医学课件agents used in endocrine

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1、AgentsusedinendocrinesystemSomeendocrinehormonesandrelativedrugs1.adrenocorticoids2.Posteriorpituitaryhormones3.insulinandoralhypoglycemicagents4.thyriodandanti-thyrioddrugsEndocrineGlandsAdrenalGlandThyriodglandpancreaticislandhypothalamuspituitaryAdrenocorticalhormo

2、nesAdrenocorticalhormonesareallthehormonesthataresecretedbyadrenal.AdrenalGlandActually2glandsEachportionhasdifferentfunctionsandsecretesdifferenthormonesAdrenalGlandAdrenalmedulla:secretes:Epinephrine(AD)Norepinephrine(NE)Adrenalcortex:secretescorticosteroidsAlladren

3、alcortexhormonesaresteroidhormonesAdrenalcortexComposedof3layers(zones)outerzone(zonaglomerulosa)producesmineralocorticoid(eg.aldosterone)middlezone(zonafasciculata)producesglucocorticoids(eg.cortisol)innerzone(zonareticularis)producessomesexhormonesAdrenalADNEaTissue

4、sectionofadrenalcortexregulationThesecretionofadrenocorticalhormonesiscontrolledbypituitarycorticotropin(ACTH),whichisreleasedinresponsetothehypothalamiccorticotrophin-releasinghormone(CRH).HPA(hypothalamic-pituitary-adrenalcortex)axisHypothalamuspituitaryadrenalcorte

5、xTheproduction,glucocorticoids,serveasnegativefeedbackinhibitorsofACTHandCRHGlucocorticoids（GCS）234176510981413121118171615212019Structure-activityrelationshipofadrenocorticalhormonesSteroidnucleusisabasicstructureC3=0(酮基)C4-5(双键)C20=0(羰基)arenecessary肾上腺皮质激素基本结构及维持生理功

6、能必需基团C17:-OH，C11:=Oor–OHarenecessoryforGCs.C1-2:=Antiinflammatoryeffectsstronger,effectsofwater-electrolytemetabolismweakerMCS:C17–no-OH,C11nofreeketoneC9:-F，C16:-CH3or-OHAntiinflammatoryeffectsstronger,effectsofwater-electrolytemetabolismweaker.[Pharmacokinetics]Abso

7、rption:orallyorinjection.Distribution:Inplasma,77%ofGCSisBoundtocorticosteroidbindingGlobulin(CBGortranscortin),10%isBoundtoalbumin,theremainderiffree.Estrogen↑CGBHepticdisease↑CGBElimination:metabolizedinliverC4-5andC3=0werereduced.!cortisoneandprednisonecanbeseparat

8、elyconvertedintohydrocortisoneandprednisolone,Thenproducetheeffects.(inseverehepticdiseae,onlyhydrocortisoneandprednisolonec