exam 1: endocrine Flashcards
thyroid hormone (T3) receptor?
nuclear receptor
steroid hormone receptor?
cytoplasmic receptor
androgens and testosterone (anabolic steroid) examples
androgen, androstenedione, nandralone
glucocorticosteroids overall function
regulating glucose metabolism and combating stress
glucocorticosteroids examples
cortisol and corticosterone
mineralocorticosteroids function
water and electrolyte balance
mineralocorticosteroids example
aldosterone
physiologic dose
same concentration as hormone is normally found in the body
pharmacological dose
use higher dose to exploit effect
glucocorticoids in normal function order
hypothalamus > CRH > anterior pituitary > ACTH > adrenal cortex > cortisol > target tissues
actions of glucocorticoids
- released during stress: physical or psychological
- later cellular “protein expression” by altering transcription of certain genes
glucose, protein, and lipid metabolism effects
- anti-inflammatory effects
- immunosuppression
- sodium and water reabsorption
- CNS changes (mood and behavior)
- alter composition fo blood and muscle
metabolic effects of cortisol in the muscle
decrease glucose uptake and increase protein breakdown
metabolic effects of cortisol in fat cells
decrease glucose uptake and increase fat breakdown
effects on glucose, protein, and lipid metabolism
- paradoxical effect: increased blood glucose while increasing glycogen storage
- accomplishes by enhancing catabolism
1 side effect of corticosteroids?
muscle wasting
anti-inflammatory effects of corticosteroids
- attenuate pain, erythema, swelling, and tenderness
- inhibit eicosanoid synthesis through lipocortins
- inhibition of cellular inflammatory response
- stabilize WBC lysosomal membranes
- decrease vascular permeability
glucocorticoid effects on other systems
- inhibits hypersensitivity reactions
- increases kidney reabsorption of sodium and water
- personality or mood changes
- impaired skeletal and cardiac muscle function
what are the 2 therapeutic uses of glucocorticoids
anti-inflammatory effects and hormone replacement therapy
anti-inflammatory uses of glucocorticoids
- injection into joints, tendons, bursa
- phonophoresis (US) and iontophoresis (e-stim)
- systemic
hormone replacement use of glucocorticoids
cortisol is given for Addison’s disease and secondary adrenal insufficiency
3 common glucocorticoids
beclomethasone, cortisone, and dexamethasone
what can hypersecretion of glucocorticoids lead to
cushings syndrome
cushing syndrome side effects
mood face, centripetal obesity, bone and connective tissue damage, muscle wasting in limbs, behavioral changes, hyperglycemia and type 2 DM
side effects of glucocorticoids
adrenocortical suppression (decreased CRH production), Cushings syndrome, peptic ulcer, growth retardation in children, immunosuppression, glaucoma, mood changes and psychosis, sodium and water reabsorption
what do alpha cells make
glucagon
what do beta cells make
insulin
insulin decreases…
blood glucose
glucagon increases….
blood glucose
what is GLP
- an incretin secreted by the intestinal L-cells in response to feeding
- promotes glucose-dependent insulin secretion by increasing insulin-sensitivity in beta cells
GLP-1 effects
- decrease glucagon secretion
- inhibits gastric emptying in stomach
- promotes satiety in brain and decreases hunger
- promotes insulin sensitivity in peripheral tissues
how does insulin work to decrease blood glucose
causes GLUT proteins to function and the GLUT proteins are responsible for transporting glucose out of the blood
insulin negative feedback mechanism
- increase in BG stimulates insulin release
- decrease in BG inhibits insulin release
glucagon negative feedback mechanism
- decrease in BG stimulates glucagon release
- increase in BG inhibits glucagon release
hyperglycemia side effects
glucosurea (peeing), dehydration, electrolyte imbalance, metabolic shift, ketoacidosis, glycosolation of vascular and neural structures, and atherosclerosis and ischemia heart disease
rapid acting insulin
given when BG is hard to control
- Humulin R
intermediate insulin
NPH and Humulin N, Isophane
long acting insulin
given when BG is stable
- Humulin U, insulin glacrine (Lantus)
increase or decrease insulin dose before a meal
increase dose
increase or decrease insulin dose if no meal planned for a while
decrease dose
increase or decrease insulin dose if going to PT
decrease dose
hypoglycemia side effects
headache, tachycardia, fatigue, anxiety and nervousness, hunger, diaphoresis, confusion
what is the “Somogy Effect” or “rebound”
an increase in BG due to antibiotics to insulin; causes a decrease in the effectiveness and insulin resistance to that particular type
list of oral hypoglycemics
metformin, sitagliptin, exenatide, repaglinide, glyburide, glucovance, rosiglitazone
thyroid hormone effects
stimulating metabolism, thermogenesis, growth and development, CV effect, and metabolism effect
thyroid hormone replacement drug
Levothyroxine
treatment of hyperthyroidism
surgical removal or radioactive iodine
bone mineralization drugs
CaCO4, calcitriol, etidronate, estrogen
