Endrocrine drugs /certified fixed orthodontic courses by Indian dental academy

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The Indian Dental Academy is the Leader in continuing dental education , training dentists in all aspects of dentistry and offering a wide range of dental certified courses in different formats.

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Endrocrine drugs /certified fixed orthodontic courses by Indian dental academy

  1. 1. Pharmacology Drugs that Affect the Endocrine System
  2. 2. INDIAN DENTAL ACADEMY Leader in continuing dental education www.indiandentalacademy.com
  3. 3. Topics • • • • • • Pituitary Drugs Parathyroid/Thyroid Drugs Adrenal Drugs Pancreatic Drugs Reproductive Drugs Sexual Behavior Drugs
  4. 4. Functions • Regulation • Control
  5. 5. Glands Exocrine Endocrine • Secrete enzymes • Close to organs • Secrete hormones • Transport via bloodstream • Require receptors
  6. 6. Nervous Endocrine Wired Wireless Neurotransmitters Hormones Short Distance Long Distance Closeness Receptor Specificity Rapid Onset Delayed Onset Short Duration Prolonged Duration Rapid Response Regulation
  7. 7. Mechanism of Action
  8. 8. Hypothalamus
  9. 9. Hypothalamic Control Pituitary
  10. 10. Posterior Pituitary Target Actions Oxytocin Uterus Mammary ADH Kidneys Contraction Milk let-down Water reabsorption
  11. 11. Anterior Pituitary Target GH Most tissue TSH Thyroid ACTH Adrenal Cortex Action Growth TH secretion Cortisol secretion
  12. 12. Anterior Pituitary Target Action FSH Ovaries Testes LH Ovaries Testes Follicles Estrogen Sperm Ovulation Progesterone Testosterone
  13. 13. Anterior Pituitary Target Prolactin Action Mammary Gland Milk production
  14. 14. Pituitary Hormones
  15. 15. Thyroid
  16. 16. Thyroid Target Action Thyroxine Most cells Triiodothyronine BMR Calcitonin Calcium Mostly bone
  17. 17. Hypothyroidism
  18. 18. Hyperthyroidism
  19. 19. Parathyroid
  20. 20. Parathyroid Target Parathyroid (PTH) Bone Kidney GI Tract Action Calcium
  21. 21. Calcium Regulation
  22. 22. Pancreas
  23. 23. Pancreas • Alpha cells: glucagon • Beta cells: insulin
  24. 24. Pancreas Target Action Glucagon Liver Glucose Insulin General Glucose
  25. 25. Glucose Regulation
  26. 26. Adrenal
  27. 27. Adrenal Medulla Target Norepi Epi Action Heart Blood vessels Liver Prolongs SNS Effects
  28. 28. Adrenal Cortex Target Aldosterone Kidney Cortisol Most Tissue Action Na reabsobtion Water retention Glucose inflammation
  29. 29. Anterior Pituitary Drugs Inadequate Growth Hormone • Dwarfism • somatrem (Protropin®) • homatropin (Humatrope®) • • • • Excessive Growth Hormone Acromegaly Gigantism Surgical removal 1º octreotide (Sandostatin®)
  30. 30. Posterior Pituitary Drugs • Oxytocin • ADH – Diabetes insipidus – Nocturnal enuresis • vasopressin (Pitressin®) • desmopressin (Stimate®) • lypressin (Diapid®)
  31. 31. Parathyroid Diseases • Hypoparathyroidism – Inadequate calcium levels • TX: increased dietary calcium • Hyperparathyroidism – Excessive calcium levels • TX: surgical removal
  32. 32. Thyroid Disease • Hypothyroidism – Hormone replacement – levothyroxine (Synthroid®) • Hyperthyroidism – Thyrotoxicosis – Surgical removal – propylthiouracil (PTU)
  33. 33. Adrenal Cortex ACTH Hypersecretion Cushing’s Disease • Surgical removal • Inhibit adrenal secretion – • • • • ketoconazol (Nizoral ®) Symptomatic tx: – Antihypertensives • ACTH Hyposecretion Addison’s Disease Replacement therapy Cortisone (Cortistan®) Hydrocortisone (SoluCortef®) Fludrocortisone (Florinef Acetate®)
  34. 34. Pancreas Blood Potassium Blood Glucose
  35. 35. Insulin Preparations • Regular Insulin – Natural insulin • Modified Insulin – Increased duration of action – NPH (neutral protamin Hagedorn) • Natural plus protamin – Lente • Attached to zinc to prolong absorption
  36. 36. Oral Hypoglycemic Agents Sulfonylureas insulin secretion tolbutamide (Orinase®) chlorpropamide (Diabinese®) glipizide (Glucotrol®) glyburide (Micronase®) Biguanides metformin (Glucophage®) Glucose synthesis Glucose uptake Alpha-glucosidase inhibitors • Delay carbohydrate metabolism acarbose (Precose®) miglitol (Glyset®) Thiazolidinediones Insulin effectiveness troglitazone (Rezulin®)
  37. 37. Hyperglycemic Agents • Glucagon – gluconeogenesis • diazoxide (Proglycem®) – Inhibits insulin release • D50W
  38. 38. Estrogens & Progestins • Estrogens used for post-menopausal hormone replacement therapy. – estradiol (Estrace®) – conjugated estrogens (Premarin®) – estropipate (Ogen®) • Progestin – Diminish side effects of estrogen therapy – Nausea, fluid retention, breast tenderness – medroxyprogesterone acetate (Provera®) – norethindrone acetate (Aygestin®)
  39. 39. Oral Contraceptives • Combination of estrogen and progestin – Loestrin®, Levora®, Nordette®, Ovocon®, Norinyl® plus many others • Minipill: progestin only – Micronor®, Nor-Q.D.®, Orvette® • Prime side effect: risk of thromboembolism
  40. 40. Uterine Stimulants & Relaxants • Stimulants (Oxytocics) • uterine contraction • Indication: – Induce labor – Postpartum hemorrhage • oxytocin (Pitocin®) • ergonovine (Ergotrate®) • Relaxants (tocolytics) • Relax uterine smooth muscle • Beta2 agonists – terbutaline (Brethine®) – ritodrine (Yuptopar®)
  41. 41. Infertility Agents • Promote maturation of ovarian follicles • clomiphene (Clomid®) • urofollitropin (Metrodin®)
  42. 42. Male Reproductive Agents • Testosterone Replacement – methyltestosterone (Metandren®) – fluoxymesterone (Halotestin®) • Benign Prostatic Hypertrophy – Surgery – finasteride (Proscar®)
  43. 43. Sexual Behavior • Most are side effects from other medications – Antihypertensives & psychoactive drugs • sildenafil (Viagra®)
  44. 44. Thank you www.indiandentalacademy.com Leader in continuing dental education

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