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