Endocrinology E-Book

Akuffo Quarde

• Herausgeber: John Wiley & Sons
• Kategorie: Fachliteratur
• Sprache: Englisch

Seitenzahl: 900

Veröffentlichungsjahr: 2023

Beschreibung

Endocrinology Enables readers to form an integrated understanding of endocrine physiology by examining the mechanisms of action of medical therapies Endocrinology: Pathophysiology to Therapy is a comprehensive resource on medical therapies; in each chapter, the relevant endocrine physiology of the medical therapy is presented, followed by a review of the detailed mechanism of action of selected medical interventions. Where applicable, emphasis is placed on clinical pharmacology pearls, such as side effects and therapeutic monitoring guidelines. Supplementary chapters address additional topics, including immune checkpoint inhibitor-related endocrinopathies, anabolic steroid abuse, pseudo-endocrine conditions, and dynamic tests in clinical endocrinology. Rather than emphasizing guideline-defined treatment protocols, this??book directs attention towards the pathophysiology and fundamental principles of endocrine therapies. Categories of therapies covered in Endocrinology include: * Pituitary gland therapies, including Cushing's disease, Acromegaly, Prolactinoma, adult growth hormone insufficiency, central diabetes insipidus, and syndrome of inappropriate ADH secretion * Thyroid gland therapies, including Hashimoto's thyroiditis, Graves' Disease, Thyroid Eye Disease, Riedel's thyroiditis, Thyroid hormone resistance, and RSH secreting tumors * Adrenal gland therapies, including primary adrenal insufficiency, primary hyperaldosteronism, classic congenital adrenal hyperplasia, and nonclassic congenital adrenal hyperplasia * Pancreatic gland therapies, including diabetes mellitus, neuroendocrine tumors, and hypoglycemia syndromes such as somatostatin analogs and calcium channel blockers Discussing the rationale for using various therapies and enabling readers to appreciate complex concepts in a clinically relevant manner, Endocrinology is an essential reference for practitioners in related fields looking for an accessible and comprehensive resource on the subject.

Leseprobe

Table of Contents

Cover

Table of Contents

Title Page

Copyright Page

Dedication

Preface

Acknowledgments

CHAPTER 1: Pituitary Gland Therapies

1.1 CUSHING'S DISEASE

1.2 ACROMEGALY

1.3 PROLACTINOMA

1.4 ADULT GROWTH HORMONE INSUFFICIENCY

1.5 CENTRAL DIABETES INSIPIDUS

1.6 SYNDROME OF INAPPROPRIATE ADH SECRETION

PRACTICE‐BASED QUESTIONS

REFERENCES

CHAPTER 2: Thyroid Gland Therapies

2.1 HASHIMOTO’S THYROIDITIS

2.2 GRAVES’ DISEASE AND THYROID EYE DISEASE

2.3 RIEDEL’S THYROIDITIS

2.4 THYROID HORMONE RESISTANCE

2.5 TSH‐SECRETING TUMORS

2.6 THYROID CANCER

PRACTICE‐BASED QUESTIONS

REFERENCES

CHAPTER 3: Adrenal Gland Therapies

3.1 PRIMARY ADRENAL INSUFFICIENCY

3.2 PRIMARY HYPERALDOSTERONISM

3.3 PHEOCHROMOCYTOMAS AND OTHER PARAGANGLIOMA SYNDROMES

3.4 CLASSIC CONGENITAL ADRENAL HYPERPLASIA

3.5 NONCLASSIC CONGENITAL ADRENAL HYPERPLASIA

PRACTICE‐BASED QUESTIONS

REFERENCES

CHAPTER 4: Pancreatic Gland Therapies

4.1 DIABETES MELLITUS

4.2 NEUROENDOCRINE TUMORS

4.3 HYPOGLYCEMIA SYNDROMES

PRACTICE‐BASED QUESTIONS

REFERENCES

CHAPTER 5: Parathyroid Gland and Bone Therapies

5.1 PRIMARY HYPERPARATHYROIDISM

5.2 HYPOPARATHYROIDISM

5.3 PAGET’S DISEASE OF BONE

5.4 X‐LINKED HYPOPHOSPHATEMIA

5.5 OSTEOPOROSIS

PRACTICE‐BASED QUESTIONS

REFERENCES

CHAPTER 6: Reproductive Organ Therapies

6.1 POLYCYSTIC OVARY SYNDROME

6.2 MALE HYPOGONADISM

6.3 MENOPAUSE

6.4 TURNER'S SYNDROME

PRACTICE‐BASED QUESTIONS

REFERENCES

CHAPTER 7: Therapies in Disorders of Lipid Metabolism and Obesity

7.1 HYPERLIPOPROTEINEMIA SYNDROMES

7.2 OBESITY

7.3 LIPODYSTROPHY SYNDROMES

PRACTICE‐BASED QUESTIONS

REFERENCES

CHAPTER 8: Miscellaneous Topics in Disorders of Endocrine Glands

8.1 RECENT TECHNOLOGICAL ADVANCES IN DIABETES CARE

8.2 IMMUNE CHECKPOINT INHIBITOR‐RELATED ENDOCRINOPATHIES

8.3 PSEUDOENDOCRINE CONDITIONS

8.4 DRUGS OF ABUSE WITH ENDOCRINE SIDE EFFECTS

PRACTICE‐BASED QUESTIONS

REFERENCES

CHAPTER 9: Dynamic Tests in Clinical Endocrinology

9.1 PITUITARY GLAND

9.2 DISORDERS OF THE THYROID GLAND

9.3 DISORDERS OF THE ADRENAL GLANDS

9.4 DISORDERS OF THE PANCREAS

9.5 DISORDERS OF THE REPRODUCTIVE ORGANS

PRACTICE‐BASED QUESTIONS

REFERENCES

Appendix A

A.1 CARDIOVASCULAR OUTCOME TRIALS IN DIABETES CARE

A.2 COMMON SIDE EFFECTS OF ENDOCRINE TREATMENTS (BOARD REVIEW)

A.3 BRAND NAMES OF COMMON MEDICATIONS IN ENDOCRINOLOGY

Index

End User License Agreement

List of Tables

Chapter 1

TABLE 1.1 Pathophysiological basis of pasireotide‐mediated hyperglycemia....

TABLE 1.2 Summary of therapeutic targets in Cushing's disease.

TABLE 1.3 Regulators of GH.

TABLE 1.4 Gene sequences encoding IGF‐1 production in specific organs.

TABLE 1.5 Regulators of prolactin secretion.

TABLE 1.6 Anabolic effects of growth hormone.

TABLE 1.7 Glycemic effects of growth hormone.

TABLE 1.8 Subtypes of AVP receptors and their physiologic effects.

TABLE 1.9 Mechanism of action of adjunctive therapies in SIADH.

Chapter 2

TABLE 2.1 Altered thyroid hormone levels: effects on physiological function...

TABLE 2.2 Summary of treatment recommendations of primary hypothyroidism....

TABLE 2.3 Thionamide therapy in hyperthyroidism.

TABLE 2.4 Dosing suggestions for potassium iodide in Graves’ disease.

TABLE 2.5 Location of adrenergic receptors and the effects of catecholamine...

TABLE 2.6 Comparison of TSH‐secreting pituitary tumors and thyroid hormone ...

TABLE 2.7 Dosing schedule of various TKIs.

Chapter 3

TABLE 3.1 Dosing schedules for glucocorticoid replacement therapies.

TABLE 3.2 Comparison of the potencies of glucocorticoid and mineralocortico...

TABLE 3.3 Management of steroid replacement in unique clinical situations....

TABLE 3.4 Perioperative management pearls for PPGLs.

TABLE 3.5 Glucocorticoid replacement therapy in congenital adrenal hyperpla...

TABLE 3.6 Comparison of CAH and NCCAH.

Chapter 4

TABLE 4.1 Mechanisms of insulin resistance in type 2 diabetes mellitus.

TABLE 4.2 Pharmacodynamic profile of various insulins.

TABLE 4.3 Pharmacokinetic profile of exogenous insulin.

TABLE 4.4 Important trials of long‐acting insulin therapies.

TABLE 4.5 Sources of glucose precursors required for gluconeogenesis.

TABLE 4.6 Mechanisms and sites of action of metformin.

TABLE 4.7 Adjustment of metformin dose in chronic kidney disease.

TABLE 4.8 The metformin study group outcomes.

TABLE 4.9 Pharmacokinetic profile of meglitinides.

TABLE 4.10 Clinical trials evaluating the efficacy of repaglinide in type 2...

TABLE 4.11 Pharmacokinetic profile of sulfonylureas.

TABLE 4.12 Summary of the GRADE study.

TABLE 4.13 Physiologic effects of PPAR activation.

TABLE 4.14 Mechanism of cardinal side effects associated with pioglitazone....

TABLE 4.15 Studies evaluating the cardiovascular safety of pioglitazone....

TABLE 4.16 Summary of landmark CVOTs for incretin mimetics.

TABLE 4.17 Summary of landmark CVOTs for SGLT2 inhibitors.

TABLE 4.18 Pharmacokinetic profile of DPP4 inhibitors.

TABLE 4.19 Summary of landmark CVOTs for DPP4 inhibitors.

TABLE 4.20 Evaluation of the efficacy of acarbose in type 2 diabetes mellit...

TABLE 4.21 Summary of the TELESTAR and TELECAST studies.

TABLE 4.22 Hormones produced by islets cells.

TABLE 4.23 Trials evaluating the efficacy of somatostatin analogs in NETs....

TABLE 4.24 Distribution of the density of somatostatin receptors in insulin...

TABLE 4.25 Interpretation of the 72 h fast.

Chapter 5

TABLE 5.1 Comparison of the percentage of cortical and trabecular at the fe...

TABLE 5.2 Comparison of the clinical features of inactivating PTH/PTHrp sig...

TABLE 5.3 Comparison of osteoporosis and osteomalacia.

TABLE 5.4 Comparison of bone modeling and remodeling.

TABLE 5.5 Selected trials of bisphosphonates approved for the treatment of ...

TABLE 5.6 Effects of SERMS in various tissues.

TABLE 5.7 Effects of various SERMS on osteoporotic fractures or bone minera...

TABLE 5.8 Comparison of the anabolic window of various anabolic agents.

Chapter 6

TABLE 6.1 Regulators of SHBG production.

TABLE 6.2 Diagnostic criteria for PCOS.

TABLE 6.3 Clinical trials assessing the role of metformin in PCOS.

TABLE 6.4 Regulation of the GnRH pulse generator.

TABLE 6.5 Sites of action of OCPs in PCOS.

TABLE 6.6 Progestogenic and androgenic potencies of low‐dose combined oral ...

TABLE 6.7 Clinical trials assessing the role of spironolactone in PCOS.

TABLE 6.8 Mechanism of action of gonadotropins in assisted reproduction.

TABLE 6.9 Dosing schedule of gonadotropins.

TABLE 6.10 Comparison of fertility outcomes of gonadotropin preparations.

TABLE 6.11 A meta‐analysis of clomiphene citrate versus placebo in PCOS.

TABLE 6.12 A meta‐analysis of clomiphene citrate versus letrozole in PCOS....

TABLE 6.13 Mechanism of action of androgen receptor blockers.

TABLE 6.14 Androgen receptor blockers in clinical practice.

TABLE 6.15 Studies evaluating the role of weight‐loss interventions in PCOS...

TABLE 6.16 Mechanism of the physiologic effects of testosterone.

TABLE 6.17 Regulators of sex hormone‐binding globulin.

TABLE 6.18 Dosing schedule and practical guide to testosterone replacement....

TABLE 6.19 Summary of the testosterone trials.

TABLE 6.20 The efficacy of hCG in male hypogonadism.

TABLE 6.21 Efficacy of recombinant human FSH in male hypogonadism.

TABLE 6.22 Efficacy of clomiphene citrate in male hypogonadism.

TABLE 6.23 Estrogen‐based therapies with efficacy in vasomotor symptoms....

TABLE 6.24 Comparison of oral and transdermal estrogens.

TABLE 6.25 Clinical studies evaluating the safety and efficacy of hormone t...

TABLE 6.26 Physiologic effects of estrogen.

TABLE 6.27 A meta‐analysis of the efficacy of transdermal versus oral estro...

TABLE 6.28 Metabolic monitoring guidelines for patients with Turner’s syndr...

Chapter 7

TABLE 7.1 Efficacy of ezetimibe in patients with acute coronary syndrome (I...

TABLE 7.2 Landmark trials of statins in patients with cardiovascular diseas...

TABLE 7.3 Trials of PCSK9 inhibitors.

TABLE 7.4 Cardiovascular efficacy of icosapent ethyl therapy.

TABLE 7.5 Trials assessing the efficacy of niacin.

TABLE 7.6 The effects of various lipid‐lowering therapies on lipid levels....

TABLE 7.7 Trials evaluating the efficacy of phentermine and topiramate in o...

TABLE 7.8 Trials evaluating the efficacy of GLP‐1 agonists in obesity.

TABLE 7.9 Clinical trial evaluating the efficacy of naltrexone and bupropio...

TABLE 7.10 Clinical trial evaluating the efficacy of orlistat in obesity.

TABLE 7.11 Clinical trial evaluating the efficacy of metabolic surgery in o...

TABLE 7.12 Distribution of fat loss in lipodystrophy syndromes.

TABLE 7.13 Results of a study evaluating the safety and efficacy of recombi...

Chapter 8

TABLE 8.1 The types of insulin pumps.

TABLE 8.2 Comparison of popular continuous glucose monitors.

TABLE 8.3 Sites of action of immune checkpoint inhibitors.

Chapter 9

TABLE 9.1 Types of the dexamethasone suppression test.

TABLE 9.2 Interpretation of radioactive iodine scans.

Appendix A

TABLE A.1 Selected trials of GLP‐1 agonists.

TABLE A.2 Selected trials of SGLT‐2 inhibitors.

TABLE A.3 Selected trials of DPP‐4 inhibitors.

TABLE A.4 Other selected clinical trials.

TABLE A.5 Landmark diabetes trials.

List of Illustrations

Chapter 1

FIGURE 1.1 Schematic representation of the HPA axis, highlighting critical s...

FIGURE 1.2 The role of retinoic acid in anterior corticotroph pathophysiolog...

FIGURE 1.3 Schematic representation of adrenal steroidogenesis pathways and ...

FIGURE 1.4 The cortisol‐to‐cortisone shunt and the role of two isoforms of 1...

FIGURE 1.5 Glucocorticoid receptor physiology. Cortisol (glucocorticoid), a ...

FIGURE 1.6 The growth hormone and insulin‐like growth factor 1 axis. Hypotha...

FIGURE 1.7 Growth hormone receptor and intracellular effects of GH to GHR bi...

FIGURE 1.8 Schematic representation of the hypothalamic–pituitary‐mammary ax...

FIGURE 1.9 Schematic representation of the mechanism of action of temozolomi...

FIGURE 1.10 The regulation of fat storage and mobilization by growth hormone...

FIGURE 1.11 The configuration of the three physiologic zones of the human gr...

FIGURE 1.12 Schematic representation of AVP‐mediated water conservation in t...

FIGURE 1.13 Mechanism of action of thiazide diuretics in the DCT. The sodium...

FIGURE 1.14 Schematic representation of the role of thiazide diuretics in ce...

FIGURE 1.15 The triphasic response of central diabetes insipidus.

Chapter 2

FIGURE 2.1 Role of deiodinases in the regulation of thyroid hormones. The ro...

FIGURE 2.2 Intracellular effects of T3. T3 exerts its intracellular effects ...

FIGURE 2.3 Comparison of treatment targets in primary and secondary hypothyr...

FIGURE 2.4 A simplified chemiosmotic proton circuit in BAT mitochondria. Ele...

FIGURE 2.5 Thyroid hormone synthesis. Summary of the steps involved in the s...

FIGURE 2.6 Effects of beta‐blockers in thyrotoxicosis. Sites of action of pr...

FIGURE 2.7 Sites of action of tyrosine kinase inhibitors.

Chapter 3

FIGURE 3.1 Schematic representation of the effects of angiotensinogen activa...

FIGURE 3.2 A schematic diagram of the renin‐angiotensin‐aldosterone axis. Th...

FIGURE 3.3 Mechanism of action of aldosterone. Sequential steps of aldostero...

FIGURE 3.4 Mechanism of aldosterone escape. Oncotic and hydrostatic pressure...

FIGURE 3.5 Vascular supply of the adrenal glands.

FIGURE 3.6 Catecholamine synthesis pathway.Synthesis of catecholamines. Th...

FIGURE 3.7 Adrenal steroidogenesis.

Chapter 4

FIGURE 4.1 Schematic diagram of the intracellular effects of insulin recepto...

FIGURE 4.2 A schematic diagram of the amino acid sequence of human insulin. ...

FIGURE 4.3 Comparison of glycolysis and gluconeogenesis.

FIGURE 4.4 Insulin‐mediated glycogen synthesis.

FIGURE 4.5 Schematic representation of insulin release from the pancreatic b...

FIGURE 4.6 Mechanism of action of incretin mimetics.

FIGURE 4.7 Mechanism of action of SGLT2 inhibitors.

FIGURE 4.8 Pathophysiologic defects of T2DM and the medications addressing t...

FIGURE 4.9 Biosynthesis of serotonin by neuroendocrine cells. Tryptophan hyd...

FIGURE 4.10 Regulation of gastric acid production by the parietal cell.

FIGURE 4.11 Pancreatic islet cells. The distribution of various islet cells ...

Chapter 5

FIGURE 5.1 Schematic representation of the regulation of PTH release by ioni...

FIGURE 5.2 The role of PTH in osteoblast–osteoclast interaction.

FIGURE 5.3 The mechanism of action of nitrogen‐containing bisphosphonates in...

FIGURE 5.4 Schematic representation of calcium transport at the distal convo...

FIGURE 5.5 Mechanism of action of furosemide at the TALH.

FIGURE 5.6 Mechanism of action of calcitriol at the distal renal tubular cel...

FIGURE 5.7 Intestinal handling of calcium.

FIGURE 5.8 The sigmoidal relationship between serum ionized calcium and para...

FIGURE 5.9 Reabsorption of phosphate at the proximal renal tubule.

FIGURE 5.10 FGF‐23 and phosphate regulation.

FIGURE 5.11 Regulation of calcitriol by FGF‐23.

FIGURE 5.12 The structural components of bone.

FIGURE 5.13 Role of sclerostin in the Wnt/β‐catenin signaling pathway.

FIGURE 5.14 Summary of the mechanism of action of various anti‐osteoporotic ...

Chapter 6

FIGURE 6.1 Role of insulin and glucagon in glucose metabolism.

FIGURE 6.2 Molecular mechanisms of insulin resistance in PCOS. Defects in do...

FIGURE 6.3 A schematic representation of the proposed model of the GnRH puls...

FIGURE 6.4 The two‐cell two‐gonadotropin model of estrogen biosynthesis.

FIGURE 6.5 A schematic representation of folliculogenesis.

FIGURE 6.6 Schematic representation of the mechanism of action of various an...

FIGURE 6.7 Metabolism of testosterone.

FIGURE 6.8 The classical testosterone signaling pathway.

FIGURE 6.9 Regulation of Sertoli cell function. GnRH from the hypothalamus p...

Chapter 7

FIGURE 7.1 Structure of LDL cholesterol. Esterified cholesterol and triacylg...

FIGURE 7.2 Summary of the exogenous and endogenous pathways of lipoprotein m...

FIGURE 7.3 Mechanism of action of ezetimibe.

FIGURE 7.4 Schematic representation of the cholesterol synthesis pathway.

FIGURE 7.5 Schematic representation of HDL metabolism.

FIGURE 7.6 Mechanism of action of inclisiran.

FIGURE 7.7 Schematic diagram of both orexigenic and anorexigenic pathways. T...

FIGURE 7.8 Types of bariatric surgery.

FIGURE 7.9 Comparison of the effects of exogenous steroids and Addison's dis...

FIGURE 7.10 Location of adipose tissue.

Chapter 8

FIGURE 8.1 Locations for continuous glucose monitor placement. A comparison ...

FIGURE 8.2 Mechanism of action of various immune check inhibitors. The phase...

FIGURE 8.3 Mechanisms of immune checkpoint inhibitor‐related adverse events....

Chapter 9

FIGURE 9.1 Circadian rhythm and cortisol regulation.

FIGURE 9.2 Dexamethasone suppression test. Administration of oral dexamethas...

FIGURE 9.3 Results of the water deprivation test. Comparison of urine osmola...

Guide

Cover Page

Table of Contents

Title Page

Copyright Page

Dedication

Preface

Acknowledgments

Begin Reading

Appendix A

Index

WILEY END USER LICENSE AGREEMENT

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Endocrinology

Pathophysiology to Therapy

Akuffo Quarde MD

Clinical Instructor, University of Minnesota Medical SchoolEndocrinology, Diabetes and Metabolism ClinicSanford HealthBemidji, Minnesota, USA

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Library of Congress Cataloging‐in‐Publication DataNames: Quarde, Akuffo, author.Title: Endocrinology: pathophysiology to therapy / Akuffo Quarde.Description: Hoboken, NJ: Wiley‐Blackwell, 2024. | Includes bibliographical references and index.Identifiers: LCCN 2023046411 (print) | LCCN 2023046412 (ebook) | ISBN 9781119863533 (paperback) | ISBN 9781119863540 (adobe pdf) | ISBN 9781119863557 (epub)Subjects: MESH: Endocrine System Diseases–physiopathology | Endocrine Glands–physiopathology | Endocrine System Diseases–therapyClassification: LCC RC649 (print) | LCC RC649 (ebook) | NLM WK 140 | DDC 616.4–dc23/eng/20231101LC record available at https://lccn.loc.gov/2023046411LC ebook record available at https://lccn.loc.gov/2023046412

Cover Design: WileyCover Image: © SEBASTIAN KAULITZKI/SCIENCE PHOTO LIBRARY/Getty Images

Dedication

To the memory of Dr. Joseph Quartson.

Preface

This book encourages an integrated understanding of endocrine physiology by examining the mechanisms of action of medical therapies. Relevant endocrine physiology is presented, followed by a review of the detailed mechanism of action of selected medical interventions.

Where applicable, emphasis is placed on clinical pharmacology pearls, such as side effects and therapeutic monitoring guidelines. Supplementary chapters address additional topics, including immune checkpoint inhibitor‐related endocrinopathies, anabolic steroid abuse, pseudo‐endocrine conditions, and dynamic tests in clinical endocrinology.

As endocrinology is a rapidly evolving subdiscipline of internal medicine, this book avoids focusing on guideline‐defined treatment protocols, instead highlighting the pathophysiological basis of endocrine therapies. While not exhaustive in its coverage of endocrine pathophysiology, I hope the discussion of the rationale for using various therapies will enable readers to appreciate complex concepts in a clinically relevant manner.

Endocrinology fellows and practicing physicians should be familiar with landmark clinical trials in the field, so an effort has been made to highlight some practice‐changing trials where relevant. This should enrich the training of endocrinology fellows and internal medicine residents, medical students, and other allied health professionals such as pharmacists, nurse practitioners, and physician assistants. Infographics of landmark trials mentioned in this book can be found on this website https://myendoconsult.com/learn/clinical‐trials/

I welcome readers' feedback regarding this first edition's limitations and look forward to incorporating valuable suggestions in future editions.

Acknowledgments

I would like to express my heartfelt gratitude to Professor Andrea Manni from Penn State College of Medicine and Professor Alan Sacerdote for their invaluable mentorship and support throughout the development and creation of this book.

I want to acknowledge that the illustrations in this book were created using Adobe InDesign and BioRender, a free online software designed for crafting biomedical diagrams.