ENDOCRINE PHARMACOLOGY

CHAPTER NINE

Learning objective

At the end of this chapter the student is expected to learn the following:

• The effects of insulin on different organ/systems
• The types of insulin with their therapeutic uses and adverse reactions
• The mechanism of action, uses and side effects of oral hypoglycemic agents
• Drugs used as oxytocic agents
• Types of hormonal contraception with their uses and adverse effects including preparations
• Actions, therapeutic uses and adverse effects of glucocorticoids

I. ANTIDIABETIC DRUGS INTRODUCTION

Introduction

Diabetes Mellitus is a disease that occurs as a result of absolute or relative deficiency of insulin that results in metabolic and vascular abnormalities.

The etiologies include Obesity (because chronic calorie intake and prolonged stimulation of b cell causes a decrease in insulin receptor and also adipose tissue and muscle are less sensitive),hereditary,damage of pancreatic tissue, diabetogenic hormones(like growth hormone, thyroid, epinephrine), diabetogenic drugs like Thiazide diuretics, epinephrine, phenothiazines, Other factors like Pregnancy.

The common Signs and symptoms include polydipsia, polyphagia, polyuria, dehydration due to glucosuria.

Diabetes has dangerous complications: including ketoacidosis (in types I), hyperglycemic osmolal non ketotic coma (in type II), cardiovascular (like atherosclerosis, myocardial infarction, peripheralarterialinsufficiency, Anemia, Hypertension,stroke), nephropathy, retinopathy, neuropathy.

Exercise

1. List the important organ/system effects of insulin.
2. Write about the clinical aspects of oral antidiabetic drugs.
3. Discuss the mechanism and beneficial effects of combined oral contraceptive pills.
4. Discuss the pharmacological action and adverse effects of glucorticoids.
5. Write about anti thyroid drugs.