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69 Cards in this Set
- Front
- Back
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Endocrine glands include |
pituitary thyroid parathyroids pancreas adrenals gonads placenta
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Pituitary gland |
1. located at the base of the brain 2. Been called the master gland because of the regulatory effect on other endocrine glands and organs of the body 3. Has a trophic effect |
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Pituitary deficiency |
loss secondary sex characteristics decreased metabolism dwarfism diabetes insipidus hypothyroidism addisons disease loss of pigmentation retarded dental development
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Hypersecretion of pituitary hormones |
sexual precocity goiter cushings acromegaly gigantism |
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Anterior pituitary |
secretes growth hormone |
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Posterior piuitary |
vasopressin (antidiuretic) ADH |
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Menotropin (Pergonal) |
hMG used to stimulate ovarian follicle development |
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Bromocriptine (Parlodel) |
Inhibits pituitary function Used to treat prolactin-stimulating adenomas acromegly Parkinson's disease |
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Thyroid hormone secretes |
2 iron containing hormones: Triiodothyronine T3 Tetraiodothyronine T4 Calcitonin |
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Thyroid hormones are synthesized from |
iodine and tyrosine |
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Thyroid gland requires ________ intake of iodine per day |
20-125 mg |
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Iodine deficiencey |
Simple goiter (thyroid hypertrophies) |
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What is the only common food that is naturally rich in iodine? |
Marine life |
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______ in high concentrations suppresses the thyroid |
Iodide |
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What symptoms will an excess of iodide produce? |
gingival pain excessive salivation sialadenitis
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Hypothyroidism in children |
cretinism |
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Hypothyroidism in adults |
myxedema |
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Oral findings in children with Hypothyroidism |
delayed tooth eruption malocclusion increased tendency of perio disease Teeth are poorly shaped and carious |
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Hypothyroidism symptoms |
More sensitive to opioids pregnant women produce offspring with large teeth |
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Most common thyroid replacement therapy |
levothyroxine |
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Hyperthyroidism |
Diffuse toxic goiter (Graves disease) toxin nodular goiter (plummer's disease) Hashimotos (chronic inflammation of thyroid) |
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Hyperthyroidism effects |
EXOPHTHALMOS (protruding eyes) excessive production of heat increased sympathetic activity increased neuromuscular activity Increased sensitivity to pain ophthalmopathy |
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Hyperthyroidism oral manifestations |
accelerated tooth eruption marked loss of alveolar process diffuse demineralization of jaw bone rapid periodontal destruction |
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Hyperthyroidism cardiovascular effect |
direct inotropic (force of contraction) |
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Hyperthyroidism in dental office |
no treatment for PT with visible goiter, exophthalmos or history of antithyroid drugs without medical clearance |
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2 common treatments |
radioactive iodine thyroidectomy |
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antithyroid agents (Hyperthyroidism) |
propylthiouracil (PTU) methimazole (Tapazole) |
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What are the 2 major hormones secreted from the pancreas? |
insulin glucagon |
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where are the 2 major hormones secreted from the pancreas? |
islets of Langerhans |
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What does glucagon do? |
promotes fuel metabolism puts glucose in the blood |
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Other hormones secreted by the pancreas |
islet amyloid polypeptide (IAPP, amylin) Pancreatic peptide |
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Diabetes Mellitus |
Inadequate or poorly timed secretion of insulin from the pancreas and/or insulin resistance of the cells |
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Diabetes Mellitus characterized by |
hyperglycemia glycosuria |
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Patients with Diabetes Mellitus experience |
polyphagia polydipsia polyuria |
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Type I diabetes |
Insulin dependant Autoimmune destruction of pancreatic beta cells Without insulin Type I is FATAL |
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Type II diabetes |
Non insulin dependant causes from sedentary lifestyle and lack of exercise Slower onset Lack of ketoacidosis
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How is Type II diabetes treated? |
first with diet and exercise then medication orally then insulin if neither of the above work |
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What does exercise do? |
Increases the sensitivity of the cells to insulin |
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Diabetes is the major cause of ______ in adults |
blindness |
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Type II diabetes dental management |
should not interfere with meals (1.5-2 hours after pt has eaten and taker regular meds) minimal stress |
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Type II diabetes dental complications |
susceptibility to caries tooth eruption accelerated perio disease fragile blood vessels delayed wound healing tendency to develop infections xerostomia
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Type II diabetes systemic complications |
poor eyesight poor circulation reduced sensation in extremities GANGRENE can occur in peripheral extremities |
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With intensive therapy (3+ injections daily) |
reduced onset of retinopathy reduced nephropathy and neuropathy Hypoglycemia is 3x higher |
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Goals for diabetes |
fasting plasma glucose 80-120 Glycosylated hemoglobin (A1C) <7 |
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treatment of hypoglycemia |
Early stages: fruit juice, cake frosting etc
Unconscious: IV Dextrose 50% |
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If you cannot tell the difference between hypo and hyper glycemia what should you do? |
Give them sugar |
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Insulin |
administered by subcutaneous injection Most common adverse reaction is HYPOGLYCEMIA |
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Oral antidiabetic agents |
Biguanides: Metformin (glucophage)
Sulfonylureas: Glyburide
Non-Sulfonylureas Secretagogues: repaglinide (Prandin) and nateglinide (Starlix)
Alpha-Glucosidase inhibitors: acarbose (Precose)
Thiazolidineadiones: pioglitazone (Actos) and rosiglitazone (Avandia)
Others: Exantatide (Byetta) Pramlintide (Symlin) Colesevelam (WelChol) Glucagon
Dipeptidyl-Peptidase 4 inhibitors: sitagliptin (Januvia) |
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Metformin |
lowers blood glucose does not produce hypoglycemia adverse reactions all GI tract Dose 1500-2500 2-3 daily doses |
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Sulfonylureas: Glyburide adverse reactions |
blood dyscrasias GI disturbance cutaneous reactions liver damage |
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Non-Sulfonylureas Secretagogues: |
must be taken with food |
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Alpha-Glucosidase inhibitors |
Dose 25-100 mg 2-3x daily taken with first bite of food |
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Colesevelam (WelChol) |
Bile acid sequestrant used to lower LDL Can interfere with the absorption of other drugs |
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Glucagon |
antagonist to insulin |
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There are both male and female sex hormones |
most sex hormones occur in both sexes but in different proportions |
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Estrogens progestins |
develop female sex characteristics develop reproductive system prepare repro system for conception
secreted primarily by ovaries but also testes and placenta |
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Estrogens |
growth and development of vagina, uterus, fallopian tubes, breasts and axillary and pubic hair increase deposition of fat in subcutaneous tissues increase the retention of salt and water Increase osteoblastic activity |
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Exogenous estrogen use |
Oral contraceptive menstrual disturbances Osteoporosis Atrophic vaginitis non development of ovaries hirsutism cancer and menopause symptoms
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Menopause |
Estradiol transdermal system (Estraderm) |
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Exogenous Estrogen side effects |
Nausea and vomiting (most common) uterine bleeding vaginal discharge edema weight gain hypertension thrombophlebitis May promote endometrial carcinoma in postmenopausal women
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Estrogen oral side effects |
puberty gingivitis pregnancy gingivitis chronic desquamative gingivitis (menopause) increase frequency of dry socket (extractions on day 23-28 better) |
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Progestins |
corpus luteum is primary source Basically pregnancy hormone (also nursing) |
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Progestin replacement |
Medroxyprogesterone (Provera)- postmenopause
Parenteral medroxyprogesterone (Depo-Provera)
IUD (Progestasert)
Implant levonorgestrel (Norplant) |
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Male sex hormones |
Androgen:testosterone |
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Clomid (Chomphene, Serophene) |
fertility |
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Leuprolide (Lupron) |
endometriosis and infertility |
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Tomoxifen (Nolvadex) |
Palliative treatment of advanced breast cancer in postmenopausal women |
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Danazol |
endometriosis and fibrocystic breast disease |
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Aromatase Inhibitors |
treatment of breast cancer |
