Endocrine Drugs

Somatotrem

IV; human synthetic growth hormone that induces the release of IGF1 (somatomedin C); contraindicated in individuals with closed epiphyses or enlarging cranial mass.

Octreotide

IV; synthetic analogue of somatostatin (longer half-life) that suppresses GH and IGF1; used in acromegaly treatment and secretory diarrhea in VIPoma; adverse effects include flatulence, nausea, steatorrhea, and cholesterol gallstones with long-term use.

Pegvisomant

SUBQ; an antagonist of the GH receptor; used for refractory acromegaly.

Leuprolide & Nafarelin

IV & nasal respectively; synthetic analogs to GnRH that overstimulate gonadal hormone production causing downregulation of GnRH receptors; used for prostate cancer, endometriosis, and precocious puberty; adverse effects include hypersensitivity, hot flashes, and osteoporosis.

hMG

IV; derived from the urine of menopausal women, contains FSH (urofollitropin) and LH; used for infertility treatment in men and women; adverse effects include ovarian enlargement and multiple births.

hCG

IV; derived from the urine of pregnant women, LH agonist; used for inducing ovulation in women and sexual maturation in men; adverse effects include ovarian enlargement and gynecomastia.

Oxytocin

IV/nasal; stimulates uterine contraction for labor and promotes ejection of breast milk; adverse effects include hypertensive crises and uterine rupture.

Vasopressin/ADH

IV; nonselective V1/V2 receptor agonist; used for diabetes insipidus and esophageal varices; side effects include water intoxication and hyponatremia.

Desmopressin

IV; selective V2 receptor agonist; preferred over vasopressin for diabetes insipidus and nocturnal enuresis.

Levothyroxine

Oral; synthetic T4; used for hypothyroidism; should not be taken with food or certain antacids; adverse effects include tachycardia and weight loss.

Pindolol and Acebutol

Sympathomimetic beta blockers; should not be given with thyroid hormones.

Propanolol and Atenolol

Non-sympathomimetic beta blockers; can be used with thyroid hormones to treat thyroid storm.

Diltiazem

Calcium channel blocker used in patients with asthma for thyroid storm management.

Reactive Iodine

Oral solution; used for thyroid cancer in cells expressing sodium-iodine symporter; adverse effects include hypothyroidism.

Propylthiouracil (PTU)

Oral; used for hyperthyroidism and thyroid storm; inhibits iodination of tyrosyl groups; adverse effects include agranulocytosis.

Methimazole

Oral; used for hyperthyroidism; similar mechanism to PTU; caution during first trimester due to risks of severe birth defects.

Glucocorticoids (thyroid storm)

Prevent shock in thyroid storm.

Iodide

Solution; used in thyrotoxicosis crisis and prior to thyroidectomy; adverse effects include sore mouth and throat.

Teriparatide

IV; PTH analogue that increases bone formation; used for osteoporosis.

Vitamin D (Cholecalciferol)

Oral; used for vitamin D deficiency; overdose can lead to hypercalcemia.

Doxecalciferol

IV/oral; prodrug used mainly for secondary hyperparathyroidism in CKD patients.

Paricalcitol

IV; analogue of calcitriol used for secondary hyperparathyroidism in CKD patients.

Calipotriene

Oral; analogue of calcitriol used mainly for skin diseases.

Salmon Calcitonin

IV/nasal; more potent than regular calcitonin; used for hypercalcemia.

Raloxifene

Estrogen receptor modifier; agonist on bones and antagonist in breast and uterus.

Cortisone & Prednisolone

Common cause of osteoporosis; may decrease hypercalcemia.

Alendronate

Oral; a bisphosphonate that inhibits osteoclast activity; used for osteoporosis and management of hypercalcemia.

Pamidronate

Bisphosphonate.

Cincalcet

Calcimimetic that lowers PTH by activating calcium-sensing receptors; used for secondary hyperparathyroidism due to CKD.

Glucocorticoids (general)

Should not be stopped suddenly if used for over 2 weeks; may cause osteoporosis and other adverse effects.

Beclomethasone

Glucocorticoid; used for asthma and allergic treatments.

Hydrocortisone

Short-acting glucocorticoid; used for cortisol deficiency.

Cortisone

Short-acting glucocorticoid.

Prednisone

Intermediate-acting glucocorticoid; contraindicated in liver disease.

Prednisolone

Intermediate-acting glucocorticoid; active form of prednisone.

Methylprednisolone

Intermediate-acting glucocorticoid.

Triamcinolone

Intermediate-acting glucocorticoid; used for skin diseases and asthma.

Betamethasone

Long-acting glucocorticoid; used mainly for inflammatory diseases.

Dexamethasone

Long-acting glucocorticoid; crosses placenta.

Fludrocortisone

High mineralocorticoid; used for aldosterone deficiency.

Deoxycorticosterone

High mineralocorticoid; used for aldosterone deficiency.

Metyrapone

Used for Cushing syndrome; inhibits 11-B hydroxylase.

Aminoglutethemide

Used for Cushing syndrome and breast cancer; inhibits cortisol synthesis.

Ketoconazole

Used for Cushing syndrome and antifungal; inhibits cortisol synthesis.

Mifepristone

Antagonist on glucocorticoid receptors; used for Cushing syndrome and abortion.

Spironolactone

Used for hyperaldosteronism and hirsutism; inhibits sodium reabsorption and affects androgen receptors.

Eplerenone

Used for hyperaldosteronism; antagonist on aldosterone receptor; avoids gynecomastia

Insulin

IV/subQ; adverse effects include hypoglycemic shock and weight gain; administered 30 min before meals.

Lispro

SubQ; rapid-onset insulin; administered immediately before meal.

Aspart

SubQ; rapid-onset insulin; administered immediately before meal.

Glulisine

SubQ; rapid-onset insulin; administered immediately before meal.

NPH insulin/Isophane

SubQ; intermediate-acting insulin; administered twice daily.

Glargine

SubQ; long-acting insulin; administered once daily.

Detemir

SubQ; long-acting insulin; modified with fatty acid for prolonged action.

Mixtard

SubQ; a mixture of regular and NPH insulin.

Pramlintide

SubQ; synthetic amylin analog; adjunct to mealtime insulin therapy.

Sulfonylureas

Oral insulin secretagogues; promote insulin release from pancreatic B cells.

Tolbutamide

First generation Sulfonylurea; high risk of hypoglycemic shock.

Glimepiride

Second generation Sulfonylurea; lower risk of hypoglycemic shock.

Glyburide

Second generation Sulfonylurea; reasonably safe for pregnancy.

Glipizide

Second generation Sulfonylurea.

Meglitinide analogs

Act by stimulating insulin release; used with caution due to hypoglycemic risk.

Metformin

Oral Biguanide; decreases insulin resistance; first-line therapy for type 2 diabetes.

Glitazones

Oral thiazolidinediones; insulin sensitizers that may contribute to weight gain.

Pioglitazone

Glitazone; improves HDL levels.

Rosiglitazone

Glitazone; raises LDL levels and is associated with cardiovascular toxicity.

Acarbose

Alpha-glucosidase inhibitor; delays carbohydrate digestion and lowers postprandial glucose levels.

Miglitol

Alpha-glucosidase inhibitor; well absorbed without systemic effects.

Exenatide

SubQ; GLP-1 agonist; used for type II diabetes and weight loss; has a short duration of action.

Ozempic

IV; Semaglutide; GLP-1 agonist used for type II diabetes; long-acting but has gastric disturbances.

Sitagliptin

Oral; inhibits DPP-IV to increase insulin secretion; has low rates of hypoglycemia.

SGLT2 inhibitors

Canagliflozin and Dapagliflozin; used for type II diabetes to lower blood glucose.