Endocrine System Overview

Endocrine System Overview

• Comprises glands producing hormones essential for regulating metabolism, growth, development, tissue function, reproduction, sleep, and mood.
• Key glands include pituitary, thyroid, parathyroid, adrenal glands, pancreas, ovaries (females), and testicles (males).

Hormones in the Endocrine System

• Insulin, thyroid hormones, adrenocortical hormones, and male/female hormones.
• Hormones are secretions released into the bloodstream to act on various organs/tissues.

Diabetes Mellitus

• Type 1: Absolute insulin deficiency requiring external insulin source for glucose processing.
• Type 2: Characterized by insulin resistance and relative insulin deficiency.
• Islets of Langerhans in the pancreas manage insulin production, differentiating basal and bolus insulin.

Insulin Types and Administration

• Four categories: rapid-acting, short-acting, intermediate, long-acting, and premixed insulin.
• Synthetic human insulin decreases allergy risk.
• Bolus insulins (e.g., aspart, lispro) act quickly with a short duration; typically administered before meals to prevent hypoglycemia.
• Basal insulins include intermediate (NPH) and long-acting (glargine, detemir) with longer lasting effects.

Blood Glucose Monitoring

• Normal glucose levels: 70-115 mg/dL.
• Diagnoses based on random glucose > 200 mg/dL and fasting glucose > 126 mg/dL.
• A1C indicates average blood glucose over time, aiding in diabetes management.

Oral Antidiabetic Medications

• Biguanides (e.g., metformin) reduce hepatic glucose production and improve insulin sensitivity; side effects include GI upset.
• Thiazolidinediones (e.g., pioglitazone, rosiglitazone) act similarly, with cardiovascular risks and potential for hypoglycaemia.
• Alpha-glucosidase inhibitors (e.g., acarbose) delay carbohydrate absorption but may cause GI issues.

Thyroid Hormones

• Thyroid drugs are used to manage hyperthyroidism (e.g., Tapazole) and hypothyroidism (e.g., levothyroxine).
• Monitoring and checking pulse is essential for dosing adjustments and monitoring metabolism.

Adrenal Hormones

• Glucocorticoids (e.g., cortisol) and mineralcorticoids (e.g., aldosterone) play a role in stress response and electrolyte balance.
• Common glucocorticoids include dexamethasone and prednisone, known for side effects like weight gain and increased infection risk.
• Mineralcorticoids (e.g., fludrocortisone) help manage blood pressure and electrolyte levels.

Patient Teaching for Steroid Use

• Educate on potential side effects including ulcers and impaired wound healing.
• Emphasize gradual tapering off to avoid adrenal crisis.
• Advise against abrupt cessation, and monitor blood glucose for diabetic patients.

Sex Hormones

• Males produce androgens (testosterone) and females produce estrogen and progesterone.
• Anabolic steroids (synthetic testosterone) are associated with muscle building and potential abuse.
• Hormone replacement therapy (HRT) for menopause includes estrogen and progestins, with risks of cardiovascular events and uterine cancer.

Conclusion

• Endocrine drugs play a significant role in managing multiple hormonal disorders, requiring precise dosing and monitoring for efficacy and safety.