Summary LATEST 2023 ENDOCRINE PHARMACOLOGY ELABOATIONS /GUARANTEED A+ GRADE

Learning objective At the end of this chapter the student is expected to learn the following: i. The effects of insulin on different organ/systems ii. The types of insulin with their therapeutic uses and adverse reactions iii. The mechanism of action, uses and side effects of oral hypoglycemic agents iv. Drugs used as oxytocic agents v. Types of hormonal contraception with their uses and adverse effects including preparations • vi. Actions, therapeutic uses and adverse effects of glucocorticoids ANTIDIABETIC DRUGS I. INTRODUCTION Diabetes Mellitus (DM)is a disease that occurs as a result of absolute or relative deficiency of insulin that results in metabolic and vascular abnormalities. Types of diabetes mellitus and etiology (DM) A. Type 1 o Autoimmune disease associated with destruction of pancreatic b-islet cells o Absolute insulin deficiency B. Type 2 Decreased number of insulin receptors • Down-regulation of receptor synthesis related to increased adipose Postreceptor dysfunction • Examples: dysfunction of tyrosine kinase; glucose transport unit dysfunction Relative insulin deficiency C. Secondary causes a. Diabetogenic drugs eg. i. Glucocorticoids ii. Thiazide diuretics iii. Phenothiazines iv. epinephrine v. Interferon-a vi. Pentamidine b. Some endocrine diseases (diabetogenic hormonal include; growth hormone, thyroid, epinephrine) examples of diseases being; • Cushing’s syndrome; • glucagonoma; • acromegaly c. Some genetic diseases (Hereditary) Eg. hemochromatosis; metabolic syndrome; maturity onset DM d. Insulin-receptor deficiency • Acanthosis nigricans is a phenotypic marker e. Some infections • Eg: mumps; cytomegalovirus in acquired immune deficiency syndrome (AIDS) D. Impaired glucose tolerance E. Gestational diabetes (pregnancy) The common Signs and symptoms include: • polydipsia, • polyphagia, • polyuria, • dehydration due to glucosuria. Diabetes dangerous complications are:  ketoacidosis (in types I),  hyperglycemic osmolal non ketotic coma (in type II),  cardiovascular;  atherosclerosis,  myocardial infarction,  peripheralarterialinsufficiency,  Anemia,  Hypertension,  stroke,  nephropathy,  retinopathy,  neuropathy.