Handbook of Clinical Neurology, Vol. 120 (3rd series) Neurologic Aspects of Systemic Disease Part II Jose Biller and Jose M. Ferro, Editors © 2014 Elsevier B.V. All rights reserved
Chapter 54
Commonly used endocrine drugs MA´RIO MIGUEL ROSA1* AND TERESA DIAS2 Neurology Department, Hospital de Santa Maria, Lisbon, Portugal
1 2
Endocrinology, Diabetes and Metabolism Unit, Hospital de Santa Maria, Lisbon, Portugal
INTRODUCTION Endocrine disorders are unique in the sense that treatment can be targeted directly to the malfunctioning path. Hormone therapy replacement in hypofunction diseases and specific antihormone treatment in hyperfunction disorders are the hallmark of endocrine treatment. It might then be expected that endocrine drugs would be among the safest in the therapeutic arsenal, at least the most commonly used. But although less risky than some groups, such as chemotherapy agents or anticoagulants, they are also related to significant neurologic adverse events (AEs). In this chapter we will provide an overview of the common neurologic AEs of endocrine drugs. Other chapters have dealt with some agents commonly used in endocrinology, such as corticosteroids or sexual hormones, and will not be discussed here. As a rule, adverse events occur independently of the indication for which the drug is used. On the other hand, some drugs, in spite of being hormones or antihormones, are not just used to treat endocrine diseases. A good example is antiandrogen use for prostate cancer. Taking this into consideration, we will not discuss agents that have been referred to elsewhere. We will thus focus on agents related to hypothalamus, pituitary, thyroid, and parathyroid hormones, and finally, diabetes mellitus (DM). Our chapter aims to summarize the most commonly used drugs in endocrinology. In order to facilitate thorough access and quick information, we provide references with the links to product information of the most relevant drugs discussed, particularly from the European Medicines Agency (EMA) and the US Food and Drug Administration (FDA). In the rare instances
where product information is not available on these sites, national drug authorities that have product information in English are also referred to. In accordance with World Health Organization (WHO) guidance, adverse reactions are listed under headings of frequency (number of patients expected to experience the reaction), using the following categories: very common ( 10%); common ( 1% to < 10%); uncommon ( 0.1% to < 1%); rare ( 0.01% to < 0.1%); very rare (
Chapter 54
Commonly used endocrine drugs MA´RIO MIGUEL ROSA1* AND TERESA DIAS2 Neurology Department, Hospital de Santa Maria, Lisbon, Portugal
1 2
Endocrinology, Diabetes and Metabolism Unit, Hospital de Santa Maria, Lisbon, Portugal
INTRODUCTION Endocrine disorders are unique in the sense that treatment can be targeted directly to the malfunctioning path. Hormone therapy replacement in hypofunction diseases and specific antihormone treatment in hyperfunction disorders are the hallmark of endocrine treatment. It might then be expected that endocrine drugs would be among the safest in the therapeutic arsenal, at least the most commonly used. But although less risky than some groups, such as chemotherapy agents or anticoagulants, they are also related to significant neurologic adverse events (AEs). In this chapter we will provide an overview of the common neurologic AEs of endocrine drugs. Other chapters have dealt with some agents commonly used in endocrinology, such as corticosteroids or sexual hormones, and will not be discussed here. As a rule, adverse events occur independently of the indication for which the drug is used. On the other hand, some drugs, in spite of being hormones or antihormones, are not just used to treat endocrine diseases. A good example is antiandrogen use for prostate cancer. Taking this into consideration, we will not discuss agents that have been referred to elsewhere. We will thus focus on agents related to hypothalamus, pituitary, thyroid, and parathyroid hormones, and finally, diabetes mellitus (DM). Our chapter aims to summarize the most commonly used drugs in endocrinology. In order to facilitate thorough access and quick information, we provide references with the links to product information of the most relevant drugs discussed, particularly from the European Medicines Agency (EMA) and the US Food and Drug Administration (FDA). In the rare instances
where product information is not available on these sites, national drug authorities that have product information in English are also referred to. In accordance with World Health Organization (WHO) guidance, adverse reactions are listed under headings of frequency (number of patients expected to experience the reaction), using the following categories: very common ( 10%); common ( 1% to < 10%); uncommon ( 0.1% to < 1%); rare ( 0.01% to < 0.1%); very rare (
