Endocrine we’re in this area specifically sensitive to certain

stimuli that regulate a number of body functions

Good day students the topic is on drugs acting on
that includes body temperature thirst hunger water
intercurrent system the learning outcomes at the
retention blood pressure respiration reproduction
end of this module the student will be able to one
and emotional reactions remember that
identify that and differentiate drugs acting on the
hypothalamus is able to influence and be
integrant system to describe the mechanism of
influenced by emotions and thoughts it is located in
action of endocrine drugs three identified the side
an area poorly protected by blood brain barrier
effects and adverse effects of each drug 4 applies
thus it is able to act as a sensor to various
the nursing process including patient teaching of
electrolytes chemicals and hormones that are in
drug therapy related to hormonal replacement or
circulation and do not affect other areas of the
hormonal inhibition for the pituitary thyroid or
brain remember also that hypothalamus maintains
thyroid and adrenal glands let's start with an
internal homeostasis by sensing blood chemistries
introduction the use of drugs to help regulate and
and by stimulating or suppressing endocrine
control endocrine function is an important area of
autonomic and central nervous system activity
pharmacology in one sense hormones can be
considered drugs that are manufactured by the
patient's body this situation presents an obvious is also hypothalamus also produce and secrete
opportunity to use exit Chinese chemicals to either releasing hormones this stimulate the pituitary
mimic or attenuate the effects of specific hormones gland which in turn stimulates or inhibits various
during Intel crane dysfunction the question is what endocrine glands throughout the body it is
are the important functions of the endocrine connected to pituitary gland by two networks the
system into current system work in conjunction vascular network and the your logical this
conjunction with the nervous system to maintain stimulate the pituitary gland which in turn
internal homeostasis and to integrate the body’s stimulates or inhibits various endocrine glands
response to the external environment it provides throughout the body it is connected to pituitary
communication within the body and helps to gland by two networks the vascular network and
regulate growth and development reproduction the neurological network this stimulates the
energy use and electrolyte bullets we need also to pituitary gland which in turn stimulates or inhibits
understand the words such as glands hormones various endocrine glands throughout the body it is
and hypothalamus glands are considered to be the connected to pituitary gland by two networks the
organized groups of specialized cells that produce vascular network and the neurological network the
and secrete hormones they do not have dots that vascular network carries the hypothalamic
secreting hormones directly to the bloodstream the releasing factors directly into the interior budgetary
hormones are chemical messengers directly into while the neurological network delivers 2 other
the bloodstream to communicate within the body hypothalamic hormones which are the anti diuretic
and can react with receptors on the cell membrane hormone and oxytocin to the posterior pituitary to
to cause an immediate effect on a cell by altering be stored it has also the releasing hormones that is
enzyme systems near the cell membrane or they included we call it growth hormone releasing
may enter the cell and react with receptor sites on hormone we have also the thyrotropin releasing
messenger RNA which then enters the nucleus and hormone the gonadotropin releasing hormone
alters cell function now we have the hypothalamus corticotropin releasing hormone
hypothalamus is the coordinating Center for the
nervous and endocrine responses to either internal
or external stimuli it is considered to be the master corticotropin releasing hormone and prolactin
plan of the near endocrine system because it releasing hormone while the two inhibiting factors
regulates the central and autonomic nervous includes growth hormone release inhibiting factors
systems as well as the endocrine system to commonly known as smash those 13 and we have
maintain homeostasis it has various near centers the prolactin inhibiting factor which is the PIF so
much to study to research P IF may actually be the posterior lobe via the nerve axis where they are
dopamine and your transmitter or in the patients produced this hormones are the 88H also known as
who are taking dopamine blocking drugs often vasopressin and oxytocin ADH is also called
develop galactorrhea it is an inappropriate milk arginine vasopressin it’s a hormone made by the
production and breast enlargement theoretically hypothalamus in the brain and stored in the
because PAF also is blocked and relative levels posterior pituitary gland OK students in this slide I
continue to rise thus simulating breast tissue and would like you to read the different drugs acting on
milk production in the current system specifically for the
hypothalamic and anterior pituitary hormones we
have also the hormones we have also the
but kerry remember also that the pituitary gland hormones of the posterior pituitary and the drugs
is located in the skull in the bonicelli torcida under affecting the thyroid let's resume with this
a layer of the dura matter but Kerry remember hypothalamic and anterior pituitary hormones look
also that the pituitary gland is located in the skull in at this illustration the hormones are always
the bonicelli torcida under a layer of the dura secreted by the hypothalamus and the pituitary
matter it has three lobes we have the anterior they’re all peptides or low molecular weight
posterior and intermediate lobe it was known as proteins they act by binding to specific receptor
the body’s master gland though through feedback sites on their target tissues now we have here the
mechanisms it regulates the function of many hardness of the anterior vegetarian they are
other endocrine glands however as knowledge of regulated by neuropeptides that are called either
the endocrine system has grown so scientists now releasing or inhibiting factors or hormones so these
designate the hypothalamus as the master gland are produced in the hypothalamus and they reach
because it has even greater direct regulatory the pituitary by the hypophyseal portal system as
effects over the near endocrine system including you can see this illustration the interaction of this
the simulation of pituitary gland so let’s start with releasing hormones with their receptors results in
the anterior budgetary it has six major hormones the activation of genes that promote the synthesis
we have the growth hormone adrenocorticotropic of protein precursors so the protein precursors
hormone follicle stimulating hormone luteinizing then undergo post translational modification they
hormone the prolactin and thyroid stimulating produce hormones which are released into the
hormone it is also called the thyroid tropine these circulation each type was allama group regulatory
hormones are released in arrhythmic money these hormone controls the release of a specific hormone
​ from the anterior pituitary although a number of
pituitary hormone preparations are currently used
therapeutically for specific hormonal deficiencies
most of these agents have limited therapeutic
hormones are released in arrhythmic manner into
applications hormones of the anterior and
the blood these hormones are released in
posterior pituitary are administered
arrhythmic manner into the bloodstream we call it
intramuscularly or either subcutaneously or
dye original rhythm it’s secretion virus and time of
intranasally because they’re fifty deal nature makes
the day and it begins when hypothalamus secrets
them susceptible to destruction by the proteolytic
corticotropin releasing factor the CRF so it is a peak
enzymes of the digestive tract the question here
at about midnight while adrenocortical peak
response is between 6:00 and 9:00 AM the levels
fall during the day until evening when the low level the question here is why the question here is why
is picked up by the hypothalamus and the CRF or hormones of the anterior and posterior pituitary
the corticotropin releasing factor the secretion are administered intramuscularly subcutaneously
begins again for the posterior pituitary it is stored or intranasally so the answer here is because their
or it has stored it has two hormones that are peptidyl nature makes them susceptible to
produced by the hypothalamus and deposited in destruction by the proteolytic enzymes of the
digestive tract again hormone is a substance of take note that the corticotropin releasing
intense biological activity which means steer up so hormone is used diagnostically the take note that
this is produced by specific cells in the body and is the corticotropin releasing hormone is used
transported through circulation to act on target diagnostically to differentiate between Cushing
cells so hormones regulate body functions to bring syndrome and ectopic adrenocorticotropic
about a programmed pattern of life events and hormone producing cells normally ACTH is released
maintain homeostasis in the face of markley from the pituitary impulses with an overriding
variable external internal environment on such as diurnal rhythm with the highest concentration
you can see here the different body functions and occurring in the early morning and the lowest in
major regulator hormone or hormones for example the late evening so stress stimulates its secretion
availability of fuel so we have here the insulin block whereas cortisol acting via negative feedback
agon growth hormone for metabolic rate we have suppresses its release for the mechanism of action
triiodothyronine thyroxine and for the somatic the Cth binds to receptors on the surface of the
growth we have the growth hormone insulin like adrenal cortex thereby activating G protein coupled
growth factors for sex and reproduction we have processes that ultimately stimulate the rate limiting
gonadotropins and androgens estrogens and step into the how do you know corticosteroids
progestins for circulating volume we have synthetic the best way which includes the
aldosterone anti diuretic hormone for adaptation cholesterol to pregnenolone this pathway ends
to stress they have glucocorticoids and adrenaline with the synthesis and release of adrenocortical
and for calcium balance we have spare thorman steroids and adrenal androgens for its therapeutic
calcitonin and vitamin D when administering uses the availability of synthetic adrenocortical
administering any drug that affects the endocrine steroids with specific properties has limited the use
or nervous systems it is important for you to of corticotropin mainly to serving as a diagnostic
remember how closely related all of these activities tool for differentiating between primary adrenal
are so it is expected or unexpected adverse effects insufficiency or the Addison disease associated
involving involving areas of the endocrine and with other Knoll atrophy and also the secondary
nervous systems often occur so let us look at this adrenal insufficiency caused by the inadequate
hypothalamus which is part of their brain or the secretion of ACTH or the adrenal corticotropic
nervous system sends the directions via hormone by the pituitary also the therapeutic
neurotransmitter so corticotropin preparations are extracts from the
anterior pituitaries of domestic animals or synthetic
human ACTH the latter the centrepin is preferred
2 two the to the peachy or pituitary gland so it is for the diagnosis of adrenal insufficiency ACTH is
also the hypothalamus that produces the ADH and also used in the treatment of infantile spasms so
oxytocin that is being stored in the posterior ACH is a first line treatment infantile spasms so ACH
pituitary gland let’s start with adrenocorticotropic is a first line treatment for infants
hormone or the corticotropin so the secretion and
actions of adrenocorticotropic hormone or the
ACTH is considered to be we call it also the infantile spasms so ACTH is a first line treatment
corticotropin releasing hormone or the CRH so it is for infantile spasms remember that they they said
responsible for the synthesis and release of the that there is an improvement in seizure control
peptide propio Milan courtine by the vegetarian after treatment of ACTH and the child's
the ACTH or corticotropin is a product of the post developmental status also may improve after the
translational processing of this precursor treatment now question what drug is used
polypeptide take note that the corticotropin diagnostically to differentiate between Cushing
releasing hormone is used the agnostically syndrome and ectopic I didn’t know corticotropic
hormone producing cells answer corticotropin
releasing hormone is used diagnostically to
differentiate between Cushing syndrome and
ectopic adrenocorticotropic hormone producing tumors IGF one levels are consistently high and it is
cells remember this answer it's the CRH reflecting elevated growth hormone so far its
corticotropin releasing hormone remember this therapeutic uses so far its therapeutic uses we
answer it’s the CRH corticotropin releasing have so for its therapeutic uses we have here
hormone next question somatotropin is used in the treatment of growth
hormone deficiency or growth failure in children it
short term use of ACTH for diagnostic purposes is
is also indicated for growth failure due to broader
usually well tolerated but with no longer use
Willy syndrome management of aids wasting
toxicities are similar to those of glucocorticoids
syndrome and growth hormone replacement in
select all that apply a hypotension B peripheral
adults with confirmed growth hormone deficiency
edema C hyperkalemia the emotional
take note that the growth hormone administered
disturbances E increased risk of infection choose
to adults increases lean body mass bone density
your answer select all that apply the correct
and skin thickness whereas adipose tissue is
answers are paper for edema emotional
decreased many consider the growth hormone as
disturbances and increased risk of infection so we
an anti-aging hormone so this has led to off label
have letter B letter T and letter E let’s move on to
use of growth hormone by older individuals and by
the growth hormone the somatotropin
athletes seeking to enhance performance so how is
somatotropin so large the somatotropin
so much octopine administered take note that this
somatotropin is a large polypeptide the
are administered or some somato somatropin
somatotropin somatotropin is a large polypeptide
drugs are administered by subcutaneous or IM
that Is released by the anterior petery in response
injection although the half life of rosamond is short
to growth hormone releasing hormone produced
approximately 25 minutes it induces the release of
by the hypothalamus please look at this illustration
insulin like growth
and the secretion of the growth hormone is
inhibited another hypothalamic hormone and that
is the somatostatin The growth hormone is take note that this are administered or some
released in a pulsatile manner with the highest somato somatropin drugs are administered by
levels occurring during sleep with increasing age subcutaneous or IM injection although the half life
the growth hormone secretion decreases of rosamond is short approximately 25 minutes it
accompanied by a decrease in lean muscle mass induces the release of insulin like growth factor
somatotropin influences a wide variety of take note that this are administered or some
biochemical processes just for an example we have somato somatropin drugs are administered by
the cell proliferation they're both girls and this subcutaneous or IM injection although the half life
leads to different bell biochemical processes so we of rosamond is short approximately 25 minutes it
have this synthetic human growth hormone we we induces the release of insulin like growth factor one
call it soma dot somatropin and this is produced which is the IGF one from the liver which is
using recombinant DNA technology the mechanism responsible for subsequent growth hormone like
of action includes although many physiologic actions so the adverse effects on this includes pain
effects of growth hormone are exerted directly at at the injection site
its targets others are mistreated through the
somato medicines insulin like growth factors one
and two or we commonly call it IGF IGF one and IGF one which is the IGF one from the liver which is
2 which is the growth factor one and IGF 2 which is responsible for subsequent growth hormone like
the growth factor one or insert then like and IGF 2 actions so the adverse effects on this includes pain
which is the growth factor one or insulin like at the injection site edema arthralgias myalgias flu
growth factor one and insulin like growth factor like symptoms and we have to make sure that we
two so they are known as somato somato midines know our nurse intervention with this adverse
so note in acromegaly which is a syndrome of effects question someone took trip summer trippin
excess growth hormone due to hormone secreting is used in the treatment of growth hormone
deficiency or growth failure in children what are of bleeding esophageal viruses but of course there
other indications of somatropin aside from are adverse effects of octreotide that includes
treatment of growth failure in children i said i've diarrhea abdominal pain flatulence nausea and
mentioned the answer or the answers are steroid yeah take note that gallbladder emptying is
delayed and asymptomatic coleslaw

I said I’ve mentioned the answer or the answers

are somatropin is also indicated for a growth take note that gallbladder emptying is delayed
failure due to brother Willis syndrome B and asymptomatic cholesterol goes take note that
management of aids wasting syndrome and 3 rd
gallbladder emptying is delayed and asymptomatic
growth hormone replacement in adults with cholesterol gallstones that occur with long term
confirmed growth hormone deficiency so take treatment so take note also that acromegaly take
note that aside from so take note that aside from note also that acromegaly that is refractory to
treating the growth growth hormone deficiency or other modes of therapy may be treated with big
failure in children some matro somatropin is also whisonant this is a growth hormone receptor
indicated for this three areas growth failure due to antagonists next we have the gonadotropin
further really syndrome management of aids releasing hormone fossil tile secretion of
wasting syndrome and growth hormone gonadotropin releasing hormone from the
replacement in adults with confirmed growth hypothalamus is essential for the release of
hormone deficiency next we have here the gonadotropins follicle fossil tile secretion of
somatostatin which is the growth hormone gonadotropin releasing hormone from the
inhibiting hormone and the pituitary somatostatin hypothalamus is essential for the release of
binds to receptors that suppress growth hormone gonadotropins follicle stimulating hormone or the
and FSH and as well as the luteinizing hormone or the
LH from the anterior pituitary however continues
administration of this you’re gonna the trapping
releasing hormone or the GNRH it inhibits
the pituitary somatostatin binds to receptors that
gonadotropin release through down regulation of
suppress growth hormone and thyroid stimulating
the GNRH receptors on the pituitary so continuous
hormone release so originally isolated from the
administration of synthetic GNRH analogs such as
hypothalamus mothers that and the pituitary
low prior lide go silverline nafarelin and his
somatostatin binds to receptors that suppress
underline or his storyline is effective in suppressing
growth hormone and thyroid stimulating hormone
production of the gonadotropins please take note
release so originally isolated from the
of that and you can see that as well in the
hypothalamus somatostatin is a small polypeptide
illustration so several of these agents are
that is also found in urones throughout the body as
well as in the intestine the stomach and Matthias
so somatostatin not only inhibits the release of GH go silverline nafarelin and his underline or his
or growth hormone but also that of insulin storyline is effective in suppressing production of
Glucagon and gastrin so we have these octreotide the gonadotropins please take note of that and
and not real tight they are synthetic analogs of you can see that as well in the illustration so
somatostatin again octreotide and lario tite there several of these agents are available got cerulean
have lives are longer than that of the natural nafarelin and his underline or his storyline is
compound and depot formulations are available effective in suppressing production of the
allowing for administration once every four weeks gonadotropins please take note of that and you can
so they have found use in the treatment of see that as well in the illustration so several of
acromegaly and in the area and even flashing these agents are available as implantable
associated with carnico tumors an intravenous formulations that provide being in continuous
infusion of octreotide is also used for the treatment delivery of the drug so suppression of
gonadotropins in turn leads to reduce reduction of threatening and of course multiple births are not
gonadal steroid hormones So what are these uncommon for this course so a little precaution for
gonadal steroid hormones we have the androgens our patients receiving this kind of drugs next we
and estrogens thus this agents the GNRH as I have have prolactin which is a peptide hormone that is
mentioned are effective in the treatment of also secreted by the anterior pituitary its primary
prostate cancer not only that it is also effective in function is to stimulate and maintain lactation in
the treatment of endometriosis and even addition it decreases also the reproductive function
precocious puberty even in women the GNRH it's decrease is
analogues may cause hot flashes and sweating as
well as diminish or depression and ovarian cysts so
they are of course contraindicated to pregnant in addition it decreases also the reproductive
women and breastfeeding mothers as well As for function it's secretion is an evidence in addition it
men they are also causing a rise in testosterone decreases also the reproductive function it's
that can result in bone pain and take note also that secretion is inhibited by the dopamine acting at D2
hot flashes demma gynecomastia it may also core receptors take note that in addition it decreases
let’s move on to Ghana doctor pins which are also the reproductive function it's secretion is
considered to be the FSH or follicle stimulating inhibited by the dopamine acting at D2 receptors
hormone and LH which is the utilizing hormone so take note that drugs that act as dopamine
they are the glycoproteins that are produced in the antagonists for example metoclopramide and
anterior pituitary so the regulation of gonadal antipsychotics such as risperidone can increase the
steroid hormones you’re gonna do trophies secretion of prolactin so we have this
depends on these agents so they find use in the hyperprolactinemia which is associated with
treatment of infertility so we have here the men galactorrhea and hypogonadism which is treated
altro apines also known as human menopausal with detour receptor agonists such as the
gonadotropins or HMG which are obtained from bromocriptine and covered bullying so both of
the urine of post menopausal women and contain these agents also find use in the treatment of
both FSH LH so we have as well the euro all literally pituitary microadenomas remove cryptic line is also
pine which is a FSH that obtained from the indicated for the treatment of type 2 diabetes
postmenopausal women and is devoid of LH or among their adverse effects
luteinizing hormone we have as well the fully
tropine and this is considered to be either alpha or
remove cryptic line is also indicated for the
beta they are considered to be human follicle
treatment of type 2 diabetes among their adverse
stimulating hormone products manufactured using
effects are remove kryptane is also indicated for
recombinant DNA technology we have as well as
the treatment of type 2 diabetes among their
the human cryonic gonadotropin which is the HCG
adverse effects are of course nausea headache and
it is a placental hormone that is excreted in the
even psychiatric problems so in contrast to the
urine of pregnant women so the effects of HCG and
hormones of the anterior lobe of the vegetarian
Cory oh gonadotropin alpha it is made using
those of the posterior lobe such as the vasopressin
recombinant DNA technology they are essentially
and oxytocin are not regulated by realistic
identical to those of luteinizing hormone so all of
hormones instead they are synthesized and the
these hormones are injected injected via the
hypothalamus transported to the posterior
intramuscular or subcutaneous route so injection of
pituitary and released in response to specific
HMG or follicle stimulating hormone products over
physiologic signals such as high plasma osmolarity
a period of five to 11:50 days may cause ovarian
or factory share both hormones are administered
follicular growth and maturation and with
intravenously and have very short half lives their
subsequent injection of HCG ovulation of course
actions are summarized such as oxytocin is used in
but of course we have adverse effects that includes
obstetrics to simulate uterine contraction and in
ovarian enlargement and possible ovarian
this labor while oxytocin also causes milk ejection
hyperstimulation syndrome which may be life
they contracting the my cellular cells around the anterior predatory and it’s used to diagnose the
memory of your life we have also toxicities on this caching sees and take note also that the ganadora
but it is very uncommon when the drug is used line and the saline are the analogues of the gnr H
properly though hypertension may occur uterine so following with an initial burst of the FSH and
rupture water retention and even fetal deaths may utilizing hormone both the rags inhibit budgetary
be reported so a little precaution also with this kind gonadotropin secretion so with the resultant
of drugs it’s anti diuretic and pressure activities are dropped in the production of the sex hormones so
much less pronounced than those of vasopressin so finally we have the sermorelin that stimulates the
so much for the hypothalamic and pituitary agents production of growth hormone by the anterior
always remember that it has therapeutic actions budgetary so let's move on to
but it may also have its adverse reactions so for the
therapeutic actions such as the decimal line which
is used to stimulate the GH and it has its lipolytic both the rags inhibit budgetary gonadotropin
effects it may help in decreasing the excess secretion so with the resultant dropped in the
abdominal fat and HIV infected patients with production of the sex hormones so finally we have
lipodystrophy take note as well that for its the sermorelin that stimulates the production of
indications it could be considered as agonist like growth hormone by the anterior budgetary so
the gasoline esterline euclide and nafarelin which let's move on to better to both the rags inhibit
are the analogs of gonadotropin releasing hormone budgetary gonadotropin secretion so with the
so they in fact they decrease the production of sex resultant dropped in the production of the sex
hormones and they are used as treatment for hormones so finally we have this sermorelin that
precocious puberty in dimitriou sis and advanced stimulates the production of growth hormone by
prostate cancer as the hypothalamic and pituitary the anterior budgetary so let’s move on to pietari
agents hypothalamus hypothalamus uses a number patients and as I have mentioned that the
of hormones or factors to either stimulate or inhibit antagonists of of this Gen. RH or the hypothalamic
the release of hormones from the anterior pituitary HHS we have here the degarelix and gunner relics
so the drugs are affecting hypothalamic hormones OK they are used as treatment for advanced
can stimulate the release of hormones so as we prostate prostate cancer and inhibition of
have already mentioned those different premature luteinizing hormone surge in women
apartments or releasing hormones we have the that undergoes controlled ovarian stimulation for
growth hormone releasing hormone thyrotropin fertility we have also the leuprolide that occupies
releasing hormone gonna do atropine releasing pituitary GNRH receptor sites so that they are no
hormone corticotropin releasing hormone prolactin longer respond to this GNRH they are considered to
releasing hormone and we have also factors that be antagonists again we have also the nafarelin
inhibit the release of hormones such as the which is used to decrease the production of gonna
somatostatin which is the growth hormone gonadal hormones through repeated stimulation of
inhibiting factor and prolactin inhibiting factor take their receptor sites take note of their
note that the agonists which is the CRH that pharmacokinetics so as you can see here we have
stimulates the release of i've been in the route which is the IM depot and we have the

which is the growth hormone inhibiting factor and take note of their pharmacokinetics so as you can
prolactin inhibiting factor take note that the see here we have the route which is the IM depot
agonists which is the CRH that stimulates the and we have the on take note of their
release of i've been no particular which is the pharmacokinetics so as you can see here we have
growth hormone inhibiting factor and prolactin the route which is the IM depot and we have the
inhibiting factor take note that the agonists which onset and we have the peak for my question is
is the CRH that stimulates the release of what is the half Life OK what do we mean by this
adrenocorticotropic hormone the ACTH from the OK so the T and ½ means the half-life and it refers
to the time required for plasma concentration of a growth growth of internal organs and protein
drug to decrease by 50% so half life is dependent synthesis the indication includes long term
on the rate constant which is related to As you can treatment of children with growth failure with
see here now it has only three hours what about sparse deficiencies grows with Turner centrum aids
the depot injection it is referring to the slow wasting and cut next share the growth hormone
release form of medication so the injection uses a deficiency in adults and treatment of growth failure
liquid that releases the medication slowly so it lasts in children of small gestational age we do not
a lot longer so depot injections can be used for achieve catch up growth by two years of age so
various types of drug including some antipsychotics take note that somatotropin such as nutropin size
take note also of this hypothalamic agents we have and genotropin service team and somatropin our
here just read it on your own including its dosage DNA origin which is the served death are used for
the route and the unusual indicate and I mean the gross harm under placement so drugs affecting
different indications of the drugs of course we have anterior pituitary hormones are agents that affect
certain contraindications and cautions the pituitary function and are used mainly to mimic
or antagonize the effects of specific budgetary
hormones they are used either as replacement
so there will be hypersensitivity to hypothalamic therapy for conditions resulting from a hypoactive
agents and any component of the drug there will budgetary or for diagnostic purposes so antagonists
be a contraindication or cautions for pregnant are also available that may used to love the effects
women and lactating mothers even for patients of the anterior pituitary hormones look here we
with renal impairment you should not be giving this have the pharmacokinetics here are the
medications with patients who have peripheral characteristic interactions of the growth hormone
vascular disorders or even ritis especially when you agonist and the body in terms of absorption
are using nafarelin let’s move on to the pituitary distribution metabolism and excretion so when you
agents and we can say that this refers to the growth say pharmacology pharmacokinetics the drugs are
hormones or the growth hormones agonists when absorbed slowly when given intramuscularly or
you say growth hormone agonists they are subcutaneously or indebted form so take note that
responsible for the in your skeletal growth growth nafarelin is given in a nasal form so it has the half
of internal organs protein synthesis and stimulation lives that last days two weeks and it is thought to
of processes required for normal growth so we be metabolized by endogenous hormonal pathways
have also here the diseased spotlight which is the it can also cross the placenta and cross into breast
growth hormone deficiency not only that we have milk and mostly it’s excreted in the urine so
the hypopituitarism which is often seen as the remember always that the drugs affecting posterior
growth hormone deficiency before any other signs pitari hormones may also have the anti diuretic
and symptoms or it occurs as a result of the hormone or vasopressin and this vasopressin is
developmental abnormalities congenital defects of commonly known as the ADH and another one is
the veterinary circulatory disturbances such as the oxytocin so ADH possesses under theoretic
hemorrhage and even acute or chronic hemostatic and vasopressor properties as indicated
inflammation of the pituitary and visitara tumors here in your slide yeah you you’re not even So what
dwarfism may also occur if there is growth is the therapeutic action of this drug so we have
hormone deficiency in children which results to either it has the pressor and or anti diuretic effect
short stature wherein somatotropin deficiency may causing the cortical and medullary parts of the
syndrome is a condition in adults with collecting duct to become permeable to waters and
hypopituitarism caused by pituitary tumors or so it increases water reabsorption and even
trauma four may have been treated for GH decreasing your information it can also increase the
deficiency as children resulting in a shutdown of levels of clotting factor 8 of
the pituitary production of somatotropin let’s move
on to the therapeutic action that includes replacing
human growth hormone and stimulates skeletal
clotting factor 8I of clotting factor eight I vasopressin and oxytocin so take note all this table
remember that the normal range of factor 8 levels we have here the growth hormone agonists for
are 50% to 150% so if your factor 8 activity level is posterior pituitary hormones and look at this
less than 50% you may have hemophilia or pharmacokinetics of this kind of drugs Take note
hemophilia A but the severity of the bleeding the swell of the contraindications and cautions as
depends on what percentage you have so well as the adverse effects no the now the
remember that sustained sustained rise in factor question here now the question here until they’re
eight are seen during pregnancy surgery chronic ready Carmen or the ADHD can be used for
inflammation malignancy even liver diseases treatment of hemophilia B&C or is deficient in
hyperthyroidism intravascular hemolysis and if in diabetes insipidus or is producing stored with the
renal disease so in most conditions there is a posterior lobe of the pituitary gland or can
concordant increase of factor 8 level so the decrease the level of clotting factor 8 what is your
treatment or the indications for this may include answer can decrease OK so the correct answer is
neurogenic or treatment of neurogenic diabetes the correct answer is letter B anti directly carman
insipidus and hemophilia as mentioned what is by anti diuretic hormone is the it’s deficient in the
the way what as a review what is abatis insipidus it’s deficiency causes patients with
their abilities and syphilis to produce a large
amount of dilute urine it is used as a treatment of
level so the treatment or the indications for this hemophilia A because it can increase the level of
may include neurogenic or treatment of clotting factor 8 it is produced by the hypothalamus
neurogenic diabetes insipidus and hemophilia as and stored in the posterior lobe of budgetary gland
mentioned what is by the way what as a review next question treatment with 88th previous
what is it about the level so the treatment or the
indications for this may include neurogenic or
treatment of neurogenic diabetes insipidus and it is used as a treatment of hemophilia A because
hemophilia as mentioned what is by the way what it can increase the level of clotting factor 8 it is
as a review what is it about diabetes insipidus so produced by the hypothalamus and stored in the
there that is syphilis can be treated with this drugs posterior lobe of budgetary gland next question
acting or affecting posterior pituitary hormones treatment with ADH preparations is a it is used as
and so this diabetes insipidus is a rare condition a treatment of hemophilia A because it can
where you always be a lot and often feel thirsty so increase the level of clotting factor 8 it is produced
it is not related to type one diabetes type 2 by the hypothalamus and stored in the posterior
diabetes but it does share some of the same signs lobe of budgetary gland next question treatment
and symptoms so the two main symptoms of with ADH preparations is associated with adverse
diabetes insipidus are extreme first or the effects including a hangover symptoms like
polydipsia and also frequent urination so you tend headache and sweating B Constipation and
to be a lot so take note of that so what about the paralytic will use C Cholecystitis and bowel
hemophilia a obstruction or D nocturia and bed wetting the
answer is a Now let’s move on to another question
which of the following is true regarding growth
and also frequent urination so you tend to be a lot hormone deficiencies a the course only in children
so take note of that So what about the hemophilia B it always results into our fission C it is treated
a so hemophilia is a hereditary bleeding disorder only in children because GH is usually produced
caused by a lack of blood clotting factor 8 so only until puberty or it can occur in adults as well
without enough factor 8 the blood cannot clot as children the correct answer is D D can occur in
properly to control bleeding so this is a very good adults as well as children with deficiencies it can
drug of choice that is being used to correct such cause either by congenital defects and pituitary
condition hemophilia A and herbicide but syphilis tumors and trauma in adults we have another
you seeing this I thought your ratic hormone or question here which is which of the following drugs
can increase the toxicity of promo kryptane a principal ingredients the first one is glycoprotein
phenothiazine B occults C earth or mycin or these called Sarah globulin which is synthesized in the
statins if you answered letter C then that is correct rough endoplasmic reticulum of follicular cell and
see is erythromycin combining erythromycin and that is secreted into the college the second
brown bromocriptine will increase the risk of ingredient is an iodide which is which is actively
toxicity phenothiazines decrease the effectiveness pumped into the cell by surgeon he died symporter
of Ramon cretin but obvious will warrant an and then is passively transported into the college
increase in dosage of growth hormone antagonists I along with Sarah globulin in in the colored with the
hope you learned something from our discussion help of an enzyme called thyroid peroxidase I did is
here and students please always review your notes oxidized to iodine and hormone synthesis begins
and get ready for our next meeting we will still have with the addition of iodine to tyrosyl residues and
more to discuss and new topics aside from this so the thyroglobulin molecules in a process called
God bless and see you soon iodination next through conjugation adjacent
tyrosyl residues are paired together and the entire
complex reenters the follicular cell back inside the
cell proteolytic enzymes digest thyroglobulin test
liberating free thyroid molecules tyrosine known as
Thyroid and Parathyroid Agents the T4 and try I do tyranny known as T3 which are
Drugs acting on thyroid glands thyroid gland is then released into the circulation where they
located in the middle of the neck and surrounds quickly bind to carrier proteins for transport to
the tracheal like a shield it produces 2 hormones target cells now free extracellular T4 and T3 enter
thyroid hormone and calcitonin the thyroid gland the target cells through transporter proteins once
uses iodine to produce thyroid hormones that inside the cell the amount of T3 which has greater
regulate body metabolism thyroid agents either biological activity than T4 is regulated by that
replace or remove hormones to prevent deficiency iodinase enzymes one and two are abbreviated D1
and exits third agents include thyroid hormones and D2 that cat catalyze the conversion of T4 to T3
T3T4 and TSH and anti thyroid drugs further their zerba increasing intracellular levels of the
classified as thyroids and iodine solution so as you active hormone on the other hand dial Denise
can see hypothalamic hormones can be broadly three everybody abbreviated as these three serves
classified into two groups the first group includes to inactivate T4 by converting it to so-called refers
the hormones that act on the anterior pituitary T3 RTR or RT3 for short therefore limiting the
gland such as thyrotropin releasing hormone or amount of T4 that can be used to form T3 in the
TRH that simulates specialists and decrane cells final step T3 moves to the nucleus and binds to the
called thyroid tropes or T to release thyroid thyroid hormone receptors or the TR which then
stimulating hormone or TSH which in turn form heterodimers with their retinoid X receptor
stimulates thyroid gland to produce and release arix RXR to induce transcription of target genes
thyroid hormones so now let’s take a closer look at known as the thyroid response elements and this
how these drugs work to produce their therapeutic leads to synthesis so far as regulatory proteins
effects starting with the agents targeting thyroid which then mediates virus which are physiological
gland to gain a better understanding of the responses now the drugs used in treatment of
mechanism of drugs action first we need to review thyroid disorders can be generally divided into two
the mechanism by which thyroid hormones are groups the first group includes agents that treat the
synthesized in the thyroid follicle that is the condition and in which there is inadequate
functional unit of the thyroid gland the thyroid production of thyroid hormones known as
follicle which is composed of intrafollicular colloid hypothyroidism medications used to treat
and follicular cells serves as most factory and hypothyroidism include levothyroxine which is a
warehouse for production of thyroid hormones the synthetic version of T4 list irony in which is a
recipe of making thyroid hormones goes forth two synthetic version of T3 litre X which is a synthetic
combination of T4 and T3 and dissipated natural
thyroid which is a natural thyroid hormone who have a a non functioning land this can lead to
prepared from dried poison thyroid containing a poor growth and development as well as mental
mix of T4 and T3 now moving on to the second retardation another sorry dysfunction which is
group that includes agents used to treat the hyperthyroidism of course when excessive amounts
condition in which there is overproduction of of thyroid hormones are produced and released
thyroid hormones known as hyperthyroidism into circulation princesses is the most common
medications used to treat hyperthyroidism include cause of hyperthyroidism OK now it answers this
propel tyrosyl and miss amoxil which work by question what is the common cause of
inhibiting thyroid peroxidase that is required for hyperthyroidism yes you are right it’s the Graves’
oxidation of the iodide as well as inhibiting coupling disease Graves’ disease that is the most common
of ideotype racines and thyroglobulin that is cause of hyperthyroidism let’s move on to the
necessary for sorry hormone synthesis in addition different start hormones and its therapeutic actions
to this referral thyroid thyroid seal is also inhibit or thyroid hormones are made available to replace
also inhibits diiodine swan or D1 which prevents the low or absent levels of natural thyroid hormone
conversion of T4 and T3 which is necessary for and suppress the offer production of TSH by the
thyroid hormone synthesis no this question it’s pituitary this can contain both natural and synthetic
related to what we just have discussed the type of thyroid hormone so it’s therapeutic action
following start inhibitor interferes with peripheral includes increasing the metabolic rate of body
conversion of sarazin to try a iodo cyanine a tissues increasing oxygen consumption and even
propulsion reseal BSM Axel C carboxyl or D the respiration the heart rate the growth and
radioactive iodine again which among the following maturation and even metabolism of fats
sarrant inhibitor interferes or interferes with carbohydrates and proteins so take note that it is a
peripheral conversion of thyroxine to replacement hormones for hypothyroid states like
triiodothyronine so the correct answer is letter A Mike cedima, goiters and thyroid cancer so we have
propelled thyroid seal let’s move on in this an example we have here the levothyroxine which
illustration you will see here the in each column is a synthetic salt of T4 and the most frequently
you will see the different hormones and with each used replacement hormone because of its
row you will see the different disorders or predictable bioavailability and reliability take note
dysfunction of the thyroid gland so please study of its indication as a replacement hormone for
this as it may come it might come out in your final hypothyroid States and treatment for thyroid
examination at the bottom table you will see also toxicity and treatment for thyroid over stimulation
the different signs and symptoms of during pregnancy study as well the
hypothyroidism hyperthyroidism and Graves’ pharmacokinetics of this drug or of this thyroid
disease so take note that the thyroxine binding hormones and we can see here the characteristic
globulin deficiency there is always extremely low interactions and the the characteristic interactions
total thyroxine or T4 and this dysfunction OK so of the thyroid hormones in the body in terms of
remember that when you say hypothyroidism this absorption distribution metabolism and excretion
is referring to a thyroid dysfunction that is the take note it has a slow onset for be all routes but it
underactivity of the thyroid gland but the has at least six to 8 hours on set where you’ve given
overactivity refers to the hyperthyroidism sorry this intravascularly take note the test the half life of six
there's a lot more sufficient levels of thyroid to seven days only and its metabolism takes place
hormones to maintain a normal metabolism so this in the liver and excretion in the bile so for
is the most common type of thyroid dysfunction contraindications and cautions the following are
and is common among older women and men contraindications and cautions for the use of
those symptoms may include the obesity and fat thyroid hormones any component of the drug to
and fatigue and their related symptoms as well as prevent hypersensitivity reactions we have to be
mentioned in the previous table so for cretinism aware as well and take precautions if the patient
another thyroid dysfunction which is a condition in has an acute thyrotoxicosis unless used in
children who are born without a thyroid gland or conjunction with antithyroid drugs it can be
exacerbated exacerbated by the drugs the same metabolism or ineffective tissue perfusion related
with myocardial infraction so we have to be careful to thyroid activity further the nursing interventions
with patients who has myocardial infraction and in here we have rationality for each administer a
acute thyrotoxicosis even with lactation and single daily dose before breakfast each day to
pregnant women for lactation drug and breast milk ensure consistent therapeutic levels we need also
and can suppress infants thyroid production while to administer with a full glass of water to prevent
with pregnant women it has a potential adverse the difficulty of swallowing and esophageal atresia
effects on the fetus for Addison disease the body what is esophageal atresia remember it is a
will not be able to deal with the drug effects so but congenital medical condition or birth defect
look at the bottom we have here the list ironing wherein the alimentary tract is affected because
and the lyrics remember this drugs are given to the end of the esophagus is not connected
patients with thyroid dysfunction of normally to the stomach so it is an abnormal
hypothyroidism so life thyronine and lyrics have embryological development of the esophagus so
greater incidence of cardiac side effects so please take note of giving this medication to patients with
take note of this contraindications and cautions if this elementary tract dysfunction so we have to
patients have some cardiac diseases with adverse also to intervene by monitoring the cardiac
effects the use of thyroid at home and hormones response to detect cardiac adverse effects arrange
may or thyroid hormones may result to these for periodic blood test of thyroid function to
adverse effects skin reactions and loss of hair and monitor the effectiveness of the therapy as well
symptoms of hyperthyroidism for the interactions and of course you have to provide comfort
the following are drug interactions that involved in measures and very important the patient education
the use of thyroid hormones we have the so as the patient will be aware of the effects of the
cholesterol tyramine which may result to decrease drug even the warning signs and the patient should
absorption of thyroid hormones so we have to take be aware that this should be reported the warning
two hours apart and for the anticoagulants it may signs and the effects of the drug so for your
increase the bleeding with the digital glycosides it evaluation here are the aspects of care that should
may also decrease effectiveness of digital be evaluated to determine effectiveness of drug
glycosides so please take note of this interactions therapy first we have to monitor the patient
with other drugs for the nursing considerations response to therapy so if the response is positive
take note of the important nursing considerations then there will be return of metabolism to normal
that when administering the thyroid hormones for and prevention of koiter we have also to monitor
your assessment these are the important things for adverse effects such as the tachycardia
that you should include and conducting assessment hypertension anxiety and skin rash we have to
history taking and examination assess of course for evaluate the patient understanding on the drug
the contraindications and cautions which we therapy by asking patient to name the drug its
discussed already to avoid adverse effects assess indication and adverse effects to watch four we
the skin lesions orientation and affect as well even have to monitor patient compliance to the drug
the vital signs that may include the blood pressure therapy as well let’s move on to some questions
the pulse the respiration and even the peripheral that may might help you with your review for your
perfusion and vessel evaluation and adventitious finals in this pharmacology SCCM one service six so
breath sounds also the thyroid function test is very for proof or for your finals we have this topic on
important in order for you to determine the endocrine system so please take note of the
baseline status before beginning the therapy for questions here that may guide you and help you
any potential adverse effects add into that we have with your final exams so first we have this question
the nursing diagnosis so here are some of the the metabolic rate of the following organs are
nursing diagnosis that can be formulated in the use significantly affected by thyroxine is it a brain or B
of this drug for therapy one decreased cardiac heart C liver or D skeletal muscle the answer is or
output related to CV effects imbalanced nutrition the answers are the following organs are
less than body requirements related to changes in significantly affected by thyroxine this organs are
heart liver and skeletal muscle next question we here the metabolism through the liver and the
have what are the actions of thyroxine is it ABC or exclusion is through the urine as well but the
D OK so we have the following actions of saracene half-life is unknown alright so the characteristics or
induction of negative nitrogen balance which is a the characteristic interactions of iodine solutions
reduction in plasma cholesterol level B and rise in and the body in terms of absorption distribution
blood sugar level letter D next question sarks in metabolism and excretion is seen here so or shown
therapy is indicated in the following conditions a BC here so please study this pharmacokinetics of
or D the correct answer is letter C non functional iodine solutions let’s move on to the
thyroid nodule which is letter C thyroxine therapy is contraindications and cautions of this anti thyroid
indicated in non functional thyroid nodule let's drugs again we have the thyroids and the iodine
move on to the next question complications of solutions so if the patient is allergic to any
overtreatment with thyroxine include the following component of the drug and pregnant or lactating or
AB C or D the correct answers are a B&C articular has a pulmonary edema or tuberculosis this drug
fibrillation angina pectoris and congestive heart should or antithyroid agents or drugs should not be
failure this are’the complications of overtreatment given why for allergic patients are for patients who
with thyroxine let’s move on to the antithyroid have allergy to any component of the drug we have
agents these are common treatment for to make sure that the patient is not allergic or else
hyperthyroidism particularly if you have an ongoing you will not be able to to control the
form of hyperthyroidism caused by Graves’ disease hypersensitivity reactions of the patient so to
or echo goiter so the goal of anti thyroid prevent this please do not give the drug same with
medication is to prevent the thyroid from pregnant women because it might result to
producing excess amounts of hormones so this development of cretinism to the fetus yes
includes the thyroids and the Iodide solutions these development of cretinism So what do you think is
groups of drugs are not chemically related but they the drug of choice for pregnant women instead of
both block the formation of thyroid hormones giving other antithyroid agents so the drug of
within the thyroid gland thyroid slower thyroid choice is pity you again it is the PTU take note
hormones by preventing the formation of thyroid alright so BTU is as I have mentioned it is one of the
hormone the thyroid cells they also partially inhibit thyroids and it is the repel fiora seal again it is for
the conversion of T4 to T3 at cellular level cyanides pregnant women what about for lactation lactation
include I say I’ve mentioned they include or if the if patients are lactating there there is a risk
propylthiouracil or PTU and misima Sol or tapazole I of anti thyroid activity activity in the infant or it
did solutions on the other hand in high doses lack could lead to neonatal goiter so we need to have
the thyroid function so they cost the cells to some cautions on this that it should not be given to
become over saturated with iodine and stop dictating mom mothers we have also pulmonary
producing hormones educations for this antithyroid edema or tuberculosis because here you should not
agents are include treatment of hyperthyroidism as be giving this anti thyroid drugs to patients with
I have mentioned and we're in the third blocking in tuberculosis or pulmonary edema because it is very
our radiation emergency as well OK so treatment of contraindicated with strong iodine products the
hyperthyroidism and thyroid blocking in irritation patient is receiving antituberculosis drugs which
emergency so this is the pharmacokinetics of the are contraindicated with strong ID products now
thyroid drugs or antithyroid drugs the route is for let’s move on to the adverse reactions the use of
REM which has an onset of 30 to 60 minutes and a antithyroid agents may result to these adverse
duration of two to four hours so it has a half life of effects for cyanides it can cause drowsiness
6 to 13 hours and the excretion is through the urine lethargy radical Richard nausea skin rash for PTU
the metabolism is unknown or not mentioned let's we have nausea vomiting GI complaints severe liver
move on to this is the pharmacokinetics for the ID toxicity methimazole bone marrow suppression
solutions this one is for As for the dynamites OK so iodine solution hypothyroidism metallic taste and
the thyroids are given per RPM and excretion is burning sensation in the mouth or even sore teeth
through the urine but for the ID solutions we have and gums darias staining of teeth skin rash and
development of quieter another one is the I131 point so provide comfort measures also to help
which is only for patients over 30 years old because patient cope with drug effects we need to provide
of adverse effects associated with radioactivity so patient education about drug effects and warning
how how is this therapy given or how is the I131 signs to report to enhance patient knowledge and
therapy works so here the third land takes up most also to promote compliance very important the
of the iodine in your body right so by making the compliance of the patient to the therapy now let's
iodine radioactive in the form of I131 it becomes move on to the evaluation for the evaluation there
toxic to cells that collect iodine from your body so are aspects of care that should be evaluated to
in turn killing these cells so this treatment can be determine the effectiveness of the drug therapy we
used to destroy any sort of tissue that was not need to monitor the patient responds to therapy so
removed during surgery or to treat some thyroid that we might see if there’s lowering of thyroid
cancers that can spread to lymph nodes and other hormone levels we have to monitor for adverse
parts of the body OK so this is a range of activity effects such as radical argia anxiety blood scratches
which is limited for patients over 30 years old and the like we need to evaluate the patient’s
because of its adverse effects let’s move on to the understanding of the drug therapy by asking the
interactions of the drug of the anti thyroid drugs patient the name of the drug is indication first
the following are the interactions involved in the effects to watch for we need to monitor the patient
use of antithyroid agents we have here for the compliance to the drug therapy that is very
thymines it increases the bleeding with oral important so let’s move on to some questions again
anticoagulants and PT for the iodine solutions the for you to study OK so radioactive iodine is the
changes in the metabolism and level of treatment of choice for the following category of
anticoagulants as well even the theophylline thyroid toxic patients is it ABC or D the correct
digoxin metropolol and Propranolol so take note answer is letter C elderly patients with this chemic
students for the nursing considerations because heart disease let's move on to with this next
when administrating administering the antithyroid question it is the most common type of thyroid
agents we have to assess important things that dysfunction I think this is a very easy question
includes the contraindications and cautions which I know everyone will be able to answer so
especially if the patient is allergic if the patient has the correct answer is letter D hypothyroidism this is
the previous renal stone or if the patient is the most common type of thyroid dysfunction
pregnant so it may help the patient not to please read the rationality behind let’s move on to
experience the adverse effects so please assess this question 3 hormone scan a simulate
rd

properly the patient we have also to assess for 16 overproduction of TSH or increase oxygen
lesions if in the liver evaluation serum calcium consumption or increase the heart rate without
magnesium and alkaline phosphate levels and affecting the respirations or letter D ****** growth
radiographs of bones is appropriate to determine and maturation what is your answer is it ABC or D if
of course the baseline status before beginning the you answered B then you are correct B increase
therapy and avoid potential adverse effects alright oxygen oxygen consumption thyroid hormones
so for some of our nursing diagnosis including increase the metabolic rate of body tissues so
balanced attrition more than body requirements increasing oxygen consumption or respiration heart
related to metabolic changes and we have the risk rate growth and maturation and the metabolism of
for injury related to bone marrow suppression for fats carbohydrates and proteins this is my phone
nursing intervention take note that these are vital next question we have here 3 hormone scan I
rd

nursing interventions done in patients who are mean this is the answer right letter P now let’s
taking antithyroid agents we need to administer move on to this question all of the following should
peteus three times a day around the clock to be included in the nursing interventions for
ensure consistent therapeutic levels take note of patients taking thyroid hormones except is it ABC
the correct timing and use the standard timing give or D OK the correct answer here is letter C OK
iodine solution through a stroke to decrease remember that no the antithyroid agent of choice
staining of teeth so tablets can be crushed at this for pregnant women is a BC or D if you are listening
a while ago then you can answer this quickly yes
that is right if you answered B you are correct let’s
move on to this which of the following history data
will possibly render strong iding products
contraindicated for the patient ABC or D yes the
correct answer is letter D OK please read the
rationale there OK so I hope that you’ve learned
something from our discussion or the slide
presentation for the third agents and to order our
in order for you to enhance your learning so please
try to read again your lecture handouts and or
watch again this video