Endocrinology & Vitamins

Pharmacology  Review:   Endocrinology   &  Vitamins Presented  by: A  Nelson  Avery,  MD Board  Certified  in  Toxicology,  Preventive  Medicine  and...
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Pharmacology  Review:  

Endocrinology   &  Vitamins Presented  by: A  Nelson  Avery,  MD Board  Certified  in  Toxicology,  Preventive  Medicine  and  Internal  Medicine Clinical  Professor  and  Director Preventive  Medicine  Residency  Program [email protected]

Endocrine  Agents  

A Nelson Avery, MD

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Insulin ► Beta  cells à proinsulin à hydrolyzed  into  C-­ peptide (which  has  no  function)  and  insulin à

ê glucose ► Mechanism  to  release  insulin: – In  response  to  glucose  and  other  sugars,  certain   amino  acids  (leucine,  arginine)   &  vagus  activity  à – é Intracellular  ATP  levels  à close  ATP-­ dependent  K+ channels à ê outward  K+ efflux  à – Depolarization   of  β  cell  and  open  voltage  gated   Ca++ channels à influx  of  Ca++ à triggers  release   of  insulin A Nelson Avery, MD

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Insulin ► Insulin  receptors  function  as  transmembrane   tyrosine  kinases ► Activates  cGMP ► Promotes  glucose  utilization in  skeletal  muscle   and  adipose  and  ê gluconeogenesis ► Promotes  glycogen  storage (liver  and  muscle) ► é Fat  synthesis (triglycerides)  in  liver  and  fat   cells;;  ê lipolysis ► é Amino  acid  uptake  and  é protein  synthesis ► Toxicity:  hypoglycemia,  lipoatrophy,  insulin   resistance

A Nelson Avery, MD

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Insulin:  Types preparation

onset

duration

peak

0-­15  mins