Pharmacology: The Endocrine System

Front 1

The endocrine system consists of various glands that secrete _________________.

Back 1

Hormones

Hint 1

Examples:

Thyroid gland --> secretes thyroid hormone and Calcitonin

Parathyroid Glands --> parathyroid hormone

Adrenal cortex ---> secretes cortisol

Front 2

Hormones are chemicals produced in the body, that:
A)
B)
C)
D)
E)
* 5 characteristics of hormones.

Back 2

A) Are produced in Small amounts
B) Are secreted DIRECTLY into the blood stream
C) Travel through the blood stream to specific receptor sites
D) Either INCREASE or DECREASE normal metabolic processes
E) Are immediately broken down

Front 3

The coordinating center for the endocrine/nervous system responses to internal and external stimuli is the _____________________.

Back 3

= The Hypothalamus

* Remember: the hypothalamus constantly monitors the body for disruptions in homeostasis. It sits at the base of the brain and receives input from different areas of the brain and also from neuro centers that send info about body functions like temperature, thirst, hunger, water retention, BP, respirations, reproduction, and emotional reactions.

Hint 3

The "master gland" or "the main guy"

Front 4

The hypothalamus receives input from the CNS and from various neurocenters about the body's current level of homeostasis. It then reacts to this information by stimulating the ______________ _____________.

Back 4

= pituitary gland

*internal and external stimuli -> neuroreceptors>hypothalamus >>pituitary gland -> glands (thyroid, adrenal, etc) >>> secrete their hormones.

Front 5

The pituitary gland is located in the skull. It is divided into 3 lobes called:
A) The ______________ lobe
B) The _____________ lobe
C) The _____________ lobe

Back 5

Anterior
Posterior
Intermediate

Front 6

The pituitary gland is located in the skull. It is divided into 3 lobes called:
A) The ______________ lobe
B) The _____________ lobe
C) The _____________ lobe

Back 6

Anterior
Posterior
Intermediate

Front 7

The anterior pituitary gland produces what 6 major hormones?

Back 7

GH - growth hormone [growth]

TSH - Thyroid Stimulating Hormone [metabolism]

ACTH - adrenocorticotropic

FSH - Follicle Stimulating Horm
LH - Leutinizing
[FSH & LH = sex hormones
W: estrogen & progesterone M:testosterone]

PRL - Prolactin [breast milk]

Front 8

The posterior pituitary gland produces what two hormones?

Back 8

= ADH & Oxytocin

ADH -
Antidiuretic Hormone
[ aka Vasopressin, released when blood volume drops, tells the body to hold all fluids in to stop all fluid loss]




Oxytocin -
[pregnancy and lactation]
* cause relaxation of the uterus in late pregnancy and labor and also causes "let down" when breast feeding

Front 9

The hypothalamus and the pituitary gland work together to maintain endocrine function along the HPA, which is the ____________ ____________ ______________.

Back 9

HPA = Hypothalamic-pituitary axis


>>> which is a negative feedback system that increases/decreases hormone production based on the supply and demand of the body.

Front 10

What function does Somatostatin have on the endocrine system?

Back 10

Somatostatin = GH (growth hormone) - inhibiting factor >>>>> it is secreted by the hypothalamus in order to stop the secretion of Growth Hormone.

Front 11

What function does Somatostatin have on the endocrine system?

Back 11

Somatostatin = GH (growth hormone) - inhibiting factor >>>>> it is secreted by the hypothalamus in order to stop the secretion of Growth Hormone.

Front 12

What function does PIF serve in the endocrine system?

Back 12

PIF = Prolactin Inhibiting Factor
(Prolactin>>causes breast milk production) ->> so it stops the release of prolactin and this stops the production of breast milk.

Front 13

The ______________ is both an endocrine gland (producing hormones) and an EXOcrine gland (releasing sodium bicarbonate and enzymes into the intestines to aid in digestion.

Back 13

The Pancreas >> makes the hormones insulin and glucagon in direct response to blood glucose levels.

Front 14

The ______________ is both an endocrine gland (producing hormones) and an EXOcrine gland (releasing sodium bicarbonate and enzymes into the intestines to aid in digestion.

Back 14

The Pancreas >> makes the hormones insulin and glucagon in direct response to blood glucose levels.

Front 15

_______________ is the most common metabolic disorder. It is a complex condition that alters the metabolism of fats, glucose, and proteins.

Back 15

Diabetes Mellitus

Front 16

What body system is the MOST affected by blood glucose level instability?

Back 16

The Nervous System

* maintaining the correct blood glucose level is important to the CNS because nerve cells here do NOT contain insulin receptors like the rest of the body's cells. Neurons receive blood glucose (their energy source) through the process of diffusion.
>>>Too HIGH of BG = moves water into nerves and causes swelling and nerve instability
>>>Too LOW BG = less energy for the nerves to function, causing loss of cell membrane integrity.

Front 17

______________ is the leading energy source for the body. It is stored for rapid release in times of stress or depletion (nerves need a constant supply of glucose to function).

Back 17

Glucose

Front 18

The pancreas contains __________ _____ ____________, collections of tissue that contain endocrine cells (alpha, beta, and delta) that release hormones in DIRECT response to blood glucose levels.

Back 18

Islets of Langerhans

Front 19

The pancreas contains __________ _____ ____________, collections of tissue that contain endocrine cells (alpha, beta, and delta) that release hormones in DIRECT response to blood glucose levels.

Back 19

Islets of Langerhans

Front 20

Alpha endocrine cells present in the pancreas release glucagon in direct response to ________ blood glucose.

Back 20

LOW

Front 21

The pancreas contains __________ _____ ____________, collections of tissue that contain endocrine cells (alpha, beta, and delta) that release hormones in DIRECT response to blood glucose levels.

Back 21

Islets of Langerhans

Front 22

Alpha endocrine cells present in the pancreas release glucagon in direct response to ________ blood glucose.

Back 22

LOW

Front 23

Beta cells in the pancreas release the hormone ___________ in response to HIGH blood glucose levels.

Back 23

Insulin

Front 24

The pancreas contains __________ _____ ____________, collections of tissue that contain endocrine cells (alpha, beta, and delta) that release hormones in DIRECT response to blood glucose levels.

Back 24

Islets of Langerhans

Front 25

Alpha endocrine cells present in the pancreas release glucagon in direct response to ________ blood glucose.

Back 25

LOW

Front 26

Beta cells in the pancreas release the hormone ___________ in response to HIGH blood glucose levels.

Back 26

Insulin

Front 27

Delta cells in the islets of Langerhans (in the pancreas) produce somatostatin (GH inhibiting factor) in response to very _________ Blood glucose:

Back 27

Low BG.

Front 28

Insulin is a hormone produced by ___________ pancreatic cells in response to elevated BG levels.

Back 28

Beta (pancreatic cells)

Front 29

Insulin is a hormone produced by ___________ pancreatic cells in response to elevated BG levels.

Back 29

Beta (pancreatic cells)

Front 30

After being released into the blood stream, Insulin circulates the body stimulating specific insulin receptor sites which in turn activates the transport of glucose ________ the cells through the process of __________ diffusion.

Back 30

INto [cells]

Facilitated [diffusion]

Front 31

Insulin stimulates the diffusion of BG into cells, and it also stimulates the synthesis of _______________ = glucose stored for immediate use in times of need.

Back 31

Glycogen

Front 32

What are some causes that make the body lose it's ability to regulate blood glucose levels through it's own release of insulin?
A)
B)
C)

Back 32

A) pancreas can't produce enough insulin
B) the insulin receptor sites have lost their sensitivity to insulin & require more to lower BG effectively
C) OR the person doesn't have enough insulin receptor sites to support his/her body [as in obesity]

Front 33

________________ is the hormone secreted by fat (adipose cells) that acts to INCREASE insulin sensitivity and DECREASES the release of stored glucose.

Back 33

Adiponectin

Front 34

The SNS affects BG levels through norepinephrine and epinephrine ... Ultimately causing _____________ blood glucose.

Back 34

Increased >>> ready in case of "fight or flight" response

Front 35

The SNS affects BG levels through norepinephrine and epinephrine ... Ultimately causing _____________ blood glucose.

Back 35

Increased >>> ready in case of "fight or flight" response

Front 36

Corticosteroids work on blood glucose levels by _____________ insulin sensitivity and __________ glucose release.

Thus a person with DM who is under extreme stress would likely need to adjust their insulin by _______________ their dose.

Back 36

Increasing
(due to increased BG and decreased sensitivity)

Front 37

As insulin becomes inefficient at controlling BG metabolic changes occur and hyperglycemia occurs. This results in the 3 P's:

Poly - _____________
Poly - _____________
Poly - _____________

Back 37

Polyuria >>> increased urination
Polydipsia >> increased thirst
Polyphagia >> increased hunger

Front 38

The SNS affects BG levels through norepinephrine and epinephrine ... Ultimately causing _____________ blood glucose.

Back 38

Increased >>> ready in case of "fight or flight" response

Front 39

Corticosteroids work on blood glucose levels by _____________ insulin sensitivity and __________ glucose release.

Thus a person with DM who is under extreme stress would likely need to adjust their insulin by _______________ their dose.

Back 39

Increasing
(due to increased BG and decreased sensitivity)

Front 40

As insulin becomes inefficient at controlling BG metabolic changes occur and hyperglycemia occurs. This results in the 3 P's:

Poly - _____________
Poly - _____________
Poly - _____________

Back 40

Polyuria >>> increased urination
Polydipsia >> increased thirst
Polyphagia >> increased hunger

Front 41

What is lypolysis and why does it occur?

Back 41

What test/level should be monitored in insulin dependent diabetics periodically and gives a 3 month average?

Hint 41

Glycosated Hemoglobin Test (HbA1c = 3 month average)

Front 42

For severe hypoglycemia (i.e. Diabetic pt found unconscious on floor), IV ______________ or ___________ may be necessary.

Back 42

Glucose or Glucagon

Front 43

What are the two types of Rapid Acting Insulins?
What are the times of:

A) Onset
B) Peak
C) Duration

Back 43

Two types of Rapid:
1) Humalog
2) Novolog

Times:
A) Onset = 15 minutes
B) Peak = 30 min - 3 hrs
C) duration = 3 hrs - 3-6 hrs

Front 44

What are the two types of Rapid Acting Insulins?
What are the times of:

A) Onset
B) Peak
C) Duration

Back 44

Two types of Rapid:
1) Humalog
2) Novolog

Times:
A) Onset = 15 minutes
B) Peak = 30 min - 3 hrs
C) duration = 3 hrs - 3-6 hrs

Front 45

When is regular insulin best given?

Back 45

30 to 60 minutes BEFORE meals

Front 46

Humulin R and Novolin R both have an onset of about __________ minutes.

Back 46

30-60

Front 47

What is the only type of insulin that can be given IV?

Back 47

Regular

Front 48

Which type of insulin is approved for once daily use and only for use in a hospital?

Back 48

= long acting

Ex/ Lantus, Humulin U, Ultralente

Front 49

Which type of insulin is approved for once daily use and only for use in a hospital?

Back 49

= long acting

Ex/ Lantus, Humulin U, Ultralente

Front 50

Which type of insulin has NO peak?

Back 50

Lantus

Front 51

NPH, Humulin N, Novolin N are all what type of insulin?

They have an onset of _________ hrs and peak at ________ hrs.

Back 51

Immediate Acting

Onset = 1 to 2.5 hrs
Peak = 6 to 15 hrs

Front 52

What are some s/s of HYPERglycemia?

Back 52

- the 3 P's: Polydipsia, Polyuria, and Polyphagia
- fatigue
- slow healing
- itchy skin
- blurred vision
- fruity breath
- kussamauls respirtations

Front 53

What are some s/s of HYPERglycemia?

Back 53

- the 3 P's: Polydipsia, Polyuria, and Polyphagia
- fatigue
- slow healing
- itchy skin
- blurred vision
- fruity breath
- kussamauls respirtations

Front 54

The thyroid gland gland secretes what three hormones?

Back 54

T3 = controls BMR (metabolism)
T4

Thyrocalcitonin = maintains blood calcium levels by inhibiting calcium release from the bone

Front 55

What are some s/s of HYPERglycemia?

Back 55

- the 3 P's: Polydipsia, Polyuria, and Polyphagia
- fatigue
- slow healing
- itchy skin
- blurred vision
- fruity breath
- kussamauls respirtations

Front 56

The thyroid gland gland secretes what three hormones?

Back 56

T3 = controls BMR (metabolism)
T4

Thyrocalcitonin = maintains blood calcium levels by inhibiting calcium release from the bone

Front 57

The release of hormones by the thyroid is triggered by what?

Back 57

TSH >>> secreted by the pituitary gland in response to some stimulus

Front 58

Hypothyroidism is caused by what?

Back 58

- absence of thyroid gland
- iodine deficiency
- lack if sufficient thyroid hormone (tumor, or autoimmune disorders)
- lack of TSH due to pituitary disease

Front 59

Cretinism is caused by ____________ .

Back 59

Hypo secretion of thyroid hormone in youth

*causes mental retardation

Front 60

Hypo secretion of thyroid hormone as an adult can cause __________________.

Back 60

Myxedema

*usually develops gradually as thyroid slowly stops functioning

Front 61

Hypo secretion of thyroid hormone as an adult can cause __________________.

Back 61

Myxedema

*usually develops gradually as thyroid slowly stops functioning

Front 62

Hashimoto disease is caused by ____________, or a __________ infection, or overtreatment of _______________ drugs.

Back 62

Hashimoto disease
= the result of an autoimmune thyroid disease, a viral infection, or over treatment with anti-thyroid drugs.

Front 63

What are the s/s of hypothyroidism?

Back 63

Thickened skin, hair loss, constipation, lethargy, anorexia

Front 64

Graves' disease is associated with (hyper/hypo) thyroidism.

Back 64

= hyper
* can cause exothalamus (protruding eyes)
* heat intolerance
*increased appetite

Front 65

Levothyroxine [synthroid, levoxine] is given to treat ____________________.

Back 65

Hypothyroidism (deficiency of T4)

Front 66

When given with Digoxin or beta blockers, thyroid hormone ___________ their levels.

Back 66

Decreases Digoxin and BB levels *a higher dose may be required.

Front 67

What time of day should thyroid medications be given?

Back 67

In the morning to prevent insomnia.
* also take 1-2 hrs before meals for increased absorption

Front 68

When taken with anticoagulants and/or theophylline ... Thyroid hormones will ___________ their levels.

Back 68

Decrease

Front 69

When taken with anticoagulants and/or theophylline ... Thyroid hormones will ___________ their levels.

Back 69

Decrease

Front 70

Anti-thyroid medications (for tx of HYPERthyroidism) include:

Back 70

PTU, methimazole, thiomid derivatives.

Front 71

Anti-thyroid meds [such as PTU and methimazole] work by:

Back 71

Inhibiting the formation of thyroid hormone to decrease levels over 2-3 weeks.

- cannot inactivate already active thyroid hormone, but instead stops t4 >>> from being converted to T3.

Front 72

The parathyroid gland controls the levels of __________ in the blood.

Back 72

Calcium

Front 73

Low blood calcium levels can cause what s/s?

Back 73

Trousseau
Fingertap reflex

Front 74

Low blood calcium levels can cause what s/s?

Back 74

Trousseau
Fingertap reflex

Front 75

Hypocalcemia is commonly caused by:

Back 75

Hypoparathyroidism
Chronic Renal Dialysis

Treatment:
Vitamin D (stimulates calcium absorption from intestines)
Calcium supplementation

Front 76

What drugs act as HYPERcalcemic agents to LOWER blood calcium levels?

Back 76

Biphosphonates >> act directly on serum levels (not on parathyroid gland)

Calcitonin >> hormones secreted by thyroid to balance effects of PTH