54 terms

Other hormones CH. 20

Pituitary gland is the
master gland
Pituitary deficiency can produce
Diabetes INSIPIDUS- polyuria, polydipsea, polyphasia
Hypersecretion of pituitary hormones can produce
Goiter, acromegaly (adults), and giantism (childhood)
Anterior pituitary: used to tx infertility
Posterior pituitary secretes
vasopressin (antidiuretic hormone [ADH]) and oxytocin
synthetic vasopressin treats
pituitary diabetes insipidus
clotting disorders: hemophilia A and von willebrand disease (both are genetic)
Oxytocin is used for
induce labor
control postpartum hemorrhage
induce postpartum lactation
Iodine rich foods
Marine life most common food
HYPOthyroidism in a small child is
HYPOthyroidism in an adult is
myxedema or simple hypothyroidism
associated w/cretinism
delayed tooth eruption
periodontal disease is more prevalent
associated w/myxedema
hypothyroidism is treated with
HYPERthyroidism forms
*Diffuse toxic goiter (graves disease)-enlarged, highly vascular thyroid gland
*Toxic nodular goiter (plummer disease)- nodules that secrete excessive hormone while the rest is atrophied
HYPERthyroidism adverse reactions
acclerated tooth eruption
rapid progressing periodontitis
HYPERthyroidism tx
radioactive iodine
Antithyroid agents if they dont tolerate surgery of R.I.
propylthiouracil (PTU)
methimazole (Tapazole)
Pancreatic hormones
Insulin: fuel storage (glucose out of the blood)
Glucagon: fuel mobilization (glucose into the blood)
Diabetes Mellitus characterized by
Diabets Mellitus types
type 1- insulin dependent (skinny) pancreas doesn't make insulin
type 2- non-insulin dependent (fat) pancreas doesn't respond to insulin
type 1 diabetes
autoimmune destruction of pancreatic BETA cells
complete LACK of insulin secretion
INCREASED glucagon secretion
type 2 diabetes
older than 40 years old
newer cases younger than 20 years old
attributed to lack of exercise and resulting obesity
insulin resistant
prolonged HYPERglycemia
result: HYPERinsulinemia
Dental issues in diabetes
tx with caution! make sure they have taken their meds and treat 1 1/2-2 hours after eaten a normal BREAKFAST
Caution and contraindication
Drugs may DECREASE insulin release or INCREASE insulin requirements - EPINEPHRINE (GIVE MORE INSULIN)
Systemic complications of diabetes
Retinopathy- DM #1 cause of blindness
Neuropathy- especially in lower extremities
Infections- gangrene due to poor circulation, reduced sensation, and poor eyesite
Healing: slower
Evaluate pt w/diabetes
serum glucose- finger prick
glycosylated hemoglobin (hba)- blood test *more accurate test for diabetes than serum glucose
tx of hypoglycemia in an unconscious pt
Intravenous dextrose 50%
Drugs used to manage diabetes
Insulin: subcutaneous injection (belly fat)
human insulin prepared by: recombinant DNA synthesis and modifying porcine (pig) insulin
Rapid acting
insulin lispro (humalog) change 2 amino acids in its structure
MOST COMMON adverse reaction to insulin
Symptoms are explained by:
Increased release of epinephrine from the adrenals
Symptoms of glucose deprivation of the brain
blurred vision
incoherent speech
type 2 antidiabetic agents
Biguanides: metformin (Glucophage)- lowers blood glucose and does NOT produce HYPOglycemia
Metformin ADE PRIMARY in the GI tract
The only orally active agent used to manage type 2 diabetes for many years
Mechanism of action type 2 diabetes
*STIMULATION OF RELEASE of insulin from beta cells of the pancreas
*REDUCTION of glucose
*REDUCTION in serum glucagon levels
*INCREASE of sensitivity of target tissues to insulin
Interaction of what drug causes DECREASE in serum glucose levels
Type 2 diabetes 1st line of tx
Sulfonylureas+biguanide (metformin)
Other new drugs
1:exenatide (Byetta) big on the market. an incretin mimetic
2:pramlintide (Symlin) doesnt replace insulin:
*Decreases caloric intake
*weight loss
*Type 1 DM use of meal time insulin not achieved desired glucose control despite optimal insulin therapy ( eat within 5 minutes)
3:Colesevelam lowers LDL cholesterol
is a polypeptide produced by alpha cells of the pancreas and is antagonist to insulin
Female sex hormones
Estrogen and Progestins
the female sex hormones are secreted by the
ovaries, testes and placenta
On day one
FSH and LH begin to increase
the ovarian egg matures in response to
increased FSH
on day 12
secretion of FSH and LH increase markedly, this culminates in ovulation
Estrogen therapy may promote
endometrial carinoma in postmenopausal women
cancelled out by administration of progestin
gingival inflammation may occur even with the decreased amount of plaque
If implantation doesnt occur, progesteron secretion declines and mensstruation stops
If implantation occurs the trophoblasts secrete chorionic gonadotropin which substains corpus luteum
Medroxyprogersterone (depo-provera)
every 3 months
Hormonal contraceptives
increase in dry sockets
Side effects of birth control
blood clot , weight gain, headache nausea
male sex hormone
antiandrogenic medicine Proscar (finasteride) used to tx prostate cancer
androgens are used for
muscle mass gain and are schedule 3 controlled substance
affect sex hormones
Tamoxifen tx of breast cancer in postmenopausal women
hormone from the opposite sex are used to manage prostate, breast, and uterine cancers