Other+Hormones

=Other Hormones =

Kimberley and Charlene will work together on this page (This is week #13 readings. Deadline is May 30th)
= Polypeptide Hormones = = = Insulin:

The Islet on Langerhans, found within the pancreas, is responsible for producing the hormone insulin. Insulin is secreted into the portal veins and travels through the bodies vascular system where it acts as a receptor to organs throughout the body allowing glucagon in. Glucagon is an essential hormone and is needed for many metabolic functions and homeostasis. Insulin, a polypeptide composed of two chains, is a member of a family peptides known as insulin-like growth factor or IGF's. Insulin secretion is a tightly regulated process designed to provide stable concentrations of glucose in the blood during fasting and feeding. Insulin and glucose control in the body is an integretly coordinated process in the body and involves: various nutrients, gastrointestinal hormones,pancreatic hormones and autonomic neurotransmitters. Pancreatic Islet Secretions: CELL TYPE HORMONE SECRETED A cell--> Glucagon, B cell--> Insulinamylin (insulin amyloid polypeptide), D cell--> Somatostain, F cell--> Pancreatic polypeptide, G cell--> Gastrin

Action of Insulin: The action of insulin is to decrease the blood glucose concentration. Insulin affects glucose production that will be taken up most commonly the liver, muscle and fat. Activation of the insulin receptor leads to a cascade of phosphoylation reactions and as a result affects the various activities of various enzymes involved in intracellular use and storage. When the control of insulin levels fails diabetes mellitus will result. Diabetes mellitus is a group of syndroms characterized by hyperglycemia and almost all forms are due to aither a decrease in the circulating concentration of insulin, or a decrease in the response of peripheral tissue to insulin. There are two types of diabetes mellitus: Type 1: An autoimmune disease of the pancreatic beta cells resulting in an absolute lack of insulin. Type 1 diabetes effects 5-10% of diabetics. Individuals with type 1 diabetes are insulin dependent.

Type 2: In type 2 diabetes, target cells relatively insensitive to insulin. This is known as peripheral resistance to insulin. Type 2 diabetics may be able to control their diabetes with strict diet and exercise therapy but often need additional drug therapy. Insulin Therapy:

Insulin is giving by injection (usually subcutaneously) and absorption is affected by the site of injection, subcutaneous blood flow, the volume and concentration of the injected insulin and the presence of circulating insulin antibodies. Insulin absorption is usually most rapid from the abdominal wall followed by the arm and the buttocks. Insulin can not be taken orally due to it's polypeptide structure (composed ogff 51 amino acids) that is broken down by protease enzymes along the digestive track.

__Rapid-Ultrashort-Acting__: Soluble insulin that has an onset of 5-15 minutes with a duration of 2-5 hours. Ultra-short acting insulin is often taking before a meal to control the increase in carbohydrates. __**Examples of Ultra-short acting insulin:**__
 * Novolog
 * Apidra
 * Humalog
 * Humalog
 * Humalog

Intermediate-ActingIntermediate acting insulin has an onset of 1-2 hours with a duration of aproxiamtely 24 hours.

__**Examples of Ultra-short acting insulin**__:


 * Humulin
 * Novolin
 * Levemir
 * Lantus

Adverse effects: Hypoglycemia is the most common adverse effect and may result from an inappropriately large dose of insulin, a mismatch between the the time of peak delivery of insulin and food intake, or increased sensitivity to insulin.

** Glucagon: **

Glucagon increases blood glucose concentration by decreasing glycogen synthesis, stimulating the breakdown of stored glycogen, and increasing gluconeogenesis in the liver. Therapeutic uses: Glucagon may be used inthe emergency treatment of severe hypoglycemic reactions and is also used to reversethe cardiac effects of toxic amounts of beta adrenergic receptor blockers.

__**SEX HORMONES**__ Androgen: Androgen, a synthetic hormone, is most commonly involved in the production and maintenance of testosterone. Testosterone is synthesized by the Leydig cells found in the male testes. In women, a small production of a androgen is produced in the ovaries and is called androstenedione. Androgens may be administered orally, topically or through intramuscular injections. Testosterone is not typically orally due to its extensive first pass effect.

Action of Androgen:

Important functions of Anrogens include: male sexual differentiation, development and growth of male sex accessory organs and anabolic actions of skeletal muscle, bone and hair, faciliation of human sexual behaivior, and regulation of metabolic processes in the liver, kidney, and salivary glands.

<span style="background-color: #b166d1; font-family: 'Arial Black',Gadget,sans-serif; font-size: 120%;">Androgen Therapy: Therapeutic Uses

Androgen therapy is used to treat testosterone deficiency in adolescent boys and men. Other less common and more controversial uses for androgens include uses for male senescence, female hypogonadism, anhancement of athletic performance, male contracpetion, angioneurotic edema and blood dyscrasias.

Adverse effects: Men:
 * bladder irritation
 * breast soreness
 * gynecomastia (enlargement of mans breast)
 * priapism (persistant and painful erection)

Women:
 * acne
 * decreased breast size
 * enlarged genitalia
 * male-pattern baldness

<span style="background-color: #65d065; color: #000000; font-family: 'Arial Black',Gadget,sans-serif; font-size: 14.6667px; text-decoration: none; vertical-align: baseline;">Estrogens: <span style="background-color: transparent; color: #000000; font-family: Arial; font-size: 14.6667px; text-decoration: none; vertical-align: baseline;">Estradiol is the most potent estrogen and is secreted by the ovary, testes, placenta, and peripheral tissues. Estrogen is also secreted by the ovary, however, the principal source in both women and men is through extragonadal conversion of androstenedione in peripheral tissues. In pre-menopausal women, the most abundant physiologic estrogen is estradiol and in men and postmenopausal women the most abundant estrogen in the plasma is estrone. Like other lipid soluble hormones, estrogens are transported in the blood principally bound to carrier proteins. Estrogens may be administered orally, topically, or through intramuscular injections.

<span style="background-color: transparent; color: #000000; font-family: Arial; font-size: 14.6667px; text-decoration: none; vertical-align: baseline;"><span style="background-color: #65d065; color: #000000; font-family: 'Arial Black',Gadget,sans-serif; font-size: 14.6667px; vertical-align: baseline;">Therapeutic uses: The two main reasons estrogen is prescribed are for prevention of conception and to reduce the sequelae associated with declining hormones levels after menopause. Another major use is for postmenopausal women for prevention of osteoporosis-related fractures to vertebral or long bones. Estrogen replacement therapy has also shown to be effective with symptoms that are associated with menopause and postmenopausal urogenital atrophy. <span style="background-color: transparent; color: #000000; font-family: Arial; font-size: 14.6667px; text-decoration: none; vertical-align: baseline;"><span style="background-color: #65d065; color: #000000; font-family: 'Arial Black',Gadget,sans-serif; font-size: 14.6667px; vertical-align: baseline;">Drug interactions: May increase effect of corticosteroids. Barbiturates, phenytoin, Rifampin, carbmazepine, and topiramates all tend to decrease the effects of estrogens because the former drugs induce liver metabolism of estrogens. Estrogen can also increase the therapeutic and toxic effect of corticosteroids. <span style="background-color: transparent; color: #000000; font-family: Arial; font-size: 14.6667px; text-decoration: none; vertical-align: baseline;">Hormones antagonists for estrogens: These are agents the modulate activity can be categorized into three groups: selective estrogens receptors modulators (SERM), pure estrogens receptors antagonist, and estrogen synthesis inhibitors. The goal for SERM is to provide agonist activity in tissues where estrogen action is desired and antagonist or no activity in tissues where estrogen activity may be harmful.

<span style="background-color: #eeee6a; color: #000000; font-family: 'Arial Black',Gadget,sans-serif; font-size: 14.6667px; text-decoration: none; vertical-align: baseline;">Progestins: <span style="background-color: transparent; color: #000000; font-family: Arial; font-size: 14.6667px; text-decoration: none; vertical-align: baseline;">Steroids that have progestational activity. The principle progestational hormone secreted into bloodstream is progesterone, which is synthesized and secreted by the corpus luteum, placenta, and adrenal cortex. Progesterone is transported in the bloodstream by plasma proteins. Progesterone is is necessary for glandular endometrial development before nidation, the development of mammary lobules and alveoli, and the maintenance of pregnancy. <span style="background-color: transparent; color: #000000; font-family: Arial; font-size: 14.6667px; text-decoration: none; vertical-align: baseline;"><span style="background-color: #eeee6a; color: #000000; font-family: 'Arial Black',Gadget,sans-serif; font-size: 14.6667px; vertical-align: baseline;">Therapeutic uses: can be used alone or in combination with estrogens for oral contraception for hormone replacement in postmenopausal women. <span style="background-color: transparent; color: #000000; font-family: Arial; font-size: 14.6667px; text-decoration: none; vertical-align: baseline;"><span style="background-color: #eeee6a; color: #000000; font-family: 'Arial Black',Gadget,sans-serif; font-size: 14.6667px; vertical-align: baseline;">Drug interactions: The hepatic enzyme-inducing medication decrease the effect of progestins. <span style="background-color: transparent; color: #000000; font-family: Arial; font-size: 14.6667px; text-decoration: none; vertical-align: baseline;">Hormone antagonists for Progestins: Agents that block of the effect of progesterone are primarily potent, competitive antagonists of the progesterone receptor. Progesterone receptor antagonists such s Mifepristone can be used as a contraceptive and for the treatment of endometriosis, lieomymoas, breast cancer, and meningiomas.

<span style="background-color: transparent; color: #000000; font-family: Arial; font-size: 14.6667px; text-decoration: none; vertical-align: baseline;"><span style="background-color: #eeee6a; color: #000000; font-family: 'Arial Black',Gadget,sans-serif; font-size: 14.6667px; vertical-align: baseline;">Adverse reactions for both estrogens and progestins: Major concerns about the effects associated with estrogens have involved thromboembolic disorders, neoplasmas, and hypertension. The association between estrogens, progestins, and breast cancer are more controversial. Estrogen therapy has also been implicated in increasing rates of gallbladder disease, nausea, vomiting, breast tenderness, edem, migraine and endometriosis. <span style="background-color: transparent; color: #000000; font-family: Arial; font-size: 14.6667px; text-decoration: none; vertical-align: baseline;">Oral contraceptives and the periodontium: <span style="background-color: transparent; color: #000000; font-family: Arial; font-size: 14.6667px; text-decoration: none; vertical-align: baseline;">Clinical studies have shown that oral contracetives have been associated with gingival enlargment in otherwise healthy women with no history of gingival hyperplasia; gingival enlargement was reversed once the oral contraceptive was discontinued. Also, clinical studies have shown that oral contraceptives have the ability to induce gingival diseases and can ultimately lead to periodontal attachment loss. <span style="background-color: transparent; color: #000000; font-family: Arial; font-size: 14.6667px; text-decoration: none; vertical-align: baseline;">Oral Contraceptives and antibiotics: <span style="background-color: transparent; color: #000000; font-family: Arial; font-size: 14.6667px; text-decoration: none; vertical-align: baseline;">Observations have suggested that antibiotics such as rifampin, penicillins, tetracyclines, and metronidazole, may reduce oral contraceptive efficacy.