Endocrine Pharmacology 2
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- What is used as replacement therapy for adrenocortical insufficiency (Addison's disease)?
- Mineralocorticoids and glucocorticoids
- Adrenal corticosteroids are used to treat what?
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-Addison's disease
-Allergic disorders
-Inflammation conditions: rheumatoid arthritis, osteoarthritis. - What is the condition associated with uncontrolled bone formation?
- Paget's disease
- What are the characteristics of Cushing's syndrome?
- Redistribution of fat, puffy face, increased body hair growth, acne, insomnia, and increase appetite
- What are some examples of Biguanides, an oral hypoglycemic agent?
- Metformin and phenformim
- Orinase is the prototype for what oral hypglycemic agent?
- Tolbutamine
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Tolbutamide realses insulin from what cells?
Alpha or Beta? - Beta
- What are the side effects of Tolbutamide?
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Hypoglycemia
*GIT: nausea, stomach pain, vomiting and diarrhea.
*Cutaneous reactions: rashes and photsensitivity
*Disulfiram like realction (headache, nausea, and flushing) after consumption of alcohol. - What are the therapeutic uses of tolbutmaide?
- used to treat patients with Type II diabetes, who cannot be treated with diet alone or who are unwilling to take insulin if dietary control fails.
- What are the three hormones produced by the Adrenal cortex?
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Minderalcorticoidsfrom zona glomerulosa (Aldosterone, fludrocortisone {Florinef})
Glucocorticioids from the zona fasciculata (cortisol hydrocortisone {Cortef}, prenisone {deltasone}, dexamethasone {decadron}, bethamethasone {celestone})
adrenal androgens from the zona reticularis. - What are the functions of mineralocorticoids?
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-Casue reabsorptions of sodium and water from kidneys
-Responisble for maintaining fluid and electrolyte balance in the body. - What are the functions of glucocorticoids?
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-Metabolic: stimulate gluconeogenesis, lipolysis,a nd protein catabolism
-Anatiinflammatory actions: inhibition of protagladin and leukotriene biosynthesis. Increase resistance to stress. -
The following are side effects of which adrenal corticosteroid?
-hypernatremia (excess NA+)
-Hypokalemia
-Fluid retention and edema; hypertension - Mineralocorticoids
- Glucocorticoids have what side effects on the Metabolic system, GI tract, CNS,and eye?
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Metabolic: weight gain, hperglycemia, oseoporosis, and muslce wasting.
GI: Gastric ulcers
CNS: Psychosis
Eye: cataract, gaucoma - What adrenal corticosteroid causes Cushing's syndrome?
- Glucocorticoids
- What is a is function of the Endocrine System?
- 1) To mainatian internal homeostasis through the use of endogenous chemicals known as hormones.
- What are Hormones and what is their place in the Endocrine System?
- Hormones are chemical messengers released into the circulation to act on target organs which may be located at some distance from the site of hormonal release.
- What is the function of the Thyroid gland?
- The thyroid gland facilitates normal growth and maturation by maintaining the level of metabolism in tissues that is optimal for their normal function.
- Name two major thryoid hormaones.
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1) Triiodothyronine (T3)
2) Thyroxine (T4) - What controls the function of the thyroid?
- Trophic hormone and thyrotropin-stimulating hormone (TSH) from the anterior pituitary.
- What effect do throid hormones play on Thermogenesis?
- Increase in basal metabolic rate.
- What are the effects of the thyroid homones on growth and development?
- Facilitate normal growth and development by enhancing the release of growth hormones.
- What is Cretinism?
- Severe mental and physical retardation associated with lack of thyroid hormone in children.
- What is the effect of thyroid hormones on the CVS?
- Increase in heart rate and contractility.
- What are two thyroid disorders?
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1) Hypothroidism
2) hyperthyroidism - What are characteristics hypothyroidism?
- lethargy, weight gain, constipation, bradycardia, cold intolerance, weakness
- What are the characteristics of Hyperthyroidism?
- Nervousness, weight loss, diarrhea, tachycardia, insomnia, muscle wasting, increased appetite, heat intolerance.
- Calcitonin is used to treat what?
- Excessive release of calcium
- What can be done to treat hypothroidism?
- Replacement therapy with synthetic and natural thyroid hormone preparations
- Name the natural extracts used to treat hypothyroidism?
- Thyroid tablets (Armour Thyroid) and thyroglobulin.
- What are the synthetic treatments used to treat hypothyroidism?
- Liotrix (Euthroid, Thyrolar) and T3 and T4
- What is done to treat hyperthyroidism?
- Reduction of thyroid activity and hormone effects can be accomplished by agents that interfere with the production of thyroid hormones.
- Agents that interfere with the production of thyroid hormones can occur through what?
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1) Attenuation of synthesis of thyroid hormones
2) Glandular destruction - What 2 drugs interfere with the production of thyroid hormones through the attenuation of synthesis of thyroid hormones?
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1) thionamides
2) iodide - What occurs when gladular destruction is used to interfere with the production of thyroid hormones?
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1) radiation (radioactice idodide)
2) Surgery - Insulin is secreted by what cells?
- B-cells of the islets of Langerhans
- Glucagon is secreted by what cells?
- a-cells of the islets of langerhans
- True or False? The pancreas is an endocrine and exocrine gland?
- True, as an endocrine gland it produces peide hormone secreting insulin and glucagon. As an exocrine gland is is in control of digestive enzymes.
- What triggers the insulin release in blood glucose levels?
- The pancreas
- What is the chronic metabolic disorder characterized by hyperglycemia which is due to insulin deficiency or insulin resistance?
- Diabetes mellitus
- What are the two main forms of diabetes?
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1. Type I (juvenile-onset, insulin dependent diabetes)
2. Type II (maturity-onset, non insulin dependent diabetes) - What occurs in type II diabetes?
- Decreased senstivity of peripheral tissues (liver & skeletal muscle) to circulate insulin, causing insulin resistance.
- What occurs in type I diabetes?
- There is complete failure of pancreatic B-cells function.
- Drugs used in the treatment of diabetes mellitus are what agents?
- insuli and oral hypoglycemic
- Sources of insulin can be isolated from?
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-Animal sources (beef and pork)
-Human insulin is produced synthetically by recombinant DNA technology. - What is the majory pharmacological action of insulin?
- To lower blood glucose levels.
- What type of hormone is insulin?
- Anabolic
- What are insulin's effects on the liver and on muscle?
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Liver: inhibits glycogenolysis and promotes glucose storage as glycogen
Muscle: Increased glycogen synthesis - How are insulin preparations classified?
- They are classified according to onset, duration and intensity of action.
- What are the side effects of insulin?
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-Hypoglycemia
*initial symptoms include headache, sweating, tachycardia, hunger, and fatigue: may prodceed to mental consuion, convulsions, coma and death.
-Allergic reactions due to antigen-antibody reactions
-Weight gain - Sulfnylureas and Biguanides are examples of what?
- Oral hypoglycemic agents that are able to effectively lower blood sugar.
- Tolbutamide, tolazamide (tolinase), chlorpropamide (diabinese) and glipizide (glucotrol) are examples of what oral hypoglycemic agent?
- Sulfonylureas
- Iodide and Radioactive Iodide are used to control hyperthyroidism in what disease?
- Graves' disease
- What is Graves' disease?
- Thyrotoxicosis auto-immune thyroid disease resulting in excess thyroxine hormone.
- What are the characteristics of radioactive iodine, in the treatment of hyperthyroidism?
- It can selectively destroy thyroid tissues in hyperthyroid patients and is active orally and can be rapidly incorporated into the thyroid glad.
- True or False? Bone is a dynamic tissue which occasionally undergoes changes in mineral content and internal structure.
- False. Bone is a dynamic tissue which CONSTANTLY undergoes changes in mineral content and internal structure.
- What controls the balance between bone resorption and formation?
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-Parathriod hormone (PTH)
-Vitamin D
-Clacitonin - What do parathyroid cells monitor?
- Plasma calcium levels
- A decrease in this activates the release of parathyroid hormone?
- plasma calcium
- PTH (parathyroid hormone) increases blood calcium levles by altering calcium metabolism in?
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-bone
-kidnys
-GI tract - A decrease in calcium in the blood causes an increase in PTH and what other substances?
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-Bone: increase in bone resorption
-Kidneys: increase in the production of Vit. D
-GI tract: increase in calcium absorption (Vit. D) - What are four conditions associated with deficiency of calcium/vitamin D?
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-rickets
-osteoporosis
-osteomalacia
-hypoparathyroidism - Pagets's disease is a condition assocated with what?
- Excess calcium
- What can be done to treat calcium deficiency?
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-Calcium Supplements
-Vitamin D analogues - What do calcium supplements prevent?
- Used to prevent bone loss in conditions such as osteoporosis, osteomalcia, and hypoparathyroidism.
- Calcitriol (Calcijex) and caldifediol (calderol) are examples of?
- Vitamin D analogues
- What do vitamin D analogues do?
- Used to enhance bone mineralization in conditions such as osteodystrophy, rickets, osteomalacia and hypoparathyroidism.
- How does Iodide used to treat hyperthyroidsim?
- In high concentrations, iodide can suppress thyroid function by inhibiting all steps invovled in thyroid hormone biosynthesis.
- Thionamides are used to treat what?
- Hyperthyroidism
- What are some examples of Thionamides, which are used to treat hyperthyroidism?
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-Propylthiouracil (Propyl-thyracil)
-Methimazole (Tapazole) - How do Thionamides, which are used to treat hyperthyroidism, work?
- Inhibition of thyroidal peroxidase.
- Whare are the therapeutic uses of thionamides?
- Treatment of hyperthyroidism due to Graves disease.