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Chapter 9: Drugs Affecting the Endocrine System

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TERMS TO LEARN

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Acromegaly Syndrome associated with excessive levels of growth hormone after puberty; symptoms include thickened skin, vocal hoarseness, joint pain, insulin resistance, hypertension, and cardiovascular disease.
Asthenia Debility or weakness.
Carcinoid Syndrome Symptoms associated with excessive levels of serotonin secreted by carcinoid tumors; symptoms include facial swelling, diarrhea, bronchial spasm, tachycardia, hypotension, and right-sided valvular disease.
Central Precocious Puberty Early onset of puberty due to activation of the gonadotropins leading to maturation of the gonads; this early gonadal maturation leads to early secretion of sex hormones and, therefore, early onset of secondary sexual characteristics in adolescents.
Craniosynostosis Premature closure of the cranial sutures.
Cushing's Disease Disease associated with excessive glucocorticoid levels most commonly caused by an adrenal cortical adenoma; symptoms include fat redistribution with a characteristic buffalo hump, thin extremities, hypertension, hirsutism, infertility, and amenorrhea.
Diabetes Insipidis Syndrome due to insufficient levels of ADH (central) or decreased renal response to ADH (peripheral); symptoms resemble the excessive thirst and urination associated with diabetes mellitus.
Endometriosis Growth of cells of the uterine lining outside of the uterus; symptoms include pelvic pain and infertility.
Hyperprolactinemia Syndrome associated with excessive levels of prolactin; symptoms include infertility, amenorrhea, galactorrhea, and mastodynia.
Hypogonadotropic Hypogonadism Inadequate function of the gonads due to insufficient secretion of pituitary gonadotropins.
Kaposi's Sarcoma Rare skin malignancy characterized by soft blue-black plaques and is typically seen in elderly and immunosuppressed patients; it is caused by human herpes virus 8.
Oligospermia Low sperm count.
SIADH Syndrome of inappropriate ADH; numerous causes include trauma, tumors, endocrine disorders, and drugs; excessive levels of ADH lead to hypernatremia.
Steatorrhea Large amounts of fat in the feces.
Uterine Fibroids Benign smooth muscle tumors; their growth is related to estrogen.
Virilization Acquisition of adult male characteristics in women or prepubescent males.

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I. HYPOTHALAMIC AND PITUITARY HORMONES

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HYPOTHALAMIC-PITUITARY HORMONAL AXIS

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Hypothalamic Hormone Pituitary Hormone Target Organ Target Organ Hormone
Hypothalamic hormones regulate the release of anterior pituitary hormones. Oxytocin and vasopressin are produced in the posterior pituitary (an outgrowth of the hypothalamus) where they are released into general circulation. All the endocrine agents listed below are peptides, except for prolactin-inhibiting hormone.
Growth hormone-releasing hormone (GHRH) Growth hormone (GH) Liver Somatomedins
Somatostatina
Thyrotropin-releasing hormone (TRH) Thyroid-stimulating hormone (TSH) Thyroid Thyroxine, triiodothyronine
Corticotropin-releasing hormone (CRH) Adrenocorticotropic hormone (ACTH) Adrenal cortex Glucocorticoids, mineralocorticoids, androgens
Gonadotropin-releasing hormone (GnRH or LHRH) Follicle-stimulating hormone (FSH) Luteinizing hormone (LH) Gonads Estrogen, progesterone, testosterone
Prolactin-releasing hormone (PRH) Prolactin (PRL) Lymphocytes Lymphokines
Prolactin-inhibiting hormone (PIH, dopamine) Breast —
Oxytocin Smooth muscle, especially uterus —
Vasopressin Renal tubule, smooth muscle —

aInhibits GH and TSH release. Also found in GI tissues; inhibits release of gastrin, glucagon, and insulin.

Modified from Trevor AJ, Katzung BG, Masters SB: Katzung & Trevor's Pharmacology Examination and Board Review, 6th ...

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