In the last two decades,great advance had been reached in the use of hormones,
hormone analogues and hormone antagonists not only in the treatment but also in
diagnosis of non endocrine diseases.
THYROID HORMONES
Thyroid hormonesare critical determinants of brain and somatic development in
infants and of metabolic activity in adults; they also affect the function of virtually
every organ system.It has therapeutic uses in:
1. cardiac remodeling.
2. left ventricular dysfunction.
3. cardiac surgery.
4. Hypercholesterolemia and heart failure.
5. Benign thyroid nodules.
6. human astrocytomas.
7. breast cancer cell proliferation.
GnRH
GnRH (also called luteinizing hormone releasing hormone or LHRH)used as
therapy in many diseases as in:
1.Metastatic prostate cancer.
2. Breast Cancer.
3. Hisutism.
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4. Fibroid.
5. Endometriosis.
GROWTH HORMONE
Growth hormone (GH), the most abundant anterior pituitary hormone recently
used in :
1.performing enhancing drugs by athletes.
2.Therapy in Osteoporosis.
3.Therapy in short gut syndrome .
SOMATOSTATIN
Somatostatinis distributed throughout the entire body. SST analogues are present in
short term and long term formulations.Act through Inhibiting serotonin release, and
the secretion of gastrin, VIP, insulin, glucagon, secretin, motilin, and pancreatic
polypeptide. Also suppresses decreases splanchnic blood flow.Also has antitumor
effects.
Diagnostic applications
SCINTIGRAPHY AND AUTORADIOGRAPHY
1.Non-Functioning Islet Cell Tumors.
2. Neuroendocrine Tumors.
3.CNS tumors.
4.Adenocarcinomas:
GI cancers,hepatocellular carcinomas,breast carcinoma,renal cell carcinomas,
prostate malignancies,overian cancer,nasopharyngeal carcinomas, lymphomas,
melanomas,thymic tumors,mesenchymal tumorc,mercle cell tumors.
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5.Granulomatous Disease.
6. Thyroid malignancy.
Therabeutic applications
1.CNS: Antipsychotic effect and Retinal disorders and epilepsy.
2. GIT:Treatment of active variceal bleeding and angiodysplasia.
Pancreatitis ,post ERCP and post pancreatictomy, Diabetic nephropathy
3. Liver diseases: Schistosomiasis and HCC.
4. Oncology:pituitary tumors, thyroid malignancies, gallbladder malignancies,
cancer prostate and cervical tumor
5. polycystic kidney.
VASOPRESSIN
Vasopressinanalogus and antagonists has variety of therapeutic applications as:
1.Congestive heart failure and cirrhosis.
2. Von Willebrand Disease and Disorders of Coagulation.
3. Variceal Bleeding .
4. Severe gastrointestinal bleeding in Crohn's disease.
5.Hypertention.
6. Hepatorenal Syndrome.
7. Cardiac Arrest.
8. Heart failure.
9.Septic shock and Hemorrhagic Shock.
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10. Anesthesia-Induced Hypotension.
11. Post cardiotomy/Cardiopulmonary Bypass–Induced Hypotension.
12. Nocturnal Polyurea.
13. Aggressive behavior.
14. Vasopressin in affective disorders.
15. Vasopressin in chronic fatigue syndrome.
16. Autism spectrum disorders.
17. Renal malignancies.
18. Nerve cell growth.
PARATHYROID HORMONE
Parathyroid hormone(PTH) is one of the two major hormones modulating calcium
and phosphate homeostasis.Used in:
1. Treating bone marrow depletion in cancer patients
2.Therapy in Osteoporosis
CALCITONIN
Calcitonin inhibits osteoclasts and therefore bone resorption in pharmacologic
doses.PTH used in:
1.Paget disease therapy.
2. Treatment of pain.
3. Myeloma cells in their osteoclast-like activity.
4. Anoretic effects.
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5. Osteoporosis.
6. Medullary thyroid cancer.
7. Hypercalcemia.
ERYTHROPOITIN
Erythropoietin (EPO) is a glycoprotein growth factor that is the primary
stimulus to erythropoiesis.It is mainly used in:
1. Anemia of chronic kidney disease.
2.Treatment of anemia in patients with cancer.
3. As hematopoietic growth factors.
INSULIN
Insulindirectly or indirectly affects the function of virtually every tissue in the
body.Its uses out of diabetes are:
1. Intensive insulin therapy during critical illness.
2. Aortic Valve and Coronary Surgery.
3. Alzheimer disease.
4. As enhancing drugs by athletes.
5. Treatment and prevention of hyperkalemia.
GLUCOCORTICOIDS
Pharmacologic doses of glucocorticoids are used to treat patients with inflammatory,
allergic, immunological disorders. A number of factors that influence both the
therapeutic and adverse effects of glucocorticoids.
Allergic conditions:
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1. Treatment and prognosis of Churg-Strauss syndrome.
2. Chronic rhinosinusitis.
3. Treatment of atopic dermatitis.
4. Treatment of eosinophilic esophagitis.
5. Anaphylaxis.
6. Allergic bronchopulmonary aspergillosis.
7. Asthma management.
8. COPD.
9. Hypereosinophilic syndromes.
Glucocorticoids in immunological and vascular disorders
1. Dermatomyositis and polymyositis in adult.
2. Wegener's granulomatosis and microscopic polyangiitis.
3. Rheumatoid Arthritis .
4. Behcet's disease.
5. Acute cardiac allograft rejection.
6. Mixed connective tissue disease.
7. Kawasaki disease.
8. Primary angiitis of the central nervous system.
9. Autoimmune pancreatitis.
10.Autoimmune hepatitis.
11.SLE.
12.Vasculitis.
13.Myasthenia gravis.
14.Idiopathic thrombocytopenic purpura .
15.IgA nephropathy.
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16.Amyloidosis.
17.Thrombotic thrombocytopenic purpura-hemolytic uremic syndrome in
adults.
18.Paroxysmal nocturnal hemoglobinuria.
19.Autoimmune hemolytic anemia.
20.Eales' disease.
21.Minimal change disease in adults.
22.Focal segmental glomerulosclerosis.
23.Membranoproliferative glomerulonephritis.
Anti inflammatory therapeutic applications
1. Pulmonary sarcoidosis .
2. Chronic inflammatory demyelinating polyneuropathy.
3. Acute gout.
4. Acute exacerbations of multiple sclerosis.
5. Bronchopulmonary dysplasia.
6. Prevent neurologic complications of bacterial meningitis in children.
7. Carpal tunnel syndrome.
8. Nonspecific interstitial pneumonia.
9. Ankylosing spondylitis.
10.Acute pericarditis.
11.Ulcerative proctitis, proctosigmoiditis, and left-sided (distal) colitis.
12.Treatment of retroperitoneal fibrosis.
13.To prevent restenosis following percutaneous coronary intervention.
14.Treatment of miliary tuberculosis.
15.Hepatic fibrosis.
16.Low back pain.
17.Septic shock.
18.In women at risk for preterm delivery.
19.Cancer pain management.
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20.Acute pain management in adults with sickle cell disease.
21.Cancer anorexia/cachexia.
22.Brain tumor.
23.Polycystic ovary.
24.Hirsutism .
Glucocorticoids in blood malignancies
1. Adult T-cell lymphoma-leukemia.
2. Natural killer (NK) cell large granular lymphocyte leukemia.
3. Advanced (stage III-IV) Hodgkin lymphoma.
4. primary central nervous system lymphoma.
ANDROGEN
Principal endogenous androgenresponsible for promoting the growth and
development of the male sex organs and maintaining secondary sex characteristics in
androgen-deficient males.Therabeutic uses are:
1. As performing enhancing drugs by athletes.
2. Management of sexual dysfunction in females.
3. Alzhymer disease.
4. Treatment of angina.
5. Endothelial dysfunction treatment.
6.Therapy in breast cancer.
7.Fibroid.
8.Endometriosis.
9. Paroxysmal nocturnal hemoglobinuria.
10. Cancer anorexia and cachexia.
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11. Osteoporosis in male.
ESTROGEN
Estrogens act most importantly on the reproductive organs, but they also act on
other organ systems. Used in:
1.Osteoporosis in postmenopausal women.
2.Estrogen and cognitive function and AD.
3.Therapy in metastatic breast cancer.
4.Therapy in management of sexual dysfunction in females.
5.Acne treatment.
6.Therapy in endometriosis.
7.Therapy in fibroid.
8.Hirsutism treatment.
9.Hormonal therapy in Endothelial dysfunction.
10.Initial hormone therapy for metastatic prostate cancer.
11.Treatment of retroperitoneal fibrosis.
12.Mifepristone in Bipolar disorders.
13.Mifepristone in malignancies.
14.Catamenial epilepsy.
Recommendations:
Wide therapeutic application of homones in practical field in Medicine. |
