pharm chapter 15

Chapter 15: Endocrine System Medications

Overview of the Endocrine System

• Hypothalamus gland

• Pituitary gland

• Gonads

• Thyroid

• Parathyroid

• Pancreas

• Adrenal glands

• Pineal gland

Hypothalamus Gland

• Location: Brain

• Function: Secretes releasing factors that trigger hormones from the pituitary gland. Acts as the body’s coordinator.

Pituitary Gland

• Known as the "master gland"

• Secretion of hormones:

  • Follicle-stimulating hormone (FSH) & Luteinizing hormone (LH): Key for female reproduction

  • Antidiuretic hormone (ADH): Prevents water loss by kidneys

  • Thyroid-stimulating hormone (TSH): Stimulates thyroid function

Gerontological Issues

• Aging symptoms may arise from various conditions, not just "old age."

• Conditions like diabetes and thyroid abnormalities should be investigated to prevent serious health consequences.

Gonads (Sex Organs)

• Respond to hormones from pituitary gland:

  • Ovaries: Produce estrogen and progesterone

  • Testes: Produce androgens, including testosterone

Thyroid Gland

• Location: Neck

• Function: Regulates metabolism, secretes calcitonin.

  • Insufficient levels cause high blood calcium and low bone calcium, risking fractures.

Parathyroid Glands

• Located on the surface of the thyroid.

• Function: Regulates sodium and calcium levels.

  • Secretes parathormone, influencing calcium balance in the body.

Pancreas

• Location: Abdominal cavity

• Functions:

  • Secretes digestive enzymes for food digestion

  • Regulates blood glucose via insulin (lowers glucose) and glucagon (raises glucose)

  • Works with the liver to maintain glucose levels

Adrenal Glands

• Location: Above the kidneys

• Hormonal secretions:

  • Cortisol and glucocorticoids: Control fight or flight response

  • Epinephrine: Provided by inner medulla during stress

  • Cortisol: Maintains blood pressure and regulates immune response

Pineal Gland

• Location: Brain

• Function: Secretes melatonin based on light exposure, regulating sleep patterns.

Thyroid & Parathyroid Function

• Thyroid: Produces Triiodothyronine (T3) and thyroxine (T4); crucial for metabolism and energy.

  • Hypothyroidism: Low hormone levels can result in decreased energy.

  • Hyperthyroidism: Excess levels lead to increased energy.

Hypothyroidism

• Definition: Condition of underactive thyroid hormone secretion.

• Myxedema: Skin disorder due to prolonged hypothyroidism.

• Cretinism: Developmental disorder caused by low thyroid in infancy; rapid treatment necessary for prevention.

Hypothyroidism Treatment

• Hormone replacement therapy (HRT): Administered as oral doses of T3 and T4, either from natural sources or synthetically (e.g., Levothyroxine).

• Generally safe in pregnancy; use caution with elderly and those with heart problems or diabetes.

Hyperthyroidism

• Graves Disease: Symptoms include bulging eyes, weight loss, and goiter.

• Thyroid storm: Untreated hyperthyroidism results in severe symptoms including tachycardia and anxiety. Treatment options include thyroidectomy and radioactive sodium iodide (I-131).

Pancreatic Disorders

Hyperglycemia

• Excess glucose in blood due to insufficient insulin secretion; leads to complications including nerve damage and poor wound healing.

Hypoglycemia

• Insufficient glucose absorption leads to energy deficits; symptoms include shakiness and lethargy. Treatment involves glucose administration or glucagon injection if patient is unconscious.

Diabetes Mellitus (IDDM - Type 1)

• Characterized by hyperglycemia due to lack of insulin.

• Symptoms include increased urination, thirst, and hunger. Patients require daily insulin injections; dietary management is vital.

Complications of Diabetes Mellitus

• Long-term effects can worsen vision, impair kidney function, and lead to ketoacidosis. Recognizing symptoms like lethargy and fruity breath is critical.

Diabetes Mellitus (NIDDM - Type 2)

• Insulin present but ineffective due to resistance; related to genetics and lifestyle. Management may involve diet, exercise, or medication.

Insulin Types

• Categorized by action duration:

  • Short-acting: Administered before meals on a sliding scale.

  • Intermediate-acting: Requires mixing.

  • Long-acting: Extended duration effects.

  • Ultra Long-acting: Lasts beyond 36 hours.

Insulin Administration

• Pumps: Deliver constant insulin levels and allow for meal-time injections, reducing need for multiple daily injections.

• Proper handling is essential for effective treatment. Insulin must be refrigerated before opening and labeled post-opening.

Cystic Fibrosis and Pancreatic Function

• Blockage of pancreatic ducts prevents secretion of digestive enzymes. Replacement involves taking pancrelipase with meals.

Glucocorticoid Hormones

• Similar to naturally occurring cortisol. Used to treat various conditions, including autoimmune disorders and inflammation.

Addison’s Disease

• Caused by underproduction of adrenal cortex hormones; symptoms include chronic fatigue and irritability. Treatment involves hydrocortisone.

Cushing’s Disease

• Symptoms differ from Addison’s; includes hypertension and specific physical changes. Treatment based on underlying causes.

Anabolic Steroids

• Synthetic male hormones that alter tissue balance; used in specific medical conditions but can lead to significant side effects.