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Pharmacy Year 3 > Endocrinology > Flashcards

Endocrinology Flashcards

1
Q

Describe the basic structure of the endocrine system

A

Hormones used as chemical messengers between endocrine organs and target cells

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2
Q

What are primary endocrine glands?

A

Secretion of endocrine hormones is the organ’s primary function

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3
Q

What are secondary endocrine glands?

A

Primary function is not endocrine but organ is also capable of secreting hormones

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4
Q

List the primary endocrine organs in order down the body

A 
Pineal Gland
Hypothalamus
Pituitary Gland
Thyroid Gland
Parathyroid Gland
Thymus
Adrenal Gland
Pancreas
Ovaries/Testes
Placenta
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5
Q

Give some examples of secondary organs

A 
Heart
Stomach
Liver
Kidneys
Small Intestine
Skin
Fat cells
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6
Q

Describe the position of the hypothalamus, pituitary and pineal glands

A

All found in brain

Hypothalamus situated above the pituitary glands

Pituitary split into posterior and anterior

Pineal gland in epithalamus (between two hemispheres)

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7
Q

How do the hypothalamus and the posterior pituitary communicate?

A

Direct neural connection

Hormones are produced by body of magnocellular neurones and travel down axon for storage in pituitary

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8
Q

How do the hypothalamus and anterior pituitary communicate?

A

Circulartory system connection

Regulatory hormones are secreted into primary plexus from parvicellular neurones

Travel through portal system into secondary plexus in AP, triggering hormone release

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9
Q

What is the function of the pituitary?

A

Produces regulatory hormones to control other endocrine organs

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10
Q

Where is the pineal gland found?

A

The brain

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11
Q

What is the function of the pineal gland?

A

Produces melatonin which is responsible for regulating circadian rhythm

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12
Q

Where are the thyroid and parathyroid glands found?

A

Below larynx around the trachea, parathyroid glands behind thyroid glands

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13
Q

What is the function of the thyroid gland?

A

Production of T3, T4 (metabolism regulation) and calcitonin

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14
Q

What is the function of the parathyroid gland?

A

Produces parathyroid hormones which is released when calcium levels drop

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15
Q

Where is the thymus located?

A

Close to heart

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16
Q

What is the function of the thymus?

A

Immune functions

Thymosin production stimulates T-cell activity (maturation of T-lymphocytes) and antibody production in bone marrow

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17
Q

Where is the pancreas located?

A

Just below the stomach

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18
Q

What is the function of the pancreas?

A

Control of blood glucose

Regulation of growth hormone production by somatostatin and ghrelin

Appetite and fat storage regulation

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19
Q

Where are the adrenal glands situated?

A

On top of the kidneys

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20
Q

What is the function of the adrenal glands?

A

Regulation of stress hormones

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21
Q

Describe the structure of the adrenal glands

A

Medulla

Cortex - Zona glomerulosa, zona fasciculata, zona reticularis

Capsule (connective tissue and blood vessel distribution)

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22
Q

Where are the ovaries located?

A

In the pelvic cavity

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23
Q

What is the function of the ovaries?

A

Production of oestrogen and progesterone steroid hormones and inhibin and relaxin protein hormones

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24
Q

Where are the testes located?

A

In the scrotum

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25
Q

What is the function of the testes?

A

Release of androgens (mainly testosterone) and sperm production

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26
Q

What is the function of the placenta?

A

Connect foetus to uterine wall

Nutrient uptake, waste removal, gas exchange from maternal blood supply

Production of oestrogen and progesterone steroid hormones, CG, CRH and placental lactogenic protein hormones

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27
Q

What is the endocrine function of the heart?

A

Production of atrial natriuretic peptide

Inc. salt secretion by kidneys lowering blood volume and pressure

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28
Q

What is the endocrine function of the GI tract?

A

Production of over 30 hormones

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29
Q

What is the endocrine function of the kidneys?

A

Secretion of renin by juxtaglomerular cells leading to increased aldosterone production

Production of erythropoietin - signals RBC production in bone marrow

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30
Q

What is the endocrine function of the skin?

A

Modified cholesterol produced with UV exposure, form via D precursor

Signals intestine to absorb calcium

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31
Q

What is the endocrine function of fat cells?

A

Release of leptin

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32
Q

Describe the pattern of cortisol released

A

Stress signal detected by hypothalamus

ACTH and CRH stimulate cortisol release from adrenal glands

Cortisol negatively feedbacks to hypothalamus inhibiting release of regulatory hormones

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33
Q

How can cortisol regulation be disturbed?

A

Long-term corticosteroid use

34
Q

What is hypersecretion? Give some examples

A

Inappropriate production, overstimulation or little negative feedback

May be due to genetic defect

Hyperinsulinism, Cushing’s disease, Congenital Adrenal Hyperplasia, Graves’ disease

35
Q

What is hyposecretion? Give some examples

A

Damaged gland, reduced detection of signal or little release of hormone

Hypothyroidism, diabetes, Addison’s disease

36
Q

What are endocrine tumours and what is their effect? Give some examples

A

Inappropriate cell division leading to increased tissue mass, may be benign or malignant

Change in mass may lead to inappropriate production but not necessarily overproduction

Multiple Endocrine Neoplasia, Pheochromocytoma

37
Q

Give two examples of peptide hormones produced by the posterior pituitary and describe their structure and functions

A

Oxytocin - 9 a. acids (2 are isoleucine and leucine). Causes uterine contractions

ADH - 9 a. acids (2 are phenylalanine and arginine). Antidiuretic function

38
Q

Describe the structure and function of growth hormone

A

191 a. acids

Protein hormone

Mitogen - growth, cell division and cell regeneration

Produced in anterior pituitary

39
Q

Describe the structure and function of prolactin

A

198 a. acids

Protein hormone

Mammary development and lactation

Produced in anterior pituitary

40
Q

Describe the structure and function of FSH and TSH

A

Both produced in anterior pituitary

Protein hormones

Dimeric structure - alpha and beta chains joined by disulphide bonds. Both interact with receptor

Similar to LH and hCG

FSH - Follicular development, TSH - stimulates production of thyroid hormones

41
Q

Describe the structure of insulin

A

Two polypeptide chains linked by disulphide bonds

Placement of cysteine residues responsible for specific 3D shape

Produced in pancreas

42
Q

What are the functions of insulin?

A

Activates a number of cascades from endogenous kinase activity

Inc. GLUT4 transporter activity, inc. number of transporters and inc. efficiency of uptake

Decrease glycogenolysis

Increase fat storage and protein production (build more insulin)

43
Q

Which hormones are derived from tyrosine?

A

Dopamine, noradrenaline, adrenaline, T3 and T4

44
Q

Which hormones are derived from tryptophan?

A

Serotonin, then further modification to melatonin

5-hydroxyindoleacetic acid - formed from serotonin, used to detect inappropriate levels

45
Q

Give the basic structure of steroid hormones and give some examples

A

All modifications of standard C17, 4 ring structure - attached groups vary

Progesterone, cortisol, testosterone, oestradiol

46
Q

What are the options for delivery of protein and peptide drugs and why?

A

IV or SC injection, inhaled aerosol , depot formulations and modified release systems

Oral administration difficult due to protein digestion

47
Q

What hormones are released from the hypothalamus?

A

Prolactin releasing hormone
Prolactin inhibiting hormone (Dopamine)
Thyrotropin releasing hormone (release of TSH)
Corticotropin releasing hormone (release of ACTH)
Growth hormone releasing hormone
Growth hormone inhibiting hormone
Gonadotropin releasing hormone (release of FSH and LH)

48
Q

What are tropic and non-tropic hormones? (REMEMBER)

A

Tropic hormones act on other endocrine glands to release more hormones

Non-tropic have physiological effect on tissue

FLAT PiG - FSH, LH, ACTH, TSH, Prolactin, Growth hormone

49
Q

What are the three cell types in the pituitary glands releasing tropic hormones?

A

Thyrotropes

Gonadotropes

Corticotropes

50
Q

What is the most common pituitary tumour and how is it treated?

A

Prolactinoma

Dopamine receptor agonists

51
Q

Which cells in the pituitary gland produce non-tropic hormones?

A

Lactotropes

Somatotropes

52
Q

What problems arise from growth hormone hypersecretion?

How is it treated?

A

Gigantism in children and acromegaly in adults

Somatostatin - inhibits growth hormone

53
Q

What problems arise from growth hormone hyposecretion?

How is it treated?

A

Dwarfism

Somatropin preparations

54
Q

Give some examples of hypothalamic and pituitary hormones as treatments

A

Thyrotropin Releasing Hormone - IV Protirelin injection, hypopituitarism

Gonadotropin - Gonadorelin causes release of FSH and LH, endometriosis and infertility

Vasopressin - Injection, pituitary diabetes insipidus

55
Q

Describe the positive feedback mechanism of oxytocin

A

Pressure on cervix from uterine contractions activate sensory neurones, causing further release of oxytocin

56
Q

When is synthetic oxytocin used?

A

Induction of labour

57
Q

Describe the physiology of diabetes insipidus

A

Excess urine production

ADH deficiency due to head trauma, tumour or infection. Hypothalamic

No reaction to ADH from kidney cells due to renal disease, receptor gene mutations or aquaporin gene mutations

58
Q

How is melatonin production controlled?

A

Light detection by retina prevents production, melatonin production regulates circadian rhythm

59
Q

Where are corticosteroids produced?

A

Cortex

Glucocorticoids (e.g. cortisol) in zona fasciculata

Mineralocorticoids (e.g. aldosterone) in zona glomerulosa

60
Q

Where are androgen precursors produced?

A

Cortex

Zona reticularis

61
Q

Why are there different zones of hormone production in the adrenal cortex?

A

Each zone has different expression of enzymes, meaning only hormones specific to that enzyme can be produced

62
Q

Which hormones are produced in the medulla?

A

Catecholamines (e.g. noradrenaline and adrenaline)

63
Q

What is the name for the backbone of steroid hormones?

A

Cyclo-pentanoperhydrophenanthrene

17 carbon ring structure

64
Q

When are steroid hormones synthesised?

A

When there is a demand in the body, not stored

65
Q

What is the rate limiting step of steroidogenesis?

A

Conversion of cholesterol to pregnenolone by pregnenolone synthase enzyme

66
Q

How is steroidogensis regulated?

A

ACTH release causes activation of pregnenolone synthase, initiates conversion of cholesterol

67
Q

What is conserved biosynthesis?

A

Same enzyme being used in a number of different pathways in different cell types

68
Q

What are the functions of glucocorticoids?

A

Metabolism, anti-inflammatory, immunosuppressive effect

69
Q

What are the functions of mineralocorticoids?

A

Water/electrolyte balance, fluid volume, blood pressure

70
Q

What are the functions of adrenal androgens?

A

Maturation and development

71
Q

How do steroid hormones work?

A

Travel in blood bound to carrier proteins (main: transcortin)

Enter cell membrane and picked up by cytoplasmic protein

Initiate gene transcription and translation at the nucleus

Can also interact with cell membrane receptors but not main function

72
Q

What metabolic and stress responses arise from cortisol release

A 
Lipolysis
Gluconeogenesis
Protein catabolism
Blood vessels sensitised to adrenaline
Reduces inflammation
73
Q

How does aldosterone increase blood pressure?

A

Released due to angiotensin 2 presence at adrenal cortex

Causes reabsorption of sodium ions in kidneys, therefore reabsorption of water. BP inc.

AT2 also causes vasoconstriction

74
Q

How can steroids be modified?

A

Varying durations of action

Different steroid activity - but difficult to remove all glucocorticoid activity

75
Q

Which backbone groups are modified to enhance glucocorticoid potency?

A

1-2 bond, ring A

Beta OH-group, ring C

OH-group, ring D

76
Q

Which backbone groups are modified to enhance mineralocorticoid activity?

A

CH2OH-group, ring D

77
Q

Which backbone groups are essential for gluco- and mineralocorticoid activity?

A

4-5 bond and 3-keto group, ring A

78
Q

How is Addison’s Disease treated using steroids?

A

Hydrocortisone (GC) with or without fludrocortisone (MC) depending on degree of adrenal gland function loss

Concentrations mimic physiological concentrations, reducing side effects

79
Q

What is Congenital Adrenal Hyperplasia?

A

Hyperfunction of adrenal cortex

Genetic defect means enzyme to convert intermediate into cortisol isn’t present, converted to androgens instead. No negative feedback mechanism

80
Q

How is Congenital Adrenal Hyperplasia treated using steroids?

A

Synthetic cortisol to reinstall negative feedback mechanism, prevents inappropriate androgen production

81
Q

What are the side effects associated with steroid use?

A

Cushing’s syndrome - proteins, lipids and metabolites from primary tissues in circulation, fat deposition on face and around trunk

Increased infection risk - esp. oral cavity, encourage frequent cleaning

82
Q

How is steroidogenesis used as a drug target?

A

Inhibit enzymes in synthesis pathway
Decrease steroid output
Selectively block particular hormone

Pharmacy Year 3 (15 decks)

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