Endocrine and Bone Mineral Density Drugs Flashcards
What does the endocrine system do?
Helps to maintain internal homeostasis through the use of endogenous chemicals called hormones
What is a positive feedback loop?
A rise in one hormone level causes an increase in other hormone levels
Examples: during menstruation, increased levels of estrogen stimulate the release of hormones from the pituitary and the hypothalamus
What is a negative feedback loop?
An increase in a specific hormone inhibits its own further release preventing the amount of that hormone from becoming excessive
**this becomes a problem when giving hormones therapeutically
What are the three hormone receptor location sites?
- surface of plasma membrane
- with the cytosol
- on the chromatin in the cell nucleus
Clinical uses of endocrine drugs
- Replacement therapy: when a hormone is deficient or absent
- Diagnosis of endocrine disorder: hormones are given to determine if endocrine function is excessive or deficient
- Exploitation of beneficial effects: hormones given to exaggerate their benefits
- Alter normal endocrine function: can affect the normal release of hormones
What are the 2 steroids and adrenal cortex produces?
- Glucocorticoids: decreases inflammation and suppresses the immune system (cortisol and corticosterone)
- Mineralcorticoids: maintains fluid and electrolyte balances in the body (aldosterone)
The 2 clinical uses of glucocorticoids
- Evaluate and treat endocrine disorders
- Help resolve symptoms of various neuroendocrine problems
What are glucocorticoids used for?
-restore normal function in conditions of adrenal hypofunction (Addison disease)
-after removal of adrenal glands or pituitary gland b/s of disease of tumors
-RA
-managing systemic inflammation from MSK injuries
-treats severe acute inflammation
-control inflammation or suppress the immune system for short periods of time
Adverse effects of glucocorticoids
-cause adrenocortical suppression (negative feedback loop)
-drug induced cushing syndrome
-breakdown of tissues
-loss of bone strength
-peptic ulcers
-slow growth in children
-glaucoma and cataracts
-HTN
-glucose metabolism alteration
What is the main mineralcorticoid?
Aldosterone- involved in maintaining fluid and electrolyte balance in the body by working on the kidneys to increase sodium and water reabsorption and potassium excretion
When is aldosterone release in our bodies?
When levels of angiotensin II increases- angiotensin II maintains BP by vasoconstricting the peripheral blood vessels
What could happen when aldosterone is increased?
can promote renal sodium and water retention which leads to HTN and heart failure
**aldosterone antagonist drugs help to control these effects
What do Aldosterone antagonist drugs treat?
-HTN
-CHF
-Metabolic syndrome
**they bind to the receptors but do not activate them
What is the clinical use of Aldosterone?
Replacement therapy when the body’s natural production is impaired
**Addison’s disease
Adverse effects of mineralocorticoids
-HTN
-edema
-weight gain
-hypokalemia
Which drugs are classified as potassium sparing diuretics?
Mineralcorticoids because they increase sodium and water excretion without increasing potassium excretion
Which metabolic bone diseases can alter blood calcium levels?
-OP
-Rickets
-Osteomalacia
-Pagets Disease
Why do patients take calcium supplements?
To ensure there is enough calcium available for the body’s physiological needs- bone formation
Calcium supplements are used to prevent bone loss in which diseases?
-OP
-Rickets
-Osteomalacia
-hypoparathyroidism
What is the maximum tolerated level of calcium per day?
2500 mg/day- a supplement should be the difference between the recommended amount and how much calcium patient gets in their diet
Supplements about _____ mg/day do not provide any additional benefits and can increase the risk of arterial calcification and cardiovascular disease
1000 mg/day
Adverse effects of calcium supplements
-hypercalcemia: constipation, drowsiness, fatigue, HA
-severe hypercalcemia: confusion, irritability, cardiac arrhythmias, HTN, nausea, vomiting, skin rashes, pain in muscles and bones
Purpose of Vitamin D
helps to increase intestinal absorption of calcium and phosphate
**too much can lead to toxicity
Purpose of Bisphosphonates
To inhibit osteoclast activity, promotes bone mineralization, inhibit abnormal bone formation (HO), prevent bone pain, prevents bone loss
