[PHARM-07] Endocrine & Metabolic Pharmacology: Diabetes, Thyroid, Adrenal Corticosteroids & Bone
PHARM-07 • 2. PharmacologyLearning Objectives
Classify oral and injectable antihyperglycaemic classes ([7.1] Metformin, Sulfonylureas, DPP-4i, SGLT2i, GLP-1 RA, Insulins) by mechanism, hypoglycaemia risk, weight impact, and cardiorenal benefit.; Compare thyroid replacement ([7.14] Levothyroxine) and antithyroid drugs ([7.15] Carbimazole, [7.16] Propylthiouracil) across pregnancy trimesters and thyroid storm.; Contrast glucocorticoid vs mineralocorticoid potency, duration, and HPA axis suppression rules across [7.19] Prednisolone, [7.20] Dexamethasone, and [7.21] Hydrocortisone.
Chapter Overview & Core Explanation
Endocrine pharmacology corrects hormone deficiencies (like insulin in diabetes or thyroxine in hypothyroidism), blocks hormone excess (like carbimazole in hyperthyroidism), or harnesses corticosteroid pathways to control life-threatening inflammation.
Key Exam & Clinical Takeaways
- [7.16] Propylthiouracil (PTU) is preferred in the 1st trimester of pregnancy (Carbimazole causes aplasia cutis) and in thyroid storm (additionally inhibits peripheral T4→T3 deiodination).
- [7.14] Levothyroxine must be taken on an empty stomach 30–60 minutes before breakfast and separated by ≥4 hours from calcium ([10.9]) and iron ([10.6]) supplements.