Endocrine Disorders and Drug Classifications

Hypothalamic & Pituitary Disorders

  • Problems:
    • Growth Hormone Deficiency (Dwarfism)
    • Acromegaly (Excess GH)
    • Diabetes Insipidus
  • Treatments:
    • Growth Hormone Antagonists (e.g., octreotide)
    • Vasopressin Analogues (e.g., desmopressin)

Hypothalamic - Pituitary - Thyroid Axis

  • Hormones:
    • TRH (Thyroid Releasing Hormone)
    • TSH (Thyroid Stimulating Hormone)
    • T3 + T4 (Thyroid hormones)
  • Regulation:
    • Hypothalamus releases TRH, stimulating the pituitary gland.
    • Pituitary gland releases TSH, stimulating the thyroid gland.
    • Thyroid gland releases T3 and T4.
    • T3 and T4 inhibit the hypothalamus and pituitary gland through negative feedback.

Pituitary Gland

  • Anterior Pituitary Hormones:
    • TSH (Thyroid Stimulating Hormone) → Thyroid gland → Thyroxine
    • Prolactin → Breast → Lactation
    • ACTH (Adrenocorticotrophic hormone) → Adrenal gland → Steroids
    • LH/FSH (Luteinizing hormone/Follicle-stimulating hormone) → Ovary/Testis → Androgens/Oestrogen
    • GH (Growth hormone) → Multiple tissues → Growth
  • Posterior Pituitary Hormones:
    • ADH/Vasopressin (Anti-diuretic hormone) → Renal tubules → Water reabsorption, Vasoconstriction
    • Oxytocin → Breast, Uterus → Milk ejection, Uterine contraction

Thyroid Disorders

  • Problems:
    • Hypothyroidism
    • Hyperthyroidism
  • Treatments:
    • Thyroid Hormone Replacements (e.g., Levothyroxine)
    • Antithyroid Drugs (e.g., Methimazole, Propylthiouracil)

Hyperthyroidism vs. Hypothyroidism

  • Hyperthyroidism:
    • Weight Loss
    • Increased Appetite
    • Heat Intolerance
    • Increased Sensitivity to Heat
    • Tachycardia, Palpitations, Arrhythmias
    • Diarrhea
    • Anxiety, Nervousness, Irritability, Insomnia, Tremors
    • Increased Hair and Nail Growth
    • Increased Sweating
  • Hypothyroidism:
    • Weight Gain
    • Decreased Appetite
    • Cold Intolerance
    • Increased Sensitivity to Cold
    • Bradycardia
    • Constipation
    • Fatigue, Depression, Impaired Memory, Impaired Concentration, "Mental Fog"
    • Hair Loss and Thin Nails
    • Dry Skin

Adrenal Disorders

  • Problems:
    • Addison’s Disease (Adrenal Insufficiency)
    • Cushing’s Syndrome (Excess Cortisol)
  • Treatments:
    • Corticosteroid Replacement Therapy (e.g., Hydrocortisone, Fludrocortisone)
    • Steroidogenesis Inhibitors (e.g., Ketoconazole) for Cushing’s Syndrome

Adrenal Insufficiency

  • Definition:
    • A condition in which the adrenal glands are deficient in the hormones they produce and release.
  • Hormones produced by the Adrenal Gland (Adrenal Cortex):
    • Mineralocorticoids (aldosterone)
    • Glucocorticoids (cortisol)
    • Androgens (DHEA)

Addison's Disease vs. Cushing's Syndrome

  • Addison's Disease (Adrenal Deficiency):
    • Personality changes
    • Anorexia, nausea, vomiting
    • Hyperpigmentation
    • Cardiac insufficiency, hypotension
    • Adrenal atrophy
    • Autoimmune, infection, tumor metastasis
    • Diarrhea, abdominal pain
  • Cushing's Syndrome (Too much cortisol):
    • Thinning of scalp hair
    • Emotional instability
    • Acne
    • Moon face
    • Increased facial hair
    • Buffalo hump
    • Osteoporosis
    • Cardiac hypertrophy and hypertension
    • Adrenal hyperplasia or tumor
    • Truncal obesity
    • Striae of skin
    • Easy bruising
    • Muscle weakness
    • Muscle wasting, Thin extremities
    • Diabetes mellitus