Alterations in Endocrine System

Negative feedback system

Basic Concepts of Endocrine Glands and Hormones The Power behind the Throne! The “Master Gland” of the Body

Hypothalamus Pituitary Axis

The Pituitary Gland

Posterior Pituitary Gland

Contrast SIADH and DI High Low Swell Shrink Gain Loss Hypertonic Fluid in vascular compartment High Low Serum sodium Brain cells Swell Shrink Weight Gain Loss Serum osmolality Urine output Specific Gravity Treatment: Fluids Hypertonic Hypotonic

The Anterior Pituitary Gland

Growth Hormone

Growth Hormone Deficiency

Gigantism

Acromegaly

The Pituitary Gland

Thyroid Hormone

T4 and T3 Tetraiodothyronine and Triiodothyronine

Hypothyroidism

Goiter

Cretinism

Myxedema

Comparison

The Pituitary Gland

Adrenal Glands

3 S’s

Cushing’s Syndrome

Cushing’s Disease Before After

Addison’s vs Cushing’s

Parathyroid Glands

Osteoblasts vs Osteoclasts “Crusher” Osteoclasts Resorption Ca level ___ “Build” Osteoblasts Calcitonin Ca level _____

PTH Negative Feedback Loop

Pancreas Insulin and Glucagon Regulation

Glucose Tolerance Test Curves

Long-term complications

Pharmacological Therapy Restores cells ability to use glucose for energy and corrects hyperglycemia Use: Type 1 and Type 2 diabetes, DKA, emergency treatment for severe hyperkalemia Generic (Trade) Name Timeframes Notes Rapid-Acting Insulin Lispro (Humalog) Onset: 5-15 mins Peak: 1-1 ½ hrs Duration: 3-4 hrs Give SubQ 5-10 mins before meal; can give with NPH (draw shorter acting insulin’s first) and give immediately Insulin Aspart (Novolog) Onset: 10-20 mins Peak: 1-3 hrs Duration: 3-5 hrs Short-Acting Insulin Glulisine (Apidra) Onset: 15-30 mins Peak: 1 hr Insulin Regular (Humulin R, Novolin R) Onset: 30-60 mins Peak: 1-5 hrs Duration: 6-10 hrs Give SubQ 30-60 mins before meal; can give with NPH (draw Reg first). Can be given IV. Can mix with sterile water and NS. Use for Sliding Scale Insulin administration Intermediate-Acting Insulin Isophane Susp (NPH, Humulin N) Onset: 1-2 hrs Peak: 6-14 hrs Duration: 16-24 hrs Give SubQ, is cloudy in appearance. Can mix with Humalog, Novolog, and Regular, do not mix with Lantus. Long-Acting Insulin Detemir (Levemir) Onset: 3-8 hrs Peak: None Duration: 24 hrs Give SubQ once or twice daily. Do not mix with any other types of insulin Insulin Glargine (Lantus) Onset: 2-4 hrs Give SubQ once daily at same timey. Do not mix with any other types of insulin