Finals Pharma Notes PDF

What is Insulin? What is insulin resistance? Insulin is a hormone produced by the  Insulin resistance is a condition pancreas. It acts like a key, allowing where your body's cells don't glucose (sugar) from the food we eat respond properly to insulin. to...

What is Insulin? What is insulin resistance? Insulin is a hormone produced by the  Insulin resistance is a condition pancreas. It acts like a key, allowing where your body's cells don't glucose (sugar) from the food we eat respond properly to insulin. to enter our body's cells for energy. Insulin Resistance Normal Insulin Function 1. You eat food, and your blood sugar 1. You eat food, and your blood sugar rises. rises. 2. Your pancreas releases insulin, but 2. Your pancreas releases insulin into the cells don't respond effectively. your bloodstream. 3. Glucose doesn't enter the cells as 3. Insulin binds to receptors on easily. your cells. 4. Blood sugar levels remain high. 4. This signals the cells to take in 5. The pancreas tries to compensate glucose from your blood. by producing more insulin. 5. Blood sugar levels return to normal. Healthy: Insulin moves sugar from the blood into your cells to be stored or used for energy. Type 1 Diabetes: The body's immune system mistakenly attacks and destroys the insulin-producing cells in the pancreas. This leads to little or no insulin production. Without insulin, glucose can't enter cells, leading to high blood sugar levels Type 2 Diabetes: The body either doesn't produce enough insulin or the cells become resistant to insulin's effects (insulin resistance). This means glucose can't enter the cells efficiently, also resulting in high blood sugar. Diabetes mellitus is a group of metabolic diseases characterized by chronic hyperglycemia (high blood sugar). Symptoms of High Blood Sugar Long-Term Complications  Frequent urination (polyuria) Over time, uncontrolled high blood sugar can damage blood vessels and  Excessive thirst (polydipsia) nerves, leading to serious  Increased hunger (polyphagia) complications such as:  Unexplained weight loss  Heart disease and stroke  Blurred vision  Kidney disease  Slow-healing sores  Eye problems (retinopathy)  Frequent infections  Nerve damage (neuropathy)  Foot problems Management  Type 1: Regular insulin injections or use of an insulin pump.  Type 2: Lifestyle changes (diet, exercise), oral medications, and sometimes insulin. BPH- benign prostatic hyperplasia is a non-cancerous prostate enlargement that constricts the urethra, slowing or blocking urine flow. Causes a. Aging: hormone changes increase prostate cell growth. b. Hormone: higher levels of DHT(dihydrotestosterone) stimulates prostate enlargement. c. Family history: a genetic predisposition may increase the risk.  Symptoms Diagnosis  Urinary Frequency: Needing to urinate  Digital Rectal Exam (DRE):checks prostate more often, especially at night (nocturia). size and consistency.  Urinary Urgency: A sudden, compelling  Prostate specific antigen (PSA) test: urge to urinate. measures PSA levels often elevated in BPH  Hesitancy: Difficulty starting urination.  Ultrasound or MRI: visualize prostate size  Weak Stream: A reduced force of the and assess bladder function. urine stream. Treatment  Intermittency: Stopping and starting during urination. a.Alpha blockers: tamsulosin  Dribbling: Leakage of urine after finishing (relax bladder neck muscles to urination. improve urine flow).  Incomplete Emptying: Feeling like the b.5-alpha-reductase inhibitors: bladder isn't fully empty. finasteride  Straining: Having to strain to urinate. ( to shrink the prostate over time). c. Surgical options: Cushing's Syndrome Cushing's Disease/Syndrome: Occurs due to HIGH secretion of cortisol. It can be caused by tumors within the pituitary or adrenal glands or chronic use of corticosteroids. Addison's Disease: Occurs due to LOW secretion of cortisol and aldosterone. It can be caused by autoimmune damage or trauma to the adrenal cortex or cancer/infection. A 50-year-old female with a past medical history of hypertension comes to your clinic for a refill of her lisinopril medication. She is also taking lovastatin and hydrochlorothiazide. The patient's vital signs are as follows: HR 80, BP 150/100, and BMI 40. Physical exam is remarkable for a waist-to-hip ratio of 1.0 and the presence of diffuse dark patches on her skin.Her fasting lab results are as follows: Sodium: 145 mmol/L, Potassium: 5.0 mmol/L, Chloride: 105 mmol/L, Bicarbonate: 25 mmol/L, BUN: 10 mg/dL, Creatinine: 1.0 mg/dL, Glucose: 200 mg/dL, Triglyceride: 200 mg/dL, LDL: 250 mg/dL, Total cholesterol: 300 mg/dL, HDL: 30 mg/dL, and Hemoglobin A1C: 7.0%. The patient's history, physical exam, and laboratory findings are most