulting in hyponatremia and can cause what

A

 dysrhythmias
 coma
 death

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13
Q

Gonad and ovaries

A

the endocrine glands
associated with human reproduction.
 Female ovaries
produce eggs
 Male gonads produce
sperm

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14
Q

Ovaries

A

located in the
abdominal cavity
adjacent to the uterus

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15
Q

What is insulin

A

a polypeptide hormone consisting of two peptide chains that are connected by disulfide bonds

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16
Q

Diabetes

A

complicated, chronic disorder characterized by either insufficient insulin production by the beta cells of the pancreas or by cellular resistance to insulin
- high risk disease hypertension, hyperglycemia and myocardial infarction

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17
Q

Glucose test

A
  • FASTING BGL 100-125MG/DL(SIGNAL
    PREDIABETES)
    > 126 MG/DL signal diabetes
    > 6.7 MMOL/L
  • ORAL GLUCOSE TOLERANCE TEST
    -test 2 hours after drink glucose rich drink
    140-199 MG/DL signal prediabetes
    >200 MG/DL signal diabetes
18
Q

Diabetes Type 1

A

commonly afflicts children, adolescents or young adults, but some latent forms occur later in life
- can also be called juvenile onset diabetes
- lack of insulin secretion from pancreas

19
Q

Characteristic of diabetes type 1

A
  • deficiency of insulin due to destruction of β cells
    ▪ Loss of β-cell function results from autoimmune mediated process that may be triggered by viruses or other environmental toxins
    ▪ Without functional β cells, the pancreas fails to respond to glucose
20
Q

Symptoms of diabetes type 1

A

polydipsia, polyphagia, polyuria,
and weight loss
- Polyuria – excessive urination
- Polyphagia - increase hunger
- Polydipsia –increase thirst
- Glucosuria - high level of glucose in urine
- weight loss
- fatigue

21
Q

Diabetes type 1 complications

A

Long term damage arteries lead to :
- heart disease
- stroke
- kidney disease
- blindness

Glucose can’t enter cell - Lipid breakdown – Ketoacid

22
Q

Diabetes type 2

A

metabolic alterations are generally milder than type 1
- typically not ketotic
- long-term clinical consequences are similar

23
Q

Causes of diabetes type 2

A
  • lack of sensitivity or target organs to insulin
  • pancreas retain some b cell function
  • increase peripheral insulin resistance
24
Q

Risk factors dt2

A
  • Obesity
    ▪ Older age
    ▪ Family history of diabetes
    ▪ History of gestational diabetes
  • Impaired glucose tolerance
25
Treatment of dt2
- maintain blood glucose within normal limits and to prevent the development of long-term complications - Weight reduction, exercise, and dietary modification - require pharmacologic intervention with oral glucose - lowering agents
26
Thyroid gland
facilitates normal growth and maturation by maintaining a level of metabolism in the tissues - in the anterior neck just below the larynyx.  Isthmus : Two lobes, located on either side of the trachea, connected by narrow band of tissue  Sacs inside the gland contain colloid - Major thyroid hormone  T3 - triiodothyronine (the most active form)  T4 - thyroxine
27
Thyroid action
 Thyroid function is controlled by thyroid-stimulating hormone (TSH; thyrotropin), which is synthesized by the anterior pituitary  TSH action is mediated by cAMP and leads to stimulation of iodide uptake by the thyroid gland
28
Hypothyroidism
Inadequate secretion of thyroid hormone (hypothyroidism) SYMPTOMS  bradycardia, poor resistance to cold, and mental and physical slowing  Children, this can cause mental retardation and dwarfism CAUSE ▪ results from autoimmune destruction of the gland or the peroxidase DIAGNOSE ▪ by elevated TSH. Levothyroxine (T4 ) is preferred over T3 (liothyronine) TREATMENT ▪ Levothyroxine OD, steady state - in 6 to 8 weeks. ▪ Toxicity - related to T4 levels / manifests as nervousness, palpitations and tachycardia, heat intolerance, and unexplained weight loss CONTRAINDICATIONS - Drugs that induce the cytochrome P450 enzymes eg: phenytoin, rifampin, and phenobarbital
29
Treatment of Hypothyroidism (Thyrotoxicosis)
- an autoimmune disease that affects the thyroid  TSH levels are reduced due to negative feedback  The goal of therapy is to decrease synthesis and or release of additional hormone  This can be accomplished by removing part or all of the thyroid gland, by inhibiting synthesis of the hormones or by block release of hormones from follicle
30
Long term hyperthyroidism can cause
Exopthalmos ( bulging of eyeballs) and thyrotoxicosis
31
Inhibition of thyroid hormone synthesis
The thioamides, propylthiouracil (PTU) and methimazole, are concentrated in the thyroid, where they inhibit both the oxidative processes required for iodination of tyrosyl group
32
Blockade of hormone release
pharmacologic dose of iodide inhibits the iodination of tyrosines (“Wolff-Chaikoff effect”) but this effect lasts only a few days
33
Thyroid storm ( extreme symptoms of hyperthyroidism ) treatment
same as that for hyperthyroidism, except that the drugs are given in higher doses and more frequent
34
Hyperthyroid treatment
1. Propylthiouracil INDICATION: Treatment of Hyperthyroidism DOSAGE: Initial 600-1200mg/day Maintenance 50-150mg/day AR: gastric distress, headache, nausea, skin rash, frequent vomit 2. Carbimazole INDICATIONS : Hyperthyroidism, prepare for thyroidism preparation & as contamination therapy / radio iodine treatment DOSAGE: Adult - Initially 20-60mg in 2-3 divided doses MAINTENANCE : 5-15mg daily for at least month up to 18 month
35
Addison's disease
CAUSE - adrenal cortex dysfunction (as diagnosed by the lack of response to ACTH administration) ▪ adrenocortical insufficiency TREATMENT ▪ Hydrocortisone - which is identical to natural cortisol given to correct the deficiency ▪ The dosage of hydrocortisone divided so two-thirds of daily dose is given in the morning and one-third is given in the afternoon
36
Cushing syndrome
CAUSE hypersecretion of glucocorticoids (hypercortisolism) results from excessive release of ACTH by anterior pituitary or an adrenal tumor DIAGNOSIS Cortisol levels (urine, plasma, and saliva) and dexamethasone suppression test
37
Corticosteroid hormones
1. Betamethasone 0.5g tab INDICATION: Acute and chronic rheumatic fever, Bronchil asthma DOSAGE: Adult - initial 1.5-3mg daily MAINTENANCE 0.5-1.5mg daily in divided doses reduce 0.25mg every 2-3 day AR : GI discomfort, menstrual irregularities, growth suppression in child 2. Injection Betamethasone 5ml INDICATION: Rheumatic disorder, Allergic AR : Fluid retention, GI disturbances, metabolic disturbance 3. Betamethasone cream INDICATION: Relief of inflammation
38
Prednisolone
1. Tablet 5mg INDICATION : Rheumatoid arthritis, Corticosteroid 2. Methylprednisolone acetate inj 40mg / ml x5 ml INDICATION : endocrine, rheumatic disorder, dermatologic, Allergic Multiple sclerosis DOSAGE - Rheumatoid A - 20-80 mg Medium joint 10-40mg Small joint 4-10mg Dermatological 20-60mg
39
Hydrocortisone
1. Hydrocortisone 10mg tablet - DOSAGE: Adult substitution therapy 20-30mg - Other indication 40-200 mg daily - Child - Adrenocorticoid insufficiency 7.5-15mg daily - Hypopituitarism 2.5mg tds 2. Hydrocortisone inj 100mg / 2ml INDICATIONS: Anti-inflammatory, anti allergic & antitoxic DOSAGE : Adult 100-500mg IV Dose may be repeated at interval of 3, 4 or 6 hours 3. Hydrocortisone cream 0.5 % INDICATION : non infected acute dermatitis and eczema
40
Antidiuretic hormone
- conserve water in body - Excreted from pituitary gland and acts on collecting ducts to increase water reabsorption - called Vasopressin because it raises blood pressure Rx of diabetes insipidus - Vasopressin, Desmopressin, Lypressin
41
Desmopressin ( Minirin )
TABLET: Adult & child - 0.1-0.2mg tds INTRANASAL : Adult 10-20mcg 1-2 times daily Child 5-10mcg 1-2 times daily NASAL SPRAY : Adult 10-20mcg 1-2 times daily Child 5-10 mcg 1-2 times daily INJECTION : Adult 1-4 mcg IV Once - bd Infant < 1 YR 0.2-0.4 mcg IV once - bd

Pharmacology Mdm. Azlina Sem 5 (9 decks)

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