Drug types: Adrenocorticosteroids

Drug types

Many different drugs are used to treat and manage endocrine disorders. Listed below are some of the more common drugs you will encounter in your dental hygiene practice that affect the endocrine system. This list is not inclusive of all medications regulating this system. Please consult with a drug handbook or your patient's physician if you have any questions regarding a medication taken by your patient.

Drug type & names	Mechanism of action	Adverse effects
Mineralcorticoids: Fludorcortisone (Florinef)	Maintain water & electrolyte balance.	Edema hypertension
Glucocorticoids (Oral): Prednisone (Deltasone) Hydrocortisone (Cortisol) Betamethasone (Valisone) (Topical): Hydrocortisone (Cortaid) Triamcinolone acetate (Kenalog, Flutex) Fluocinolone (Lidex)	increase concentration of neutrophils decrease number of lymphocytes, monocytes, eosinophil, & basophils inhibit many factors involved in the inflammatory response increase glucogenesis & protein catabolism decrease bone density decrease resistance to infection.	Truncal obesity weight gain muscle wasting hyperglycemia possible masking of signs of infection mood swings agitation depression increase in stomach acid impairment of collagen synthesis osteoporosis increase in intraocular pressure sodium & water retention adrenal atrophy oral candidasis
Antihyperthyroid agents (Hyperthyroidism): methimazole (Tapazole) propylthiouracil (PTU)	Interfere with synthesis of thyroid hormones (T3 & T4)	Transient leukopenia skin reactions agranulocytosis arthralgias hypoprothrombinemia GI disturbances
Antihypothyroid agents (Hypothryoidism): Levothyroxine (Levoxyl, Synthroid)	Replace thyroid hormone	No significant side effects
Antidiabetic agents: Insulin (Humulin N, Humulin R) Sulfonylurea	Stimulate glucose uptake by cells & glycogen formation in the liver, thereby lowering blood glucose levels.	Hypoglycemia sweating weakness nausea tachycardia headache blurred vision mental confusion incoherence coma convulsions death
Hypoglycemic agents: Metformin (Glucophage) Glyburide (Micronase) Glipizide (Glucotrol XL) Tolbutamide (Orinase)	Stimulate release of insulin from pancreas. Increase number of insulin receptors on peripheral tissues.	Hypoglycemia blood dycrasias GI disturbances muscle weakness fatigue dizziness anorexia cutaneous reactions liver damage
Hormone Replacement: Estradiol (Estrace, Estraderm) Estrogen (Premarin, Prempro)	Replace estrogen to relieve symptoms of menopause.	Nausea vomiting uterine bleeding vaginal discharge edema thrombophlebitis weight gain headache hypertension endometrial cancer
Oral Contraceptives: Ortho-Novum 7/7/7 Ortho-Tri-Cyclen Tri-Levlen Triphasil	Inhibit ovulation render uterine lining unsuitable for implantation alter cervical mucus to prevent sperm penetration inhibit enzymes needed by sperm for fertilization	Nausea dizziness weight gain headache breast tenderness hypertension liver damage thrombophlebitis thromboembolis increased gingival fluid gingivitis gingival inflammation increased risk for dry socket