De Padua, Jastine Joy M.

PHARM1A
05-29-21

MODULE 6

individual report in PDF/WORD explaining 3 disease entities for body system/s in the module
and pointing out the pathophysiologic mechanism and feasible pharmacologic mechanisms (with
drugs) to counteract such disease process.

ENDOCRINE SYSTEM
1. diabetes mellitus
- Type 2 diabetes, also called non-insulin-dependent diabetes mellitus (NIDDM), is
caused by the failure of the pancreas to make enough insulin, coupled with resistance
to its effects in the periphery. Both these problems cause a rapid rise in blood glucose
levels, with severe long-term consequences for β cells. Metformin (Fortamet, Glumetza,
and others) is frequently administered as the first drug for type 2 diabetes. It works
mainly by decreasing liver glucose synthesis and increasing your body's insulin
sensitivity, allowing insulin to be used more effectively.

References:
Mahler, R. J., & Adler, M. L. (1999, April 01). Type 2 Diabetes Mellitus: Update on Diagnosis,
Pathophysiology, and Treatment. Retrieved from
https://academic.oup.com/jcem/article/84/4/1165/2864079

Type 2 diabetes. (2021, January 20). Retrieved from https://www.mayoclinic.org/diseases-

conditions/type-2-diabetes/diagnosis-treatment/drc-20351199

2. Addison's disease 
- Addison disease is most frequently caused by idiopathic autoimmune adrenocortical
insufficiency, which is caused by autoimmune atrophy, fibrosis, and lymphocytic
infiltration of the adrenal cortex, usually sparing the adrenal medulla. All medications are
used to treat Addison's disease. You will be offered hormone replacement treatment to
compensate for the lack of steroid hormones produced by your body. Oral
corticosteroids such as hydrocortisone (Cortef), prednisone, or methylprednisolone may
be used to replace cortisol. Hydrocortisone is a Corticosteroid. The mechanism of
action of hydrocortisone is as a Corticosteroid Hormone Receptor Agonist.

References:
What is the cause and pathophysiology of Addison disease? (2020, March 11). Retrieved from
https://www.medscape.com/answers/116467-23418/what-is-the-cause-and-pathophysiology-of-
addison-disease#:~:text=The%20most%20common%20cause%20of,sparing%20of%20the
%20adrenal%20medulla.
Addison's disease. (2020, November 24). Retrieved from https://www.mayoclinic.org/diseases-
conditions/addisons-disease/diagnosis-treatment/drc-20350296#:~:text=All%20treatment%20for
%20Addison's%20disease,or%20methylprednisolone%20to%20replace%20cortisol.

Hydrocortisone. (n.d.). Retrieved from

https://pubchem.ncbi.nlm.nih.gov/compound/Hydrocortisone#:~:text=Hydrocortisone%20is
%20a%20Corticosteroid.,a%20Corticosteroid%20Hormone%20Receptor%20Agonist.

3. Cushing's syndrome
- The adrenal gland secretes cortisol and other steroid hormones in response to ACTH
stimulation. The pituitary gland produces ACTH and releases it into the petrosal venous sinuses
in response to hypothalamic activation with corticotropin-releasing hormone (CRH).
Ketoconazole, mitotane (Lysodren), and metyrapone are all medications used to regulate the
adrenal gland's excessive cortisol production (Metopirone). Mifepristone (Korlym, Mifeprex) is
recommended for the treatment of Cushing syndrome in individuals who also have type 2
diabetes or glucose intolerance. Mifepristone (RU-486) is a synthetic competitive inhibitor of the
progesterone and glucocorticoid receptors (Baulieu, 1989). Its mode of action is irreversible
suppression of the progesterone receptor complex's transcriptional activity.

References:
Lawrence F. Kirk, J., Hash, R. B., Katner, H. P., & Jones, T. (2000, September 01). Cushing's
Disease: Clinical Manifestations and Diagnostic Evaluation. Retrieved from
https://www.aafp.org/afp/2000/0901/p1119.html#:~:text=Pathophysiology%20of%20Cushing's
%20Disease,-Jump%20to%20section&text=When%20stimulated%20by%20ACTH%2C
%20the,the%20hypothalamus%20(Figure%202).

Cushing syndrome. (2021, April 30). Retrieved from https://www.mayoclinic.org/diseases-

conditions/cushing-syndrome/diagnosis-treatment/drc-20351314#:~:text=Medications%20to
%20control%20excessive%20production,2%20diabetes%20or%20glucose%20intolerance.

Mifepristone. (n.d.). Retrieved from

https://www.sciencedirect.com/topics/neuroscience/mifepristone#:~:text=Mifepristone%20(RU
%2D486)%20is%20an%20oral%20antiprogestational%20agent%2C,of%20the%20progesterone
%20receptor%20complex.

DIGESTIVE SYSTEM

1. Constipation
- Normal defecation causes the rectum to dilate, the internal anal sphincter to relax
reflexively, and the perception of the need to defecate (Figure 2). Unknown sensory
systems in the anal canal permit detection of whether rectal contents are gas or feces.
Dulcolax Bisacodyl is a medication that is frequently used to treat constipation.
Additionally, it may be used to cleanse the intestines before to a gut examination or
surgery. Bisacodyl is a laxative stimulant. It works by stimulating bowel movement,
which aids in the passage of stool.

References:
Andrews, C. N., & Storr, M. (2011, October). The pathophysiology of chronic constipation.
Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3206564/#:~:text=During
%20normal%20defecation%2C%20stool%20distends,content%20is%20gas%20or%20stool.

Dulcolax (Bisacodyl) Oral: Uses, Side Effects, Interactions, Pictures, Warnings & Dosing. (n.d.).
Retrieved from https://www.webmd.com/drugs/2/drug-3721/dulcolax-bisacodyl-
oral/details#:~:text=Bisacodyl%20is%20used%20to%20treat,the%20stool%20to%20come
%20out.

2. Gastroesophageal Reflux Disease (GERD)
- The pathophysiology of gastro-oesophageal reflux disease is complex, involving
transient lower oesophageal sphincter relaxations and various anomalies of the lower
oesophageal sphincter pressure. And as result, acid, bile, pepsin, and pancreatic
enzymes reflux, causing harm to the oesophageal mucosa. Dexlansoprazole (Dexilant),
esomeprazole (Nexium), lansoprazole (Prevacid), omeprazole (Prilosec),
omeprazole/sodium bicarbonate (Zegerid), pantoprazole (Protonix), and rabeprazole
are all examples of proton pump inhibitors (Aciphex). Prokinetics: In rare situations,
these medications assist your stomach in emptying more quickly, leaving less acid
behind. PPIs work by reducing the activity of the hydrogen/potassium adenosine
triphosphatase (H/K ATPase), also known as the proton pump, which is present in
parietal cells of the gastric mucosa.

References:
De Giorgi, F., Palmiero, M., Esposito, I., Mosca, F., & Cuomo, R. (2006, October).
Pathophysiology of gastro-oesophageal reflux disease. Retrieved from
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2639970/#:~:text=The%20pathogenesis%20of
%20gastro%2Doesophageal,leading%20to%20oesophageal%20mucosal%20injury.

GERD: Symptoms, Causes, Treatments, Remedies for Relief. (n.d.). Retrieved from
https://www.webmd.com/heartburn-gerd/guide/reflux-disease-gerd-1#:~:text=PPIs%20include
%20dexlansoprazole%20(Dexilant)%2C,as%20much%20acid%20left%20behind.
Skrzydło-Radomańska, B., & Radwan, P. (2015). Dexlansoprazole - a new-generation proton
pump inhibitor. Retrieved from
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4697039/#:~:text=The%20mechanism%20of
%20action%20of,cells%20of%20the%20gastric%20mucosa.
3. Gastritis
-  Continuous mucosal injury caused by a long-standing H. pylori infection results in stomach
atrophy. This ongoing pathological process results in mucosal erosion or ulceration, resulting in
the elimination of the glandular layer and its replacement by fibrous tissue. Acid-blocking
medications that aid healing. These pharmaceuticals include omeprazole (Prilosec), lansoprazole
(Prevacid), rabeprazole (Aciphex), esomeprazole (Nexium), dexlansoprazole (Dexilant), and
pantoprazole (Pantoprazole) (Protonix). Omeprazole inhibits the proton pump. It inhibits the
parietal cell's H+ / K+ ATP pump, which is responsible for the final stage in acid generation.
Omeprazole, on the other hand, inhibits gastric basal and stimulates acid output.

References:
Gastritis pathophysiology. (n.d.). Retrieved from
https://www.wikidoc.org/index.php/Gastritis_pathophysiology#:~:text=in%20atrophic
%20gastritis.-,Pathogenesis,and%20followed%20by%20fibrous%20replacement.

Gastritis. (2020, April 03). Retrieved from https://www.mayoclinic.org/diseases-

conditions/gastritis/diagnosis-treatment/drc-20355813#:~:text=Medications%20that%20block
%20acid%20production%20and%20promote%20healing.&text=These%20drugs%20include
%20the%20prescription,)%20and%20pantoprazole%20(Protonix).

Shah, N. (2020, October 17). Omeprazole. Retrieved from

https://www.ncbi.nlm.nih.gov/books/NBK539786/#:~:text=Go%20to%3A-,Mechanism%20of
%20Action,basal%20and%20stimulated%20acid%20secretion.