Lecture Notes: Drug Classes Affecting the Endocrine System

Introduction

Professor Hoffman

• Series of three videos
• Covers drugs affecting the endocrine system:
  • Corticosteroids
  • Diabetic medications (glucose control)
  • Thyroid medications

Overview of the Endocrine System

• Role: Communication system in the body (complements neurological system)
• Components:
  • Endocrine glands excrete hormones into the bloodstream
  • Hormones circulate and bind to specific receptor sites
• Function: Similar to neurotransmitter theory in the nervous system

Focus Areas for Course

• Adrenal Gland: Specifically adrenal cortex (Corticosteroids)
• Next video: Pancreas (glucose control)
• Final video: Thyroid medications

Hormonal Communication

• Negative Feedback Loop: Regulatory system to control hormone levels
  • Stimulus triggers hormone production
  • Hormones produce effects in target organs/cells
  • Feedback signals gland to stop production
• Types of Stimuli:
  • Hormonal (e.g., pituitary gland hormones affecting adrenal gland)
  • Bloodborne changes (e.g., chemical levels, osmolarity)
  • Neuro stimuli (e.g., sympathetic nervous system response)

Corticosteroids

• Function: Mimic adrenal gland hormones
• Adrenal Glands:
  • Location: On top of kidneys
  • Structure: Cortex (outer layer) and medulla (interior)
  • Medulla: Produces norepinephrine and epinephrine (fight or flight response)
• Cortex Hormones:
  • Mineralocorticoids: (e.g., aldosterone)
    • Regulates sodium, potassium, and fluid balance
    • Part of the renin-angiotensin-aldosterone system (RAAS)
  • Glucocorticoids: (e.g., cortisol)
    • Released during prolonged stress
    • Increase glucose availability by converting stored energy sources
    • Suppress inflammation and immune processes

Glucocorticoids in Medication

• Common Glucocorticoids: Prednisone, Methylprednisolone
• Uses:
  • Hormone replacement (e.g., adrenal insufficiency)
  • Anti-inflammatory action
  • Pain management
• Mechanism: Mimic cortisol to block inflammatory and immune processes

Side Effects & Risks

• Prolonged Use:
  • Fluid and electrolyte imbalances
  • Hypokalemia risk (mimic aldosterone to some degree)
  • Increased blood glucose levels
  • Muscle weakness
  • Increased risk of infection
  • Potential masking of disease symptoms
• Monitor for:
  • Elevated blood glucose
  • Early signs of Cushing's syndrome
  • Systemic infections
• Tapering Off: Necessary to avoid adrenal insufficiency
  • Adrenal glands need time to resume natural cortisol production

Conclusion

• Next Video: Pancreas and blood glucose control