F1. Hormone therapies Flashcards
main types of steroid hormones (contain cholesterol)?
-oestrogen
-progesterone
-testosterone
-cortisol
main types of peptide hormones?
-insulin
-glucagon
-ADH
-oxytocin
main types of amine hormones?
-adrenaline
-thyroxin
-triiodothyronine
-human growth hormone
Describe type 1 diabetes
-Autoimmune
- progressive destruction of islet b-cells
-Onset usually < 40 years
-Rapid onset
-Treatment with Insulin, regular exercise, healthy diet
Explain type 1 diabetes and cells involved
one note
role of insulin?
-Acts on insulin receptor
-Tyrosine kinase receptor
-Stimulates glucose uptake into skeletal muscle through increase in GLUT-4 transporters
-Stimulates conversion of glucose into glycogen in liver
-Prevents glycogen breakdown
-Inhibits synthesis of glucose (gluconeogenesis)
-Stimulates lipogenesis- storage of fat
-Inhibits food intake
-Stimulates cells to take up potassium
How does insulin receptor work?
Tyrosine kinase activity of enzyme leads to phosphorylation of each subunit, and activation of signalling cascade
ONE NOTE
Insulin is classified according to?
Duration of Action:
1. Short-acting- human insulin analogues
2. Intermediate
3. long-acting
Describe Short-acting- human insulin analogues
-soluble
-rapid-acting
-Normally insulin forms into hexamers which break into monomers to be absorbed into blood stream
-Recombinant analogues are modified to remain as monomers- increase rate of absorption
Describe long acting insulin
-Mix of insulin complexed other ingredients
-Gradually absorbed into blood stream
-eg insulin Isophane (complexed with protamine, NPH)- intermediate acting
-Insulin glargine and insulin detemir- long acting (24 hours)
Describe Detemir- 14-carbon fatty acid (Myristic acid) and Insulin glargine
-Detemir- 14-carbon fatty acid (Myristic acid) bound which promotes binding to albumin. Dissociates slowly from albumin
-Insulin glargine-structural changes to insulin molecule make it less soluble at physiological pH.
-Precipitates on injection- leads to slow absorption from subcutaneous space
Biphasic (pre-mixed) insulin?
-Mix of short- and intermediate-acting insulins
-To suit lifestyle of patient - insulin regimens
action profiles of insulins?
one note
daily plasma insulin profile?
one note
Describe insulin pump
-Continuous subcutaneous insulin infusion (CSII)
- Continuous basal dose, with patient-activated bolus doses at meal times
-Regular monitoring is essential for good glycaemic control to minimise acute and long-term (secondary) complications of DM
symptoms of Anaphylaxis (Shock)?
-Itching, hives, redness or swelling of the skin
-Throat tightness or swelling
-Swelling of the lips, tongue and throat
-Coughing, wheezing, trouble breathing
-Dizziness, disorientation or confusion
-Low blood pressure or hypotension
-Nausea, vomiting, diarrhea, abdominal cramps, loss of bowel movements
-Weakened pulse, increased heart rate, or loss of consciousness
phases of an allergic response?
one note
what causes a severe allergic reaction?
one note
b adrenoceptors: Subtypes?
-b1 adrenoceptors eg sino atrial node and ventricles in heart- rate and force of contraction
-b2 adrenoceptors eg airway smooth muscle- relaxation
-b3 adrenoceptors eg skeletal muscle, adipose tissue
aim of treatment for allergic reaction?
Rapid Relief of symptoms
Block early phase of allergic attack
Clinical guidance (NICE)
what are the two routes of treatment for an allergic reaction?
Route 1:
Intramuscular injection
500micrograms, using adrenaline 1 in 1000 (1mg/mL) injection, repeat dose after 5 minutes if no response;
Injected into the anterolateral aspect of the middle third of the thigh.
Route 2:
Slow intravenous injection
1mg every 3–5minutes as required, a 1 in 10000 (100micrograms/mL) solution is recommended.
Describe epipen
-Patients must carry 2 devices with them at all times
-Use the adrenaline auto-injector
-Especially any signs affecting the
-Airways(swelling of the tongue or a feeling of constriction in the throat),
-Breathing(wheezing, difficulty in breathing),
-Circulation(feeling faint, dizzy, cold clammy skin)
cause for breast cancer?
-Before themenopause, the ovaries produce the hormones oestrogen and progesterone.
-After the menopauseoestrogen is made in body fat and muscle.
-These hormones can stimulate the growth of some breast cancer cells
Describe Tamoxifen (TAM)
-Selective oestrogen receptor modulators (SERMs)
-Most common chemo-preventative medicine (used after cancer therapy)
-Only effective in ER positive breast cells- Confirmed with biopsy
-Binds to the ER in competitive manner
-To prevent new cancer cells from growing
