Endrocrine drugs
-
Upload
rkrajreliance9 -
Category
Documents
-
view
461 -
download
1
description
Transcript of Endrocrine drugs
![Page 1: Endrocrine drugs](https://reader036.fdocuments.us/reader036/viewer/2022081413/5497768eb4795932538b4569/html5/thumbnails/1.jpg)
Drugs that Affect the
Endocrine System
Drugs that Affect the
Endocrine System
![Page 2: Endrocrine drugs](https://reader036.fdocuments.us/reader036/viewer/2022081413/5497768eb4795932538b4569/html5/thumbnails/2.jpg)
TopicsTopicsTopicsTopics
• Pituitary Drugs
• Parathyroid/Thyroid Drugs
• Adrenal Drugs
• Pancreatic Drugs
• Reproductive Drugs
• Sexual Behavior Drugs
• Pituitary Drugs
• Parathyroid/Thyroid Drugs
• Adrenal Drugs
• Pancreatic Drugs
• Reproductive Drugs
• Sexual Behavior Drugs
![Page 3: Endrocrine drugs](https://reader036.fdocuments.us/reader036/viewer/2022081413/5497768eb4795932538b4569/html5/thumbnails/3.jpg)
FunctionsFunctionsFunctionsFunctions
• Regulation
• Control
• Regulation
• Control
![Page 4: Endrocrine drugs](https://reader036.fdocuments.us/reader036/viewer/2022081413/5497768eb4795932538b4569/html5/thumbnails/4.jpg)
GlandsGlandsGlandsGlands
Exocrine
• Secrete enzymes• Close to organs
Exocrine
• Secrete enzymes• Close to organs
Endocrine
• Secrete hormones• Transport via
bloodstream• Require receptors
Endocrine
• Secrete hormones• Transport via
bloodstream• Require receptors
![Page 5: Endrocrine drugs](https://reader036.fdocuments.us/reader036/viewer/2022081413/5497768eb4795932538b4569/html5/thumbnails/5.jpg)
NervousNervous EndocrineEndocrine
NeurotransmittersNeurotransmitters HormonesHormones
Short DistanceShort Distance Long DistanceLong Distance
ClosenessCloseness Receptor SpecificityReceptor Specificity
Rapid OnsetRapid Onset Delayed OnsetDelayed Onset
Short DurationShort Duration Prolonged DurationProlonged Duration
![Page 6: Endrocrine drugs](https://reader036.fdocuments.us/reader036/viewer/2022081413/5497768eb4795932538b4569/html5/thumbnails/6.jpg)
Mechanism of ActionMechanism of ActionMechanism of ActionMechanism of Action
![Page 7: Endrocrine drugs](https://reader036.fdocuments.us/reader036/viewer/2022081413/5497768eb4795932538b4569/html5/thumbnails/7.jpg)
HypothalamusHypothalamusHypothalamusHypothalamus
![Page 8: Endrocrine drugs](https://reader036.fdocuments.us/reader036/viewer/2022081413/5497768eb4795932538b4569/html5/thumbnails/8.jpg)
Hypothalamic Control PituitaryHypothalamic Control PituitaryHypothalamic Control PituitaryHypothalamic Control Pituitary
![Page 9: Endrocrine drugs](https://reader036.fdocuments.us/reader036/viewer/2022081413/5497768eb4795932538b4569/html5/thumbnails/9.jpg)
Posterior PituitaryPosterior PituitaryPosterior PituitaryPosterior Pituitary
Target Actions
Oxytocin Uterus Mammary
Contraction Milk let-down
ADH Kidneys Water reabsorption
Target Actions
Oxytocin Uterus Mammary
Contraction Milk let-down
ADH Kidneys Water reabsorption
![Page 10: Endrocrine drugs](https://reader036.fdocuments.us/reader036/viewer/2022081413/5497768eb4795932538b4569/html5/thumbnails/10.jpg)
Anterior PituitaryAnterior PituitaryAnterior PituitaryAnterior Pituitary
Target Action
GH Most tissue Growth
TSH Thyroid THsecretion
ACTH AdrenalCortex
Cortisolsecretion
Target Action
GH Most tissue Growth
TSH Thyroid THsecretion
ACTH AdrenalCortex
Cortisolsecretion
![Page 11: Endrocrine drugs](https://reader036.fdocuments.us/reader036/viewer/2022081413/5497768eb4795932538b4569/html5/thumbnails/11.jpg)
Anterior PituitaryAnterior PituitaryAnterior PituitaryAnterior Pituitary
Target Action
FSH OvariesTestes
FolliclesEstrogenSperm
LH OvariesTestes
OvulationProgesteroneTestosterone
Target Action
FSH OvariesTestes
FolliclesEstrogenSperm
LH OvariesTestes
OvulationProgesteroneTestosterone
![Page 12: Endrocrine drugs](https://reader036.fdocuments.us/reader036/viewer/2022081413/5497768eb4795932538b4569/html5/thumbnails/12.jpg)
Anterior PituitaryAnterior PituitaryAnterior PituitaryAnterior Pituitary
Target Action
Prolactin MammaryGland
Milkproduction
Target Action
Prolactin MammaryGland
Milkproduction
![Page 13: Endrocrine drugs](https://reader036.fdocuments.us/reader036/viewer/2022081413/5497768eb4795932538b4569/html5/thumbnails/13.jpg)
Pituitary HormonesPituitary HormonesPituitary HormonesPituitary Hormones
![Page 14: Endrocrine drugs](https://reader036.fdocuments.us/reader036/viewer/2022081413/5497768eb4795932538b4569/html5/thumbnails/14.jpg)
ThyroidThyroidThyroidThyroid
![Page 15: Endrocrine drugs](https://reader036.fdocuments.us/reader036/viewer/2022081413/5497768eb4795932538b4569/html5/thumbnails/15.jpg)
Thyroid Thyroid Thyroid Thyroid
Target Action
ThyroxineTriiodothyronine
Most cells BMR
Calcitonin Mostly bone Calcium
Target Action
ThyroxineTriiodothyronine
Most cells BMR
Calcitonin Mostly bone Calcium
![Page 16: Endrocrine drugs](https://reader036.fdocuments.us/reader036/viewer/2022081413/5497768eb4795932538b4569/html5/thumbnails/16.jpg)
HypothyroidismHypothyroidismHypothyroidismHypothyroidism
![Page 17: Endrocrine drugs](https://reader036.fdocuments.us/reader036/viewer/2022081413/5497768eb4795932538b4569/html5/thumbnails/17.jpg)
HyperthyroidismHyperthyroidismHyperthyroidismHyperthyroidism
![Page 18: Endrocrine drugs](https://reader036.fdocuments.us/reader036/viewer/2022081413/5497768eb4795932538b4569/html5/thumbnails/18.jpg)
ParathyroidParathyroidParathyroidParathyroid
![Page 19: Endrocrine drugs](https://reader036.fdocuments.us/reader036/viewer/2022081413/5497768eb4795932538b4569/html5/thumbnails/19.jpg)
ParathyroidParathyroidParathyroidParathyroid
Target Action
Parathyroid(PTH)
BoneKidneyGI Tract
Calcium
Target Action
Parathyroid(PTH)
BoneKidneyGI Tract
Calcium
![Page 20: Endrocrine drugs](https://reader036.fdocuments.us/reader036/viewer/2022081413/5497768eb4795932538b4569/html5/thumbnails/20.jpg)
Calcium RegulationCalcium RegulationCalcium RegulationCalcium Regulation
![Page 21: Endrocrine drugs](https://reader036.fdocuments.us/reader036/viewer/2022081413/5497768eb4795932538b4569/html5/thumbnails/21.jpg)
PancreasPancreasPancreasPancreas
![Page 22: Endrocrine drugs](https://reader036.fdocuments.us/reader036/viewer/2022081413/5497768eb4795932538b4569/html5/thumbnails/22.jpg)
PancreasPancreasPancreasPancreas
• Alpha cells: glucagon
• Beta cells: insulin
• Alpha cells: glucagon
• Beta cells: insulin
![Page 23: Endrocrine drugs](https://reader036.fdocuments.us/reader036/viewer/2022081413/5497768eb4795932538b4569/html5/thumbnails/23.jpg)
PancreasPancreasPancreasPancreas
Target Action
Glucagon Liver Glucose
Insulin General Glucose
Target Action
Glucagon Liver Glucose
Insulin General Glucose
![Page 24: Endrocrine drugs](https://reader036.fdocuments.us/reader036/viewer/2022081413/5497768eb4795932538b4569/html5/thumbnails/24.jpg)
Glucose RegulationGlucose RegulationGlucose RegulationGlucose Regulation
![Page 25: Endrocrine drugs](https://reader036.fdocuments.us/reader036/viewer/2022081413/5497768eb4795932538b4569/html5/thumbnails/25.jpg)
AdrenalAdrenalAdrenalAdrenal
![Page 26: Endrocrine drugs](https://reader036.fdocuments.us/reader036/viewer/2022081413/5497768eb4795932538b4569/html5/thumbnails/26.jpg)
![Page 27: Endrocrine drugs](https://reader036.fdocuments.us/reader036/viewer/2022081413/5497768eb4795932538b4569/html5/thumbnails/27.jpg)
![Page 28: Endrocrine drugs](https://reader036.fdocuments.us/reader036/viewer/2022081413/5497768eb4795932538b4569/html5/thumbnails/28.jpg)
Adrenal MedullaAdrenal MedullaAdrenal MedullaAdrenal Medulla
Target Action
NorepiEpi
HeartBloodvesselsLiver
ProlongsSNS Effects
Target Action
NorepiEpi
HeartBloodvesselsLiver
ProlongsSNS Effects
![Page 29: Endrocrine drugs](https://reader036.fdocuments.us/reader036/viewer/2022081413/5497768eb4795932538b4569/html5/thumbnails/29.jpg)
Adrenal CortexAdrenal CortexAdrenal CortexAdrenal Cortex
Target Action
Aldosterone Kidney Nareabsobtion Waterretention
Cortisol Most Tissue Glucose inflammation
Target Action
Aldosterone Kidney Nareabsobtion Waterretention
Cortisol Most Tissue Glucose inflammation
![Page 30: Endrocrine drugs](https://reader036.fdocuments.us/reader036/viewer/2022081413/5497768eb4795932538b4569/html5/thumbnails/30.jpg)
Anterior Pituitary DrugsAnterior Pituitary DrugsAnterior Pituitary DrugsAnterior Pituitary Drugs
Inadequate Growth Hormone
• Dwarfism• somatrem (Protropin®)• homatropin
(Humatrope®)
Inadequate Growth Hormone
• Dwarfism• somatrem (Protropin®)• homatropin
(Humatrope®)
Excessive Growth Hormone
• Acromegaly• Gigantism• Surgical removal 1º• octreotide
(Sandostatin®)
Excessive Growth Hormone
• Acromegaly• Gigantism• Surgical removal 1º• octreotide
(Sandostatin®)
![Page 31: Endrocrine drugs](https://reader036.fdocuments.us/reader036/viewer/2022081413/5497768eb4795932538b4569/html5/thumbnails/31.jpg)
Posterior Pituitary DrugsPosterior Pituitary DrugsPosterior Pituitary DrugsPosterior Pituitary Drugs
• Oxytocin
• ADH– Diabetes insipidus– Nocturnal enuresis
• vasopressin (Pitressin®)
• desmopressin (Stimate®)
• lypressin (Diapid®)
• Oxytocin
• ADH– Diabetes insipidus– Nocturnal enuresis
• vasopressin (Pitressin®)
• desmopressin (Stimate®)
• lypressin (Diapid®)
![Page 32: Endrocrine drugs](https://reader036.fdocuments.us/reader036/viewer/2022081413/5497768eb4795932538b4569/html5/thumbnails/32.jpg)
Parathyroid DiseasesParathyroid DiseasesParathyroid DiseasesParathyroid Diseases
• Hypoparathyroidism– Inadequate calcium levels
• TX: increased dietary calcium
• Hyperparathyroidism– Excessive calcium levels
• TX: surgical removal
• Hypoparathyroidism– Inadequate calcium levels
• TX: increased dietary calcium
• Hyperparathyroidism– Excessive calcium levels
• TX: surgical removal
![Page 33: Endrocrine drugs](https://reader036.fdocuments.us/reader036/viewer/2022081413/5497768eb4795932538b4569/html5/thumbnails/33.jpg)
Thyroid DiseaseThyroid DiseaseThyroid DiseaseThyroid Disease
• Hypothyroidism– Hormone replacement– levothyroxine (Synthroid®)
• Hyperthyroidism– Thyrotoxicosis– Surgical removal– propylthiouracil (PTU)
• Hypothyroidism– Hormone replacement– levothyroxine (Synthroid®)
• Hyperthyroidism– Thyrotoxicosis– Surgical removal– propylthiouracil (PTU)
![Page 34: Endrocrine drugs](https://reader036.fdocuments.us/reader036/viewer/2022081413/5497768eb4795932538b4569/html5/thumbnails/34.jpg)
Adrenal CortexAdrenal CortexAdrenal CortexAdrenal Cortex
ACTH Hypersecretion
Cushing’s Disease• Surgical removal• Inhibit adrenal
secretion– ketoconazol (Nizoral ®)
• Symptomatic tx:– Antihypertensives
ACTH Hypersecretion
Cushing’s Disease• Surgical removal• Inhibit adrenal
secretion– ketoconazol (Nizoral ®)
• Symptomatic tx:– Antihypertensives
ACTH Hyposecretion
Addison’s Disease• Replacement therapy• Cortisone (Cortistan®)• Hydrocortisone
(SoluCortef®)• Fludrocortisone
(Florinef Acetate®)
ACTH Hyposecretion
Addison’s Disease• Replacement therapy• Cortisone (Cortistan®)• Hydrocortisone
(SoluCortef®)• Fludrocortisone
(Florinef Acetate®)
![Page 35: Endrocrine drugs](https://reader036.fdocuments.us/reader036/viewer/2022081413/5497768eb4795932538b4569/html5/thumbnails/35.jpg)
PancreasPancreasPancreasPancreas
BloodGlucose
BloodGlucose
BloodPotassium
BloodPotassium
![Page 36: Endrocrine drugs](https://reader036.fdocuments.us/reader036/viewer/2022081413/5497768eb4795932538b4569/html5/thumbnails/36.jpg)
Insulin PreparationsInsulin PreparationsInsulin PreparationsInsulin Preparations
• Regular Insulin– Natural insulin
• Modified Insulin– Increased duration of action– NPH (neutral protamin Hagedorn)
• Natural plus protamin
– Lente• Attached to zinc to prolong absorption
• Regular Insulin– Natural insulin
• Modified Insulin– Increased duration of action– NPH (neutral protamin Hagedorn)
• Natural plus protamin
– Lente• Attached to zinc to prolong absorption
![Page 37: Endrocrine drugs](https://reader036.fdocuments.us/reader036/viewer/2022081413/5497768eb4795932538b4569/html5/thumbnails/37.jpg)
Oral Hypoglycemic AgentsOral Hypoglycemic AgentsOral Hypoglycemic AgentsOral Hypoglycemic Agents
Sulfonylureas
insulin secretiontolbutamide (Orinase®)
chlorpropamide (Diabinese®)
glipizide (Glucotrol®)
glyburide (Micronase®)
Sulfonylureas
insulin secretiontolbutamide (Orinase®)
chlorpropamide (Diabinese®)
glipizide (Glucotrol®)
glyburide (Micronase®)
Alpha-glucosidase inhibitors
• Delay carbohydrate metabolism
acarbose (Precose®)miglitol (Glyset®)
Alpha-glucosidase inhibitors
• Delay carbohydrate metabolism
acarbose (Precose®)miglitol (Glyset®)
Biguanidesmetformin (Glucophage®)
Glucose synthesis Glucose uptake
Biguanidesmetformin (Glucophage®)
Glucose synthesis Glucose uptake
Thiazolidinediones Insulin effectivenesstroglitazone (Rezulin®)
Thiazolidinediones Insulin effectivenesstroglitazone (Rezulin®)
![Page 38: Endrocrine drugs](https://reader036.fdocuments.us/reader036/viewer/2022081413/5497768eb4795932538b4569/html5/thumbnails/38.jpg)
Hyperglycemic AgentsHyperglycemic AgentsHyperglycemic AgentsHyperglycemic Agents
• Glucagon gluconeogenesis
• D50W
• Glucagon gluconeogenesis
• D50W
• diazoxide (Proglycem®)– Inhibits insulin release
• diazoxide (Proglycem®)– Inhibits insulin release
![Page 39: Endrocrine drugs](https://reader036.fdocuments.us/reader036/viewer/2022081413/5497768eb4795932538b4569/html5/thumbnails/39.jpg)
Estrogens & ProgestinsEstrogens & ProgestinsEstrogens & ProgestinsEstrogens & Progestins
• Estrogens used for post-menopausal hormone replacement therapy.– estradiol (Estrace®)
– conjugated estrogens (Premarin®)
– estropipate (Ogen®)
• Estrogens used for post-menopausal hormone replacement therapy.– estradiol (Estrace®)
– conjugated estrogens (Premarin®)
– estropipate (Ogen®)
• Progestin– Diminish side effects
of estrogen therapy
– Nausea, fluid retention, breast tenderness
– medroxyprogesterone acetate (Provera®)
– norethindrone acetate (Aygestin®)
• Progestin– Diminish side effects
of estrogen therapy
– Nausea, fluid retention, breast tenderness
– medroxyprogesterone acetate (Provera®)
– norethindrone acetate (Aygestin®)
![Page 40: Endrocrine drugs](https://reader036.fdocuments.us/reader036/viewer/2022081413/5497768eb4795932538b4569/html5/thumbnails/40.jpg)
Oral ContraceptivesOral ContraceptivesOral ContraceptivesOral Contraceptives
• Combination of estrogen and progestin– Loestrin®, Levora®, Nordette®, Ovocon®,
Norinyl® plus many others
• Minipill: progestin only– Micronor®, Nor-Q.D.®, Orvette®
• Prime side effect: risk of thromboembolism
• Combination of estrogen and progestin– Loestrin®, Levora®, Nordette®, Ovocon®,
Norinyl® plus many others
• Minipill: progestin only– Micronor®, Nor-Q.D.®, Orvette®
• Prime side effect: risk of thromboembolism
![Page 41: Endrocrine drugs](https://reader036.fdocuments.us/reader036/viewer/2022081413/5497768eb4795932538b4569/html5/thumbnails/41.jpg)
Uterine Stimulants & Uterine Stimulants & RelaxantsRelaxantsUterine Stimulants & Uterine Stimulants & RelaxantsRelaxants• Stimulants (Oxytocics) uterine contraction• Indication:
– Induce labor– Postpartum
hemorrhage
• oxytocin (Pitocin®)• ergonovine
(Ergotrate®)
• Stimulants (Oxytocics) uterine contraction• Indication:
– Induce labor– Postpartum
hemorrhage
• oxytocin (Pitocin®)• ergonovine
(Ergotrate®)
• Relaxants (tocolytics)• Relax uterine smooth
muscle
• Beta2 agonists– terbutaline (Brethine®)
– ritodrine (Yuptopar®)
• Relaxants (tocolytics)• Relax uterine smooth
muscle
• Beta2 agonists– terbutaline (Brethine®)
– ritodrine (Yuptopar®)
![Page 42: Endrocrine drugs](https://reader036.fdocuments.us/reader036/viewer/2022081413/5497768eb4795932538b4569/html5/thumbnails/42.jpg)
Infertility AgentsInfertility AgentsInfertility AgentsInfertility Agents
• Promote maturation of ovarian follicles
• clomiphene (Clomid®)
• urofollitropin (Metrodin®)
• Promote maturation of ovarian follicles
• clomiphene (Clomid®)
• urofollitropin (Metrodin®)
![Page 43: Endrocrine drugs](https://reader036.fdocuments.us/reader036/viewer/2022081413/5497768eb4795932538b4569/html5/thumbnails/43.jpg)
Male Reproductive AgentsMale Reproductive AgentsMale Reproductive AgentsMale Reproductive Agents
• Testosterone Replacement– methyltestosterone (Metandren®)– fluoxymesterone (Halotestin®)
• Benign Prostatic Hypertrophy– Surgery– finasteride (Proscar®)
• Testosterone Replacement– methyltestosterone (Metandren®)– fluoxymesterone (Halotestin®)
• Benign Prostatic Hypertrophy– Surgery– finasteride (Proscar®)
![Page 44: Endrocrine drugs](https://reader036.fdocuments.us/reader036/viewer/2022081413/5497768eb4795932538b4569/html5/thumbnails/44.jpg)
Sexual BehaviorSexual BehaviorSexual BehaviorSexual Behavior
• Most are side effects from other medications– Antihypertensives & psychoactive drugs
• sildenafil (Viagra®)
• Most are side effects from other medications– Antihypertensives & psychoactive drugs
• sildenafil (Viagra®)