Endocrine System

Drugs

Orlistat

 Mechanism: Alters fat metabolism by

blocking pancreatic lipase
Use: Long-term obesity management in
conjunction with modified diet
Toxicity: Steatorrhea, GI Discomfort,
Reduced absorption of Fat Soluble
Vitamins, Headache

Sibutramine

 Mechanism: Sympathomimetic serotonin

and norepinephrine reuptake inhibitor
Use: Short-term and long-term obesity
management
Toxicity: Hypertension and Tachycardia

Propylthiouracil

 Mechanism: Inhibit organification and

coupling of thyroid hormone synthesis.
Decreases peripheral conversion of T4 to
T3.
Use: Hyperthyroidism
Toxicity: Skin Rash, Agranulocytosis
(Rare), Aplastic Anemia

Methimazole

 Mechanism: Inhibit organification and

coupling of thyroid hormone synthesis.
Use: Hyperthyroidism
Toxicity: Skin Rash, Agranulocytosis
(Rare), Aplastic Anemia

Growth Hormone

 Use: GH Deficiency, Turners Syndrome

Octreotide (Somatostatin)

 Use: Acromegaly, Carcinoid, Gastrinoma,

Glucagonoma

Oxytocin

 Use: Stimulates Labor, Uterine Contraction,

Milk Let-Down, Controls uterine
hemorrhage

Levothyroxine
(Triiodothyronine)

 Mechanism: Thyroxine Replacement

Use: Hypothyroidism, Myxedema
Toxicity: Tachycardia, Heat Intolerance,
Tremors, Arrhythmia

Glucocorticoids
List the five!

Hydrocortisone
Prednisone
Triamcinolone
Dexamethasone
Beclomethasone

 Mechanism: Decrease production of leukotrienes

and prostaglandins by innhibiting phospholipase
A2 and expression of COX-2
Use: Addisons Disease, Inflammation, Immune
Supression, Asthma
Toxicity: Iatrogenic Cushings- Buffalo Hump,
Moon Face, Truncal obesity, Muscle Wasting, Thin
skin, Easy Bruisability, Osteoporosis,
Adrenocortical atrophy, peptic ulcers, diabetes

Insulin Types:
Name the 5 and give their legnth of
action

Lispro (Short-acting)
Aspart (Short-acting)
NPH (Intermediate)
Lente (Long-acting)
Ultralente (Long-acting)

 Mechanism: Bind insulin receptor: In liver,

increase glucose stored as glycogen. In muscle,
increae glycogen and protein synthesis and K
uptake, in Fat, aids TG storage.
USE: Type I DM, life-threatening hyperkalemia,
stress-induced hyperglycemia
Toxicities: Hypoglycemia, hypersensitivity
reaction (Very Rare)

Sulfonylureas
Give 2 first generation drugs and 3
second generation drugs

 First Generation
Tolbutamide
Chlorpropamide

Second Generation
Glyburide
Glimepriride
Glipizide

 Mechanism: Close K channel in Beta Cell

Membrane, so cell depolarizes triggering of
insulin release through Ca influx
Use: Stimulate release of insulin in type 2
DM. It doesnt work in type 1
Toxic: First generation has disulfiram
reaction. Second generation can cause
hypoglycemia

Metformin
This is a Biguanide

 Mechanism: Unknown: Possibly decrease

gluconeogenesis, increase glycolysis,
decrease in serum glucose
Use: Oral hypoglycemic. Can be used in
patients w/out islet function
Toxicities: Most grave adverse effect is
lactic acidosis

Glitazones
Name the 2

 Pioglitazone
Rosiglitazone

 Mechanism: Increase target cell response to

insulin
Use: Monotherapy in type 2 DM or
combined with other agents
Toxicity: Weight gain, edema,
hepatotoxicity, CV toxicity

Alpha-glucosidase Inhibitors
Name 2

 Acarbose
Miglitol

 Mechanism: Inhibit brush border alpha

glucosidases. Delayed sugar hydrolysis and
glucose absorption lead to decreased
postprandial hyperglycemia.
Use: monotherapy in type II DM or with
other agents
Toxicities: GI Disturbance