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PITUITARY GLAND HORMONES HYPOTHALAMUS CONTROL
GHRHCGHReleasing Hormone ]
Growth Hormone [ GH ]
GHIHCGHInhibiting Hormone ]
Thyroid Stimulating Hormone C TSH ] TRH C Thyroid Releasing Hormone ]
Adrenocorticotropic Hormone C ACTH ] CRH C corticotropin Releasing Hormone )
Gonadotropins GnRH C Gn Releasing Hormone ]
Prolactin PIH [ Prolactin Inhibiting Hormone ]
GROWTH HORMONE INHIBITING HORMONES C GHIH ] / SOMATOSTATIN
ORGAN ACTION USES
• PITUITARY I GH Acromegalya
PANCREAS
a cells C Glucagon ] T Blood sugar
13 Celts [ Insulin ] t , Blood sugard cells C somatostatin ] I Glucagon Iletcell tumors
I Insulin
• GIT t , secretions secretory diarrhoea
• BLOOD VESSELS vasoconstriction Oesophageal varices
SOMA to statins
S Secretory diarrhea
O Oesophageal varices
M Malignancy [ Ilet cell tumors ]
A Acromegaly
→ somatostatin → Short actingOCTREOTIDE → Long acting somatostatin derivative
→ ANY PHYSIOLOGICAL SUBSTANCE ENDING iG INA IS PEPTIDE
→
They will be degraded when given by oral route
→OCTREOTIDE → given by SC route
GONADOTROPIN RELEASING HORMONE E Gn Rtl ]
PULSATILE FASHION CONTINUOUS FASHION
T Gonadotropins t , Gonadotropins
T'
Estrogen ,I progesterone I Estrogen ,
I, progesterone
T Testosterone I ,Testosterone
INDICATIONS OF GnRH
In Pulsatile manner
I Hypo gonadotropic hypogonadism2 Delayed Puberty
In continuous Fashion
I cancers
→ prostate cancer
→ Breast cancer
2 Endometriosis
3 Precocious puberty
GnRH AGONISTS
I LEUPROLIDE
2
NAFARELIN3
GOSERELIN4
BUSURELIN5 HI STAR ELIN
→ FLARE UP REACTION
→When these drugs given in continuous manner
, initial 2-3 days
there is aggravation of disease
GnRH ANTAGONISTS
I CETRO RELIX
2 GANI RELIX
3 ABA RELIX
4 DEGA RELIX
NO flare up reaction
→ but they do not Tse sex hormones
→Either GnRH Agonists or GnRH antagonists , not effective orally
PROLACTIN INHIBITING HORMONE C PIH ] I DOPAMINE [ DA ]
→ DA acts through D2 Receptors→
Drugs stimulating D2 Receptors act like PIH
→ D2 RECEPTOR AGONISTS
⇒ BROMO CRIP TINE
→ CABER LINE C Long acting ]
→INDICATIONS
I HYPER PROLACTIN E MIA
→ CABER GO LINE → DOC , can be given orally
2 PARKINSONISM
3 ACROMEGALY
→ CABERGOLINE is the preferred drug→ t , GH
→can be given orally
PEG VISONIANT [ GH RECEPTOR ANTAGONIST ]
→
PEGVISOMANT → somatotropin Antagonist
→PEG VI SONANT → causes Visual Field defect
→PEG VISOMANT
→ polyethylene Glycol → Long acting
4 TYPE 2 DM
→ BROMOCRIPTINE → t , Insulin resistance
→ SECRETS
T3
T4
CALCITONIN
T T3 4
→ shoot acting → longer acting→
more active → Less active
→ LIOTHYRONINE→
L - THYROXINE
-
only indicator → -
Doc For hypothyroidism
Myxedema coma-
Doc For myxedema coma
[ Emergency ]
PHYSIOLOGY OF THYROID HORMONE PRODUCTION
7
--
-
I ✓ Tz "
2I
-HE÷÷.:Lt •
5
+ K
4 43"
His
I Iodide C I-
] enters into thyroid Follicle by Nat I-
Sym porter2 From Follicles Iodide enters into colloid
3 In COLLOID
I-
. .oxidation
Io
. , organificatn i tyrosine
MIT
DIT
u Coupling
T3
T4
→ all the 3 reactions catalysed by Thyroid Peroxidase
→Tz , Ty stored in colloid
4 .
ISH Stimulates thyroid5 Tz , To,
released into circulation
6 Hormone reaches peripheral tissues I organs [ Liver ]
→In the blood , Tg is active but Less in quantity
Ty is abundant but not much active
7 Peripheral conversion takes place in peripheral tissues I organs [ Liver ]
>TK metabolised T3
HYPERTHYROIDISM - DRUGS #4
I NIS INHIBITORS ✓ Tz "
2 THYROID PEROXIDASE INHIBITORSI }(3 SECRETION INHIBITORS
4 PERIPHERAL CONVERSION INHIBITORSB
5 THYROID DESTROYING DRUGS+ K
43"
HNIS INHIBITORS
is
I PERCHLORATE
2 PERTECHTE NATE
3 THIOCYANATE
→ not used clinically Cioxic ]
→ cabbage is a rich source Of Thiocyanate → GOITROGEN
THYROID PEROXIDASE INHIBITORS
I CARBIMAZOLE C inactive ] 3 PROPYL THIOURACIL [ PTU ]
v
2 METHIMAZOLE C active )
→ more potent → less potent
→ →more plasma tis Less plasma tyz
→crosses placenta easily → Less crossing of Placenta
→Doc in Ist trimester pregnancy
→no action on peripheral conversos → decreases peripheral conversion
→ slow acting drugs→
on N person , stored Tz , Ty Suffice For I - 2 WKS
on hyperthyroidism , they Suffice for 3- 4 Wks
Dose increase OF these drugs Should be done after 4 WKS .
SECRETION INHIBITORS
= NAI
2 KI
3 LUGOL 'S IODINE
→ Fastest acting anti thyroid drugs
PERIPHERAL
CONVERSION INHIBITORS
I PRO PANO LOL
2 PTU
3
PREDNISOLONE
THYROID DESTROYING DRUGS [ I' 31 ]
131→ I used because
I Nati -
Sym porter is specific For Iodine intake
→ restricts I 131 to thyroid gland2 It 31 stored in colloid
,emission of radioactive rays confined
3 '
L' 31 emits p rays , have less penetrating power
CII in pregnancy→ can be given orally
→ Radioactive drugs cause Irreversible hypothyroidism , requires lifelongthyroid hormone thearapy
→ Cl 't in a 35 yrs aged patients→ All Other anti thyroid drugs cause Reversible hypothyroidism , discontinuation
OF drug suffice
→I
131e yz
→ 8 days