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AUTONOMIC AND SYSTEMIC PHARMACOLOGY SIXTH SEMESTER

Hypoglycemic agents
and thyroid hormones

DR.JIBACHHA SAH, LECTURER, M.V.Sc (Veterinary Pharmacology)

College of Veterinary Science
Nepal polytechnic, Bhojard, Chitwan, Nepal
Email:jibachhashah@gmail.com;Mobile:00977-9845024121

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Hypoglycemic agents www.jibachhavet.com 2
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Drugs used in diabetes treat Diabetes

mellitus by lowering the glucose level in
INTRODUCTION blood With the exceptions of insulin,
exenatide, liraglutide and pramlintide all
are administered orally and are thus also
called oral hypoglycemic agents or oral
antihyperglycemic agents
 1 Introduction
Hypoglycemic agent / Thyroid hormone

2 Classification
Hypoglycemic agent and thyroid hormone

Table of 3 Mechanism of action

Pharmacological effect after drug bind in body

Contents 4 Pharmacokinetic
Movement of drugs within the body.

5 Availability
Form of drugs

6 Administration & dosage

Route of drug administration

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 Anti-diabetic medication
Oral hypoglycemic agent

Type -1 diabetes
Diabetes mellitus type -1
Juvenile diabetes, Insulin
dependent diabetes

Type 1 diabetes (T1D), also known as juvenile diabetes, is a form of diabetes in which
very little or no insulin is produced by the pancreas

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 Type 2 diabetes
This form of diabetes
usually are a combination
of insulin resistance and
impaired insulin secretion

The management of type 2 diabetes relies on a series of changes in diet and

physical activity with the purpose of reducing blood sugar levels to normal
ranges and increasing insulin sensitivity.Biguanides such as metformin are also
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 Pancreas
Its head section connects to the first part of the small
intestine (duodenum). Anatomically divided into…….

Head Neck Body and tail

When blood glucose levels are low, alpha cells secrete glucagon, which increases blood
glucose levels. When blood glucose levels are high beta cells secrete insulin to decrease
glucose in blood. Delta cells in the islet also secrete somatostatin which decreases the
release of insulin and glucose.

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Diabetes in Dogs
Diabetes is a chronic disease that can affect dogs and cats and
other animals (including apes, pigs, and horses) as well as humans.

• Insulin-deficiency diabetes—This is when the dog’s body isn’t

producing enough insulin. This is the most common type of
diabetes in dogs.

• Insulin-resistance diabetes—This is when the pancreas is

producing some insulin, but the dog’s body isn’t utilizing the
insulin as it should. This type of diabetes can especially occur
in older, obese dogs.

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 Symptoms

Excessive thirst Increased urination Weight loss.

The dog may drink Increased urination (and The dog can lose weight
frequently and empty the increased thirst) happens despite eating normal
because the body is trying to portions.
water bowl more often.
get rid of excess sugar by
sending it out through urine.
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 Other & advance stage symptoms are
Loss of appetite, Lack of energy, Depressed attitude, vomiting

Ketoacidosis a potentially life-threatening acute condition that can be accompanied

by rapid breathing, dehydration, lethargy, vomiting, or sweet-smelling breath.

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 Pathophysiology

Pathophysiology of
diabetes
Glucose

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Mechanism of action
of sulphonyl ureas
(first generation) Stimulate the release of insulin from pancreatic B-cells
(can only be used in patients with some B-cell function)

ATP-dependent potassium channels (on B-cells) contain

the sulfonylurea receptor – binding inhibits these
channels and alters the resting potential of the cell – this
leads to calcium moving into the cell and insulin being
secreted

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 CLASSIFICATION OF ORAL HYPOGLYCEMIC
AGENTS

1.Sulphonyl ureas – first generation (tolbutamide, chlorpropamide); second generation

– (glibenglamide, glipizide, gliclazide, glimiperide)

2.Biguanides – metformin

3Meglitinides – repaglinide, nateglinide

4.Thiazolidine diones – rosiglitazone, pioglitazone

5.Alpha glucosidase inhibitors – acarbose, miglitol

6.Dipeptidyl peptidase-4 (DPP-4) inhibitors – sitagliptin

7.Glucagon like peptide (GLP-1) analogue – exenatide

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Side effect
Hypoglycemia
Most common side effect; occurs more
often in long-acting sulfs
(chloropropamide glyburide and
glimepiride)

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Pharmacokinetics

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 Thyroid hormones
Thyroid hormones are two hormones produced and released by the thyroid gland,
namely triiodothyronine (T3) and thyroxine (T4).
FUNCTION
The thyroid hormones act on nearly every cell in the body. They act to increase the basal metabolic
rate, affect protein synthesis, help regulate long bone growth (synergy with growth hormone) and
neural maturation, and increase the body's sensitivity to catecholamines (such as adrenaline)
by permissiveness.

These hormones also regulate protein, fat, and carbohydrate metabolism, affecting
how human cells use energetic compounds.

This plays an important role in the hibernation cycles of mammals and

the moulting behaviour of birds. One effect of administering the thyronamines is a
severe drop in body temperature.
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Anatomical morphology

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 Causes of Primary Hypothyroidism in dog

Diagnosis:

Combination of elevated serum TSH and decreased T4 or fT4 has a specificity of 98% for diagnosis of hypothyroidism.
Serum TSH concentration greater than 0.6 ng/ml is consistent with hypothyroidism.
T3 is a poor gauge of thyroid gland function and should not be used to diagnose hypothyroidism.
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 Production

Thyroid hormones (T4 and T3) are produced by the follicular cells of
the thyroid gland and are regulated by TSH made by the thyrotropes of
the anterior pituitary gland.

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 Mechanism of action

The thyroid hormones function via a well-studied set of nuclear receptors, termed
the thyroid hormone receptors. These receptors, together with corepressor molecules,
bind DNA regions called thyroid hormone response elements (TREs) near genes. This
receptor-corepressor-DNA complex can block gene transcription. Triiodothyronine (T3),
which is the active form of thyroxine(T4), goes on to bind to receptors.

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Related diseases
Both excess and deficiency of thyroxine can cause disorders.

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 Myxedema
Severe form of hypothyroidism

When thyroid hormone levels

become extremely low, a
person may experience
symptoms such as
drowsiness, confusion,
and hypothermia, as well as
changes to the skin.

Myxedema occurs because of severe hypothyroidism that is not diagnosed or is

not treated successfully.

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 Myxedema

One life-threatening complication of hypothyroidism is myxedema coma. This

complication is also known as myxedema crisis
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 Goiter in animal
Hypothyroidism

Goiter in calf Goiter in horse Hypothyroidism in dog Hypothyroidism in dog

Symptoms Symptoms Symptoms

Hoffman's syndrome(proximal laminitis, a grave hoof Excessive weight loss Hyperthyroidism is rarer in
weakness and condition; anhidrosis, (an dogs than hypothyroidism,
pseudohypertrophy of inability to sweat;) tying up, Increased appetite and it usually results from an
muscles.), hypothyroidism, or exertional rhabdomyolysis; Frequent urination and aggressive thyroid tumor.
myopathy fertility problems
increased thirst, Vomiting

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 Symptoms
Myxedema is a serious condition. A person with myxedema may notice
swelling in their face, legs, or tongue. Their skin may also become dry and
pale.

Other symptoms of severe hypothyroidism can include:

●intolerance to cold ● tiredness

● weight gain ● drooping eye
● Shock ● decreased breathing
● Confusion ● apathy or depression
● Psychosis ● constipation
● coarse hair ● goiter
● low energy ● seizures
● reduced mobility ● coma
● low body temperature

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 Medical use

Both T3 and T4 are used to treat thyroid hormone deficiency (hypothyroidism).

They are both absorbed well by the gut, so can be given orally. Levothyroxine is
the pharmaceutical name of the manufactured version of T4, which is metabolized
more slowly than T3 and hence usually only needs once-daily administration

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 Antithyroid agent
An antithyroid agent is a hormone antagonist acting upon thyroid hormones.

The main antithyroid drugs are carbimazole (in the UK), methimazole (in the US),
and propylthiouracil/PTU. A less common antithyroid agent is potassium perchlorate.

Adverse effects

The most common side effects are rash and peripheral neuritis. These drugs also cross
the placenta and are secreted in breast milk. Lugol's iodine is used to block hormone
synthesis before surgery.
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 Treatment in dog

Surgical excision of tumor.

External beam radiation therapy.
Chemotherapy.

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Thank You
Any Questions?

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