Endocrine Pharm

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Somatropin

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Growth hormone analog

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Somatrem

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Growth hormone analog

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Mercasermin

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complex of recombinant human IGF-1 and recombinant human IGFBP-3

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Octreotide

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somatostatin analogue

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Lanreotide

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somatostatin analogue

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Pegvisomant

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GH receptor antagonist

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Bromocriptine

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dopamine agonist

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Cabergoline

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dopamine agonist

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Levothyroxine

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Thyroid hormone synthetic (T4)

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Liothyronine

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Thyroid hormone synthetic (T3)

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Liotrix

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Thyroid hormone synthetic (T4 & T3)

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Useful in treating certain symptoms of hyperthyroidism such as tachycardia, tremors (via blocking beta 2 receptors on skeletal muscle), and hypertension

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Propranolol

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Methimazole

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Thioamide drug

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Propylthiouracil

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Thioamide drug; also inhibits the peripheral deiodination of T4 to T3

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Adverse effects of the Thioamides:

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maculopapular pruritic rash, arthralgias, fever, nausea, rare but potentially fatal agranulocytosis and hepatotoxicity (less with methimazole), might want to give propylthiouracil if pregnant as it binds more strongly to plasma proteins therefore not crossing to the placenta as readily as methimazole

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Wolff-Chaikoff effect

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giving lots of iodine will inhibit synthesis and release of thyroid hormone

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Hydrocortisone

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Glucocorticoid agent: short acting (modest mineralocorticoid activity)

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Prednisone

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Glucocorticoid agent: intermediate acting (little to no mineralocorticoid activity)

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Dexamethasone

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Glucocorticoid agent: long acting (no mineralocorticoid activity)

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Fludrocortisone

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Mineralocorticoid agent

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Mitotane

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used for a medical adrenalectomy

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Aminoglutethimide

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Adrenal Steroid Synthesis Inhibitor

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Ketoconazole

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Adrenal Steroid Synthesis Inhibitor

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Calcitonin

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Decreases osteoclast activity; also increases Ca, phosphorus excretion from kidneys

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Down side to Calcitonin

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Tachyphylaxis can occur - efficacy is limited to first 48 hours

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Bisphosphonates are used for this

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Used for a more sustained lower of serum calcium

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Etidronate

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Bisphosphonate

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Pamidronate

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Bisphosphonate

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Alendronate

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Bisphosphonate

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Risedronate

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Bisphosphonate

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Ibandronate

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Bisphosphonate

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Zoledronic acid

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Bisphosphonate

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Bisphosphonates mechanism of action

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Absorbs to hydroxyapatite in bone, concentrates at sites of active remodeling; inhibits osteoclasts

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Bisphosphonates adverse effects

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Etidronate, tiludronate can cause osteomalacia; esophagitis, osteonecrosis of the jaw, sever bone, joint and/or muscle pain, zoledronic acid (renal toxicity)

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Cinacalet

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Enhances the sensitivity of the calcium sensing receptors in the parathyroid to calcium - decreases PTH secretion

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Cholecalciferol

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Vitamin D3 (not active as it needs to be activated by the liver/kidney

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Ergocalciferol

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Vitamin D2 (plant form, not active)

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Calcitriol

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1, 25 dihydroxyvitamin D3 (active)

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Paricalcitol

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Active vitamin D3 but different from Calcitriol in that it is really good for lower PTH secretion

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Osteoporosis treatment

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Bisphosphonates, Calcitonin, Teriparatide

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Teriparatide

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Recombinant PTH; if you stimulate PTH receptor intermittently then the osteoclasts are not recruited

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Adverse effects of Teriparatide

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Dizziness or tachycardia after injection; long term concern about increasing risk of osteosarcoma

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Leptin

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Decreases your appetite

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Implicated in the cause of obesity and insulin resistance

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TNF-alpha and IL-6

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Plasminogen Activator Inhibitor-1 (PAI-1)

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Serum protease inhibitor of uPA and tPA (thrombolytics)

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Adiponectin

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The more adiponectin, the less insulin resistance and inflammatory states

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Resistin

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Increases resistance to insulin, decreases liver uptake of glucose

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Adipokines secreted in higher concentrations in visceral fat

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IL-6, PAI-1, resistin, angiotensinogen, ACE, 11beta-HSD1 (activates cortisol)

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Adipokines secreted in higher concentrations in subcutaneous fat

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Leptin, TNF-alpha, adiponectin

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First known peptide to elicit satiety

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Cholecystokinin

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Ghrelin

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Stimulates GH and increases appetite

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Lectin

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Appetite suppressing hormone (stimulates POMC and inhibits Neuropeptide Y)

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Peptide YY

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Anti-appetite (pancreatic polypeptide)

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Amylin

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Anti-appetite; from pancreatic beta cells

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GLP-1

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Anti-appetite

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Glucagon

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Anti-appetite

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Oxyntomodulin

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Anti-appetite