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36 Cards in this Set
- Front
- Back
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Endocrine glands and the types of hormones that can be found in them |
Endocrine glands are ductless They secrete hormones into the capillaries Types of hormones: Amines - tyrosine, thyroxine, epinephrine, norepi Proteins - insulin, calcitonin Steroids - cholesterol, cortisol, aldosterone, estrogen, progesterone, testosterone |
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Negative Feedback Mechanism |
Change detected -> Corrective mechanisms activated -> Conditions returned to set point -> Corrective mechanisms switched off -> conditions in the body change from set point -> Back to beginning |
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Pancreas Functions |
Produces digestive enzyme which breakdown food in the small intestine
Produces insulin for the bloodstream |
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Role of Insulin |
Promotes transport of glucose across cell membranes Conversion of glucose to glycogen Utilization of fatty acids by cells, inhibition of lipolysis Amino acid utilization, enhancing protein synthesis and inhibiting protein breakdown |
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Natural Response to Nutrient Intake |
Carb intake Blood sugar rises Triggers insulin release from the pancreas Increased insulin = hypoglycemia and stops insulin release (negative feedback loop) |
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Diabetic Response to Nutrient Intake |
Insulin deficiency/resistance causes increase glucose Cells lack energy requirements and trigger hunger (polyphagia) Glucose over 180 starts to spill over to urine, attracting water and increasing urination (polyuria) Fluid depletion causes increased thirst (polydipsia) |
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2 Types of Diabetes |
Type 1 Insulin deficiency Insulin dependent Type 2 Insulin resistance Non-insulin dependent Can be controlled through lifestyle changes Commonly caused by metabolic syndrome Increase cholesterol, HTN, obesity |
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Complications of diabetes |
Hyper/Hypo glycemia Hypertension Heart disease Stroke Retinopathy Peripheral Vascular Disease (amputation) Nephropathy Neuropathy |
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Insulin Therapy |
Insulin preparations differ in: Degree of purity Onset, peak, duration Route: SubQ or IV (regular only) Cannot be given orally - digested
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Insulin Types - Rapid Acting (Aspart, Lispro, Humalog) |
Onset 5-15 min.; given 5 min. before eating; Peak 1-3 hrs; Duration 3-5 hrs |
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Insulin Types - Short Acting (Regular) |
Onset 30 min. - 1 hr.;Peak 2-4 hrs;Duration 6-8 hrs |
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Insulin Types - Intermediate Acting (NPH 70/30) |
Onset 1-2 hrs; Peak 6-12 hrs; duration 18-24 hrs |
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Insulin Types - Long Acting (Lantus, Glargine) |
Onset 2 hrs; no peak; even distribution over 24 hrs |
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Hypoglycemia |
May result from not eating regularly, too much exercise, too much insulin adm. Blood sugar less than 60 Symptoms - sweating, confusion, tachycardia, headache, hunger, weakness, motor/emotional disturbances, cold, clammy skin |
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Hypoglycemia treatment |
Oral glucose intake - Meal now! Simple carb followed by complex carb Glucagon given IM |
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Hyperglycemia |
May occur with illness or with adequate insulin Blood sugar over 250 Emergency: diabetic ketoacidosis - body burns fat as fuel Symptoms: thirst, polyuria, warm and dry mucous membranes, fruity breath odor, Kussmaul respirations, rapid, thready pulse Insulin and KCl needed immediately |
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Oral hypoglycemics - for Type 2 Diabetes Mellitus |
Sulfonylureas
Meglitinides Biguanides: Metformin Thiazolidinediones: Glitazones Alpha - glucosidase inhibitors |
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Oral hypoglycemics - Sulfonylureas |
Mechanism of Action: Stimulate release of preformed insulin from pancreas Drug Interactions: ASA, Coumadin, anticonvulsants Side Effects: Increased heart rate, sweating, confusion Examples: glipizide (Glucotrol), glyburide (Micronase), glimepiride (Amaryl) |
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Oral hypoglycemics - Meglitinides |
Mechanism of Action: Stimulate release of insulin from pancreas within minutes Examples: repaglinide (Prandin), nateglinide (Starlix) Before meals |
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Oral hypoglycemics - Biguanides: Metformin |
Mechanism of action: Decrease glucose production in liver Caution: Must not be given 48 hrs before or after contrast dye given - risk of lactic acidosis and renal failure Adverse Effects: hepatoxicity. Examples: Metformin (Glucophage) |
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Oral hypoglycemics - Thiazolidinediones: Glitazones |
Mechanism of Action: Decrease insulin resistance by making insulin receptor more sensitive to insulin Combined with other hypoglycemic drugs Examples: Rosiglitazone (Avandia), pioglitazone (Actos) |
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Oral hypoglycemics - Alpha - glucosidase inhibitors |
Mechanism of Action: Delay absorption of carbohydrates in intestine so blood sugar doesn't rise as fast Examples: Acarbose (Precose), miglitol (Glyset) |
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Pituitary Gland |
Master gland Regulates and coordinates action of other endocrine glands and influences growth and development of body Anterior lobe secretes ACTH, GH, prolactin, FSH, LH, TSH Posterior lobe secretes vasopressin, oxytocin |
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Anterior Pituitary: Growth Hormone |
Produced by pituitary gland Spurs growth in children/adolescents Helps regulate body composition, body fluids, muscle and bone growth, sugar and fat metabolism, heart function Used for children born small for gestational age Not FDA regulated when used in conjunction with steroids for performance |
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Anterior Pituitary: Adrenocorticotropic Hormone (ACTH) |
Secreted intermittently throughout the day Addison's Disease - Hyposecretion - Fatigue, dizziness, weight loss, muscle weakness, mood changes, darkened skin Cushing's Disease - Hypersecretion - Progressive obesity, buffalo back, moon face, and skin changes |
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Adrenal Drugs: Glucocorticoids |
Cortisol Naturally released from the adrenals; also made synthetically Anti-inflammatory, anti-allergic Side Effects: Hyperglycemia, HTN, moonface Examples: prednisone, hydrocortisone |
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Posterior Pituitary: Antidiuretic hormone (ADH) |
Effect: increases water reabsorption in kidneys Therapeutic use: Diabetes Insipidus Deficiency or absence of ADH secretion by posterior pituitary - Congenital, or due to surgery, trauma, tumor Inability to concentrate urine - massive volumes of urine - dehydration and electrolyte depletion Synthetic forms: Vasopressin (Pitressin), Desmopressin acetate (DDAVP) |
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Hypothyroidism |
Pale, puffy face Cold, dry skin Decreased metabolism Brittle hair Hair Loss Lethargy, fatigue Myxedema (severe hypo) can lead to coma and death |
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Hypothyroidism treatment |
Lifelong treatment Effects: Increases metabolic rate, cardiac output, formation of protein Check pulse daily - if 20 bpm above normal for longer than a week - contact MD Levothyroxine sodium (Synthroid) - Synthetic T4 (inactive hormone) thyroid replacement Liothyronine sodium (Cytomel) - Synthetic T3 (active hormone) replacement |
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Hyperthyroidism |
Rapid heart beat, CNS stimulation, Increased metabolism, Increased appetite, Weight Loss, Diaphoresis, Exopthalmos (Grave's disease), Fine silky hair, Insomnia, anxiety Can lead to thyroid storm - HR over 200, High RR, BP |
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Hyperthyroidism Treatment |
Thyroidectomy RAI - 131 Medications: Propylthiouracil (PTU) Methimazole (Tapazole) Mechanism of Action: blocks formation of thyroid hormone Takes 3-4 weeks to work Monitor Liver function Pregnancy category D |
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Parathyroid Glands |
Regulates calcium levels |
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Hypoparathyroidism |
Causes - Congenital, inadvertent surgical removal Symptoms: increased neuromuscular irritability Rickets - deficiency of vitamin D - seen in infancy and childhood - abnormal bone formation - bowlegs, knock knees, large skull |
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Treatment of Hypoparathyroidism |
Oral Calcium salts (TUMS, Calcium acetate) Calcitriol (Rocaltrol) Form of Vitamin D (key to calcium absorption) |
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Osteoporosis Medications |
Estrogen - not recommended for postmenopausal women Raloxifene (Evista) - mimics estrogen Adverse reactions: venous thromboembolism, hot flashes |
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Osteoporosis Medications - Bisphosphonates |
Mechanism of Action: Prevent bone breakdown Adverse reaction: esophagitis/esophageal ulceration Special instructions: take before breakfast, full glass of water, sit or stand for 30 minutes Examples: Alendronate (Fosamax), ibaddronate sodium (Boniva) |
