treatment of congenital adrenal hyperplasiaadministering ☆low (ie, physiologic) doses of exogenous corticosteroids to suppress ACTH secretion
By removing excessive ACTH stimulation, exogenous corticosteroids can decrease androgen production by the adrenal cortex. endocrinologyUWorld HirotoShishido
change in PTH for the patients with multiple myelomaosteolytic cytokines→
liberate calcium from bone→
hypercalcemia→
inhibits the release of PTH from parathyroid cells→
①increase urinary calcium excretion(☆hypercalciuria)
②reduce renal 1-alfa-hydroxylase→☆low 1,25 dihydroxyvitamine D endocrinologyhematologyUWorld HirotoShishido
sevelamer
mechanism, clinical usephosphate binder that ☆prevents phosphate absorption from the GI tract
what degrade triglylerides during fasting☆hormone sentitive lipase
+ stress hormone(catecholamines, glucagons, ACTH)
- insulin endocrinologyUWorld HirotoShishido
β2 receptor effect
what should be careful about with the patient who has both DM and hypertension(protein kinase A blocks ☆myosin light chain kinase in smooth muscle)
smooth muscle cells relaxation
bronchodilation
decrease GI motility
¥decrease uterine tone
secretion of aquaous humor
increase cellular K+ uptake(↓serum pottacium)
☆increase insulin(⇔α2)
☆increase glucose via liver
☆release of glucagon via pancreous
deficient enzyme in maturity-onset diabetes of the young(MODY)
characteristics(若年発症成人型糖尿病)
glucokinase(production of glucose-6-phosphatase from glucose)
mild hyperglycemia that often worsens with pregnancy-induced insulin resistance
☆can maintain very good glycemic control with dietary modification only
patients with MODY are typically younger and nonobese, and the condition is nonprogressive, even without the treatment
not associated with an elevated risk of long term diabetic complications endocrinologybiochemistryUWorld HirotoShishido
counseling on the patents with insulin-induced weight gainReview for changes in diet
☆Ask about hypoglycemic symptoms(may cause patients to attempt to suppress feelings of hypoglycemia)
