1. Endocrien systeem
1.1 Antidiabetische geneesmiddelen
Groep Ftie in kort Voorbeelden Gebruik bij
Insuline Gluc uit bloed halen / Type I
Metformine ↑ gevoeligheid voor insuline in perifeer / Type II >>>
Hypoglycemische Stimulatie β-cellen -> ↑ insuline Glibenclamide (Daonil)
sulfonamides
Glinides Stimulatie β-cellen -> ↑ insuline (sneller in en uit) Repaglinide (Novonorm) Type II
Glitazones Genexpressie -> verbeteren ftie vetweefsel en ↓ insulineresistentie Pioglitazone (Acetos) Type II
Incretine mimetica/ Stimulatie β-cellen -> ↑ insuline Semaglutide (Ozempic, Wegovy, Rybelsus) Type II
GLP-1 agonisten Stimulatie α-cellen -> ↓ glucagon
Vertraagde maaglediging
Hypothalamus -> minder honger
DPP-4-inhibitoren / Inhibitie DPP-4 -> ↓ afbraak GLP / Type II
gliptines -> Stimulatie β- (↑ insuline) en α-cellen (↓ glucagon), vertraagde maaglediging
SGLT2 inhibitoren / Inhibitie glucosetransporter -> ↑ glucose uitplassen -> ↓ glucose in circulatie Empagliflozine, canagliflozine Type II
gliflozines
Glucagon Afbraak glycogeen + ↑ gluconeogenese Glucagen (SC) Hypoglycemie
, 1.2 Obesitas
Groep Ftie in kort Voorbeelden
GLP-1 agonisten Stimulatie β-cellen -> ↑ insuline Semaglutide (Ozempic, Wegovy, Rybelsus)
Stimulatie α-cellen -> ↓ glucagon
Vertraagde maaglediging
Hypothalamus -> minder honger
GLP-1/GIP dual incretine mimetica OO GLP-1 en GIP receptoren Tirzepatide
-> Stimulatie β- (↑ insuline) en α-cellen (↓ glucagon), vertraagde maaglediging (Mounjaro -> diabetes)(Zepbound -> obesitas)
GLP-1/glucagon dual receptor OO GLP-1 en glucagon receptoren /
agonisten -> ↑ ftie mitochrondria -> ↑ verbranding vet
-> ↓ leververvetting en inflammatie
-> glycogenolyse en hyperglycemie -> nood aan comb met GLP-1 agonist
Amyline ↓ hongergevoel
Fibroblast groeifactor 21 ↓ inname voedsel, ↑ oxidatie vetzuren en gezond vet
1.3 Thyroid
Groep Ftie in kort Voorbeelden Indicaties
Thyroid hormonen No groei, werking en O2 verdeling in weefsels Levothyroxine (Tetraiodothyronine, T4) Hypothyroïdie (OO antithyroide
No ontwikkeling CZS en verhoogde exciteerbaarheid neuronen medicatie)
Pos ionotroop en chronotroop effect op hart
Thyrostatische gm’en ↓ iodinatie, koppeling en perifere omzetting T4->> T3 Propylthiouracil Hyperthyroidie (OO β-blokkers en later
Antilich tegen TSH -> ↓ stimulatie thyroid thyroidhormonen)
Iodide ↓ iodinatie en secretie thyroidhormonen (directe werking) / Thyrotoxische crisis (thyroid storm)
Voorbereiding chirurgie
Desinfectatie OK
Nucleair accident
Radioactief iodine
1.4 Corticosteroïden
Groep Ftie in kort Voorbeelden Indicaties
Cortisol
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