Hormones Neuroendocrine sys, which controlled by pituitary & hypothalamus.

Coordinates body function by transmiting message between individual cells & tissues.

Hormones secreted by hypothalamus & pituitary They all peptides / low molecular weight proteins that act by binding to specific receptor sites on their target tissues. Hormones of anterior pituitary are rugulated by neuropeptides, called either releasing / inhibiting factor / hormones, which produced in cell bodies in hypothalamus & reach cell of pituitary by hyphysial portal sys. Each hypothalamic regulatory hormones control release of specific hormone from anterior pituitary.

Hormones of hypothalamus

Growth releasing hormone (Somatostatin) Inhibit release release growth hormone & can be used in treatment of acromegaly. Gonadotropin releasing hormone (GnRH) It is employed to stimulate gonadal hormones production in hypogonadism.

Hormones of anterior pituitary

Corticotropin (ACTH-adrenocorticotropic hormone) Stimulate synthesis of glycocorticoids & mineralocorticoids in adrenal cortex; It can be used as a diagnostic tool for differentiating between primary adrenal insufficiency (Addisons disease, associated with adrenal atrophy) & secondary adrenal insufficiency (caused by inadequate secretion of ACTH by pituitary). Growth hormones (Somatotropin) stimulate protein synthesis processes, cell proliferation & can promote bone growth; Therefore, it is used in treatment of growth-hormone deficiency in children.

Hormones of posterior pituitary They are synthesized in hypothalamus transported to posterior pituitary & released in response to specific physiologic signals

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Oxytocin Only used in obstetrics, where it is employed to stimulate uterine contraction to induce / reinforce labor / to promote breast milk ejection. [Note : The sensitivity of uteus to Oxytocin with duration of pregnancy when it is under Estrogenic dominance]

Vasopressin (ADH - Antidiuretic hormone) - H2O permeability & resobtion in collecting tubules; Major use to treat diabetes insipidus. Side effects: vasocontriction, bronchoconstriction, headache, tremor

Thyroid hormones T3 (Triiodothyronine-most active form), T4 (Thyroxine) Thyroid gland is not essential for life, inadequate secretion of thyroid hormone (hypothyroidism) result is bradycardia, poor resistance to cold, mental & physical slowing (in children this can cause mental retardation & dwarfism); However, excess thyroid hormones secreted (hyperthyroidism), tachycardia, cardiac arrthymias, body wasting nervousness tremor. Treatment of hypothyroidism (myxoedema) Levothyroxine (T4)- drug is given once daily because of its long half-life; Steady state achieved at 6-8 weeks Adverse effects: nervousness, tachycardia, intolerance to heart & unexplained weight loss Treatment of hyperthyroidism (thyrotoxicosis) Can be accomplished by removing part / all of thyroid gland by inhibiting synthesis of hormones / by blocking release of hormones from follicle

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Removal part / all thyroid: Radioactive iodine (I 131)- selective taken up by thyroid follicular cell (destroy thyroid tissue) Mercasodil (Methimazole) inhibits thyroid hormone synthesis (block conversion of T3 & T4) Rare adverse effects: agranulocytosis, rash, edema

Perchlorates inhibit iodide trapping (ionic inhibitor), but they are toxic & not used now Adverse effects: rashed, fever, aplastic anaemia, agranulocutosis

Iodides They inhibit thyroid hormone release by mechanisms not yet understood Adverse effects:

A. Acute reaction:- sore mouth & throat; angiodema of larynx (maybe dangerous); rashes; metallic taste in
mouth; swelling of lips & eye lids; fever & joint pain; petechial haemorrhages B. Chronic overdose (iodism) :- infalmmation of mucous membranes (salivation, rhinorhoea, lacrymation, swelling of eye lids); headache; rashes; GI symptoms

Insulin Synthesized in cells in pancreas; Acts on specfic receptor located on the cell membrane of practically all cells, but their density depends on cell type: liver & fat cells are rich Action:

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I. II.

It facilitates glucose transport across cell membrane (skeletal muscle & fat are highly sensitive) It facilitates glycogen synthesis from glucose in liver, muscle & fat by stimulating the enzyme glycogen synthetase (also inhibits glycogenolysis in liver) It inhibits gluconeogenesis (from protein) in liver It inhibit lipolysis in adipose tissue & favours triglyceride synthesis It facilitates amino acid entry & their synthesis into proteins in muscle & possibly other cells

III.
IV. V.

Uses : diabetes; diabetic ketoacidosis (diabetic coma) Adverse effects: hypoglycaemia; local reaction [swelling, eryhema,lipodystrophy occurs at injection sites after long usgae]; allergy Oral hypoglycaemic drugs These drugs lower blood glucose levels & effective orally

Chlorpropamide - insulin secretion from cells & glucagon secretion & causes hypoglycaemia

Adverse effects: hypoglycaemia, non-sepcific effetcs (nausea, vomiting, diarrhoea, headache, weight gain), hypersensitivity

Metformin mechanism of action not clearly understood. Do not causes insulin release but presence of some insulin essential for thei action. Explaination offered for their hypoglcaemia action are: i. ii. iii. Inhibit hepatic gluconeogenesis & glucose output from liver (probably most important action) Inhibit intestinal absorption of glucose Promotes peripheral glucose utilization by enhancing anaerobic glycolysis

Adverse effects: lactic acidosis, vitmain B12 deficiency, hypoglycaemia Sex hormones Estrogenes Estradiol most potent estrogen produced & secreted by ovary Mechanism of action: Estradiol binds with high affinity to specific nuclear receptor proteins. Activated steroidreceptor complex interacts with nuclear chromatin to initaiate hormone-specific RNA synthesis & later synthesis of specific proteins that mediate numbe of physiologic functions Uses: i. Post menopausal hormone therapy:- for menopausal women, who are experiencing vasomotor symptoms (hot flashes); for women wish to reduce risk of osteoporosis; for women wish to reduce risk of endometrial carcinoma Primary hypogonadism As contraceptive

ii. iii.

Side effects:- hypertension, breast tenderness, headache, edema, nausea & vomiting Androgenes Testosterone

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Androgens are group of steroid have anabolic & / masculinizing effetcts in both females & males; Testosterone most important androgene in human synthesized by Leydig cell in testes. Androgene required for:- normal maturation in male, sperm production, synthesis muscle proteins & haemoglobin, bone resorption Mechanism of action: Like estrogen, androgens bind to specific nuclear receptor in target cell Therapeutic uses:-

1. Androgenic effetcs (they are used for males with inadequate androgen secretion for replacement
therapy in testicular failure) 2. 3. Anabolic effetcs (they can be used to treat senile osteoporosis & severe burns) Growth (they are used in conjuction with other hormones to promote skeletal growth in prepubertal boys with pituitary dwarfism)

Adverse effetcs:1. In females:- androgens can cause masculinization, with acne, growth of facial hair, deepening of voice, male pattern baldness & excessive muscle development.

2. In males:- excess androgens can cause priapism impotence, spermatogenesis & gynecomastia.
3. In children:- androgens may cause abnormal sexual maturation & growth disturbances resulting from premature closing of epiphysial plates

4. In athletes:- uses of anabolic steroids can cause premature closing of epiphysis of long bones, which
can stunt growth & interrupts development. High doses can taken by these athletes may result in reduction of testicular size, hepatic abnormalities aggression (roid rage) & psychotic episodes

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