meds + physiology Flashcards
where is insulin produced
beta cells of pancreas
function of insulin
causes liver, skeletal, and fat tissues to absorb glucose from the blood
how + where is sugar stored
liver and skeletal = glycogen // adipocytes = triglucerides
how is insulin formed
rough ER makes pro-insulin –> cleaved to insulin + C peptite
what electrolyte causes insulin to be released
Ca
function insulin (5)
manage hyperglycaemia // glycogen synthesis // inhibit lipolysis // reduce muscle loss // increase uptake of K+
what do alpha pancreas cells secrete
glucagon (encourage glucose stores to be released)
what do delta pancreas cells release
somatostatin
function somatostatin
inhibits release of GH, glucagon, and insulin
what is octreotide
somatostatin analogue
uses ocrteotide (6)
variceal bleed // acromegaly // carcinoid // VIPoma // prevent complication in pancreatic surgery // diarrhoea
SE octreotide
gallstones
when is GH therapy indicated (4)
GH deficiency // turner’s // prader willi // renal insufficiency pre-puberty
SE GH therapy
headache, intracranial hypertension, fluid retention
what hormones are increased in the body’s stress response (8)
GH, cortisol, renin, ACTH, aldosteroine, prolactin, ADH, glucagon
what hormones are decreased in the body’s stress response (3)
insulin, testosterone, oestrogen
what hormones are unchanged in stress (3)
FSH, LH, TSH
what does the sympathetic NS stimulate release of –> what response
catecholamines (norephiphrine) –> tachycardia + hypertension
what stimuates cortisol release
ACTH
functions cortisol
break down protein via skeletal muscle // stimulate lipolysis (anti-insulin) // anti -inflamattory // mineralcorticoid effects
metabolic effects of stress response (5)
hyperglycaemia // protein anabolism, (catabolism if severe) // lipolysis –> ketones // Na + water retention // interluekins
what mx can suppress stress response
opioids // spinal anaesthesia // nutrition // (GH + steroids maybe)
what steroid has minimal glucocorticoid activity, and v high mineralocorticoid
fludrocortisone
what steroid has low glucocorticoid activity, and high mineralocorticoid
hydrocortisone
what steroid has mostly glucocorticoid activity, and low mineralocorticoid
prednisolone
what steroid has high glucocorticoid activity, and minimal mineralocorticoid
dexamethasone, betmethasone
endocrine SE steroids (5)
impaired glucose regulation // increased appetite // hirsutism // raised lipids // cushings - moon face, hump, striae
psychiatric SE steroids (4)
insomnia // mania // depression // psychosis
MSK SE steroids (3)
osteoporosis // proximal myopathy // AVN femoral head
GI steroid SE (2)
peptic ulcer, pancreatitis
eye SE steroids (2)
glaucoma // cataracts
general health SE (5)
reactivated TB // infection // supressed growth // neutrophilia (raised WCC) // intracranial hypertension
SE mineralocorticoids (2)
fluid retention // raised BP
what should happen to those on long term steroid in acute illness
double dose
whatc can sudden withdrawal of corticosteroids cause
addisons croisis
when should systemic steroids be considered for gradual withdrawal > abrupt stopping (3)
40mg+ of pred daily for more than 1 week + received more than 3 weeks + recently repeated dose
where is prolactin released from
ant pit (with ADH)
function prolactin
stimulated breast develpoment + milk production // decreased GnRH (and blocks LH)
what inhibits prolactin secretion
dopamine
what increases secretion of prolactin
thyrotropin releasing hormone // pregnancy + breastfeeding // oestrogen // sleep // stress // metoclopramide
