Professional Documents
Culture Documents
1. Pituitary
Hormones
Anterior
Growth hormone (GH),
Prolactin (Prl),
Adrenocorticotropic hormone (ACTH, Corticotropin),
Thyroid stimulating hormone (TSH, Thyrotropin),
Follicle stimulating hormone (FSH)
Luteinizing hormone (LH)
Posterior
Oxytocin,
Antidiuretic hormone (ADH, Vasopressin).
2. Thyroid
Thyroxine (T4),
Triiodothyronine (T3),
Calcitonin.
3. Parathyroid
Parathormone (PTH).
4. Pancreas (Islets of Langerhans)
Insulin,
Glucagon.
5. Adrenals
Cortex
Glucocorticoids (hydrocortisone)
Mineralocorticoids (aldosterone)
Medulla
Adrenaline,
Noradrenaline
6. Gonads
Androgens (testosterone)
Estrogens (estradiol)
Progestins (progesterone)
Hormones
In addition, hypothalamus, which is a part of the
CNS and not a gland, produces many releasing and
inhibitory hormones which control the secretion of
anterior pituitary hormones.
GROWTH HORMONE (GH)
Excess production of GH is
responsible for gigantism in
childhood and acromegaly in
adults.
Hyposecretion of GH in children
results in pituitary dwarfism.
Adult GH deficiency is rare, but
when it occurs, it results in low
muscle and bone mass, lethargy,
decreased work capacity,
hyperlipidaemia and increased
cardiovascular risk.
GROWTH HORMONE (GH)
Somatropin –human GH produced by recombinant
DNA technique for clinical use.
Indications :
pituitary dwarfism
catabolic states (severe burns, bedridden patients,
chronic renal failure, osteoporosis)
Adverse effects:
Pain at injection site,
hypothyroidism
hand stiffness,
Myalgia,
Cancer.
GH Inhibitors
Short action (t½ 2–3 min)Somatostatin
It inhibits the secretion of GH, prolactin, and TSH by pituitary;
insulin and glucagon by pancreas, almost all GIT secretions
including gastrin and HCl.
It constricts splanchnic, hepatic and renal blood vessels
Indications :
Acromegaly
For controlling upper g.i.bleeding (esophageal varices and
peptic ulcer)
Antisecretory action is beneficial in pancreatic, biliary or
intestinal fistulae
ADR:
steatorrhoea, diarrhoea, hypochlorhydria, dyspepsia and
nausea as side effect.
GH Inhibitors
Octreotide (SANDOSTATIN)
40 times more potent in suppressing GH secretion
and longer acting (t½ ~90 min),
Help to stop esophageal variceal bleeding
It is preferred over somatostatin for:
Acromegaly
Pancreatic surgery
Acute pancreatitis
Uses:
For the diagnosis if the adrenals are functional
Hypocorticism
OXYTOCIN
Secreted by the posterior pituitary
ACTIONS
Uterus :
↑ the force and frequency of uterine contractions
Mammary glands:
contracts the mammary alveoli → milk 'lets down' →
excretes via the nipple.
USES
Induction of labour in case of slow childbirth
Postpartum bleeding
To stimulate milk release (intranasal spray)
Vasopressin
Antidiuretic Hormone (ADH)
Actions:
Vasoconstriction
Increasing the water reabsorption in collecting ducts
Adult hypothyroidism
(Myxoedema)
Causes:
Graves’ disease
(autoimmune disorder-
antibodies bind to and
stimulate thyroid cells and
produce TSH-like effects)
Toxic nodular goiter
CLASSIFICATION
1. Inhibit hormone synthesis (Antithyroid drugs)
Propylthiouracil
Thiamazole (Mercazolil)
Carbimazole (ANTITHYROX)
Compounds in groups 1 and 2 may be collectively called goitrogens because, if given in excess, they cause
enlargement of thyroid by feedback release of TSH.
ANTITHYROID DRUGS
Mechanism of action:
Inhibit iodination of tyrosine residues in thyroglobulin
Inhibit coupling of iodotyrosine residues to form T3 and T4
Do not affect release of T3 and T4
Adverse effects
Hypothyroidism
Goiter
Agranulocytosis
g.i. intolerance, skin rashes and joint pain
IONIC INHIBITORS
Inhibition of iodide trapping into the thyroid →
T4/T3 cannot be synthesized.
Long acting
Insulin glargine 2 - 24
Ultralente 2 - 24
Types of insulin
Regular (soluble) insulin
It is a buffered neutral pH solution of unmodified
insulin stabilized by a small amount of zinc.
Mechanism of action
Provoke a brisk release of insulin from pancreas
Improvement in glucose tolerance / increase in
number of insulin receptors
Adverse effects
Hypoglycaemia
Hypersensitivity (Rashes, photosensitivity, transient
leukopenia, agranulocytosis).
Nausea, vomiting, flatulence, diarrhoea or
constipation, headache and paresthesias
Meglitinide analogues
Act as sulfonylurea
It induces fast onset short-lasting insulin release → It
is administered before each major meal to control
postprandial (“after meal”) hyperglycaemia
Indicated only in type 2 diabetics
Side effects
Hypoglycaemia
Headache
Dyspepsia
Arthralgia
Weight gain
Biguanides
Mechanism of action
Do not stimulate pancreatic β cells → do not cause insulin release
Adverse effects
Lactic acidosis
Abdominal pain, anorexia, bloating, nausea, metallic taste,
mild diarrhoea and tiredness
cause hypoglycaemia in overdose
Thiazolidinedione
Pioglitazone
Rosiglitazone (withdrawn in Europe due to high risk of myocardial
infarction, CHF, stroke and death)
Mechanism of action
Suppresse hepatic gluconeogenesis and glucose output from liver.
Enhance insulin-mediated glucose uptake and disposal in skeletal
muscle and fat
Adverse effects
edema,
weight gain,
headache,
myalgia
anaemia
α Glucosidase inhibitors
It slows down and decreases digestion and absorption
of polysaccharides (starch, etc.) and sucrose.
Acarbose (GLUCOBAY) is a mild antihyperglycaemic
and not a hypoglycaemic; may be used as an adjuvant
to diet in obese
ADR:
Flatulence
Abdominal discomfort
Loose stool