Chapter 23: Endocrine System Drugs

insulin

required as replacement therapy for Type 1 diabetics with insufficient production of insulin from the islets of Langerhans in the pancreas required in patients with Type 2 who have failed to maintain satisfactory concentrations of blood glucose with therapy including dietary regulation and oral antidiabetic agents

meglitinides

starlix and prandin stimulate beta cells to produce insulin

endocrine

the body's "slow" chemical communication system; a set of glands that secrete hormones into the bloodstream

pituitary gland

the master gland regulates the function of the other glands secretes several hormones somatotropin (human growth hormone): -secreted by the anterior pituitary lobe -regulates growth -insufficient production will result in growth abnormalities associated disorders treated via corticosteroids

biguanides

work by decreasing hepatic glucose production and enhancing insulin uptake in muscle glucophage (Metformin)

thyroid

endocrine gland located in the front part of the neck responsible for regulating the rate of metabolism when thyroid levels are low, the pituitary gland releases TSH, which promotes the synthesis of T4 (thyroxine) and T3 (triiodothyronine), the active form of thyroid hormone thyroxine is later converted in the body to T3

hyperthryoidism

can be caused by Graves disease treated with anythryroid agents -Tapazole and propylthiouracil (PTU) Methimazole (treatment of choice)

alpha-glucosidase inhibitors

precose delay digestion of complex carbohydrates (e.g., starch) and subsequent absorption of glucose, resulting in a smaller rise in blood glucose concentrations following meals

thiazolidinediones (TZDs)

Actos and Avandia lower blood glucose by decreasing insulin resistance and improving sensitivity to insulin in muscle, liver, and adipose tissue

replacement therapy

administration of a naturally occurring substance that the body is not able to produce in adequate amounts to maintain normal function

adrenal corticosteroids

adrenal glands secrete hormones called corticosteroids act on the immune system to suppress the body's response to infection or trauma relieve inflammation, reduce swelling, and suppress symptoms in acute conditions two broad categories: replacement therapy and immunosuppressant agents

immunosuppressant agents

agents that decrease or prevent immune response used in the treatment of organ rejection

incretin therapies

agents that mimic actions of incretin hormones Byetta, (a GLP-1), Januvia and Onglyza

conditions treated with corticosteroids

allergic reactions acute flare-ups of rheumatic or collagen disorders acute flare-ups of severe skin conditions acute respiratory disorders long-term prevention of symptoms in severe persistent asthma or chronic management of COPD cancer brain swelling organ transplant life-threatening shock acute flare-ups of ulcerative colitis

diabetes mellitus

characterized by impaired metabolism of carbohydrates, fats, and proteins that results in elevated levels of blood glucose Type 1: insulin dependence; destruction of pancreatic beta cells Type 2: insulin resistance and deficiency

hormones

chemical messengers with specialized functions in regulating activities of specific cells or organs

sulfonylureas

consist of first-generation agents (e.g., chlorpropamide, tolbutamide) and second-generation agents (e.g., glipizide, glyburide) increaase insulin production from the pancreas

hypothyroidism

most common thyroid problem in the U.S. causes slowed metabolism treated with thyroid agents

SGLT2 inhibitors

newest class decrease the reabsorption of glucose in the kidney Invokana