Pharmacology
Endocrine Pharmacology
Endocrine drugs for MBBS and NEET-PG: insulin, oral antidiabetics, thyroid drugs, corticosteroids and bisphosphonates, mapped to NMC codes.
MedNext Academy | 3 min read
Endocrine Pharmacology
Endocrine drugs for MBBS and NEET-PG: insulin, oral antidiabetics, thyroid drugs, corticosteroids and bisphosphonates, mapped to NMC codes.
This chapter covers the drugs used to treat endocrine disorders, including diabetes mellitus, thyroid disease, adrenal disorders, bone disease and reproductive hormones. It links hormone physiology to the therapeutics of hyperglycaemia, thyroid dysfunction, osteoporosis and pituitary disease.
High-yield: Endocrine Pharmacology
- Metformin is first-line for type 2 diabetes, lowers glucose without causing hypoglycaemia and can rarely cause lactic acidosis.
- Sulphonylureas such as glibenclamide stimulate insulin release and can cause hypoglycaemia and weight gain.
- Insulin is essential in type 1 diabetes; its main adverse effect is hypoglycaemia, and it is the safest agent in pregnancy.
- SGLT2 inhibitors lower glucose by increasing urinary excretion and give cardiovascular and renal benefit but risk genital infection and ketoacidosis.
- Levothyroxine replaces thyroid hormone in hypothyroidism and is monitored by the thyroid-stimulating hormone level.
- Carbimazole and propylthiouracil treat hyperthyroidism; both can cause agranulocytosis, and propylthiouracil is preferred in the first trimester.
- Corticosteroids have anti-inflammatory and immunosuppressive effects; long-term use causes Cushingoid features, osteoporosis and adrenal suppression.
- Long-term corticosteroids must never be stopped abruptly because of the risk of an adrenal crisis.
- Bisphosphonates such as alendronate inhibit osteoclasts in osteoporosis and can cause oesophagitis and jaw osteonecrosis.
- Oestrogen and progestogen combinations are used for contraception and hormone therapy but increase venous thromboembolism risk.
- Oxytocin contracts the uterus and is used to induce labour and control postpartum haemorrhage.
- Bromocriptine and cabergoline are dopamine agonists that lower prolactin and shrink prolactinomas.
- Growth hormone and its analogues treat deficiency states, while somatostatin analogues such as octreotide treat acromegaly.
- Desmopressin, a vasopressin analogue, treats central diabetes insipidus and nocturnal enuresis.
Endocrine drug essentials
- **Type 2 diabetes:** Metformin first-line; sulphonylureas risk hypoglycaemia; SGLT2 inhibitors give organ benefit.
- **Thyroid:** Levothyroxine for hypothyroidism; carbimazole for hyperthyroidism, watch for agranulocytosis.
- **Corticosteroids:** Never stop abruptly after long-term use; risk of adrenal crisis.
- **Osteoporosis:** Bisphosphonates inhibit osteoclasts; risk of oesophagitis and jaw osteonecrosis.
NMC competencies in this chapter
- **PH1.36:** Insulin and oral antidiabetic drugs
- **PH1.37:** Thyroid and antithyroid drugs and corticosteroids
- **PH1.38:** Drugs for calcium homeostasis and bone disorders
Frequently Asked Questions
Why is metformin the first-line drug in type 2 diabetes?
It lowers glucose without causing hypoglycaemia or weight gain, has cardiovascular benefit and is well tolerated, making it the preferred initial agent.
Why must long-term steroids not be stopped suddenly?
Chronic steroids suppress the adrenal glands, so abrupt withdrawal can precipitate an adrenal crisis; the dose must be tapered gradually.
Which antithyroid drug is preferred in early pregnancy?
Propylthiouracil is preferred in the first trimester because carbimazole carries a higher risk of congenital malformations at that stage.
What is the main adverse effect of bisphosphonates?
Oesophageal irritation, so they are taken upright with water on an empty stomach; rare jaw osteonecrosis is another recognised concern.
Continue reading
MBBSAll Pharmacology chapters
Continue through the Pharmacology chapter map.
Continue studying Pharmacology
Explore clinician-written learning resources, structured revision and practice across the MedNext platform.
Open in the MedNext appSee plans