INTERNATIONAL MEDICAL UNIVERSITY

MALAYSIA

Bachelor of Pharmacy (Hons)

Intake B1/07
Semester 5

Endocrine System
(BPH3012)

Module Guide
(22 June 2009 2 October 2009)

TITLE: THE ENDOCRINE SYSTEM

LEVEL: SEMESTER 5

COURSE CODE: BPH3012

PROGRAMME: BPharm (Hons)

CONTENT SYNOPSIS:
Hormones are regulatory substances synthesised, stored and released in small amounts by
specialised tissues. Endocrinology, the study of hormones and hormonal systems, is based on
two fundamental principles: hormone secretion and action (effects), and the regulation of these
actions or effects by feedback control mechanisms. Endocrine disorders, particularly diabetes
mellitus, form a substantial and growing part of the global burden of disease. This Module
introduces the human endocrine system, which together with the nervous system co-ordinates
and integrates tissue and organ activity. Because of this vital regulatory function, disorders of
the endocrine system often affect more than one body system; and relevant knowledge of the
major organ systems is necessary. The companion module, also undertaken in Semester 5, is
the Reproductive System.
As with all Systems Modules in the BPharm, this Module integrates relevant anatomy,
physiology, pathology, pharmacology and practice skills. Facilitated self-learning tasks include
problem-based learning and portfolio writing. Small group learning includes workshops and
pharmacy skills development sessions, and in these sessions you can expect to encounter
cases or scenarios which draw from all the Body Systems Modules covered to date.
OBJECTIVES:
The objectives of this module are to1.
describe the secretion, actions, inter-relationships and regulation of hormones;
2.
outline the role of hormonal systems in the reaction to stress; and to
3.
describe major endocrine disorders and their management, with a particular focus on drug
therapy;
LEARNING OUTCOMES:
On completion of this module, the student should be able to1.
describe basic principles of endocrinology, including the classification of hormones, their
regulation, metabolism and feedback control; hormonal receptors and second messenger
systems; and outline factors that lead to hypo- or hyper-function of endocrine glands;
2.
describe the nature of the relationship between higher centres, the hypothalamus, the
pituitary and peripheral endocrine glands;
3.
describe the hormones produced in the hypothalamus and pituitary;
4.
describe the mechanism of action and unwanted effects of agents used to treat endocrine
disorders of the hypothalamus and pituitary;
5.
outline the structure and describe the function of the thyroid gland and the synthesis,
release and action of thyroid hormones;
6.
describe the actions and unwanted effects of agents used to treat hypo and hyper
thyroidism, and how treatment is monitored;
7.
outline the structure and describe the function of the parathyroid glands, adrenal glands
and endocrine pancreas; and describe the regulation of release and action of hormones
secreted by these glands;
8.
describe Types 1 and 2 diabetes mellitus; the aims and monitoring of treatment, and the
role of pharmacotherapy in achieving these aims;
9.
describe the actions, clinical uses, unwanted effects and evidence base for
pharmacotherapy of diabetes mellitus;
Intake B1/07 [Sem 5]
Module Guide
International Medical University

10.

identify stress stimuli and outline the bodys response to stress, particularly in terms of the
hormonal response.

LEARNING HOURS:
Lectures
Practicals
Workshops
PBL
PSD
Portfolio
Guided Reading
TOTAL LEARNING HOURS

12 hours
2 hours
6 hours
3 hours
1.5 hours
2 hours
6 hours
32.5 HOURS

ASSESSMENTS:
Coursework
Workshops
PBL
Portfolio
PSD
Written examination: Degree Paper, 2 hours
MEQ, I hour, 2 questions
Essay, 1 hour, 1 of 3 questions

TEACHING AND LEARNING METHODS:

Lectures
12 hours
Practical
2 hours
Workshops
6 hours
PBL
3 hours
PSD
1.5 hours
TOTAL CONTACT HOURS

24.5 HOURS

10%
10%
5%
5%
40%
30%

MODULE LEADER: Mr. Syed Imran Ahmed

ASSOCIATED LECTURERS: Dr. Chen Yu Sui, Dr. Madhukatyayani Balijepalli, Mr. Syed
Shahzad Hasan
SYLLABUS:
1.
Hormones (Lecture 1 hr)
a.
Chemistry of hormones
b.
Hormone target cell specificity
c.
Molecular mechanisms of hormonal action
d.
Regulation of hormone release
2.

The hypothalamus and pituitary (Lecture 1hr)

a.
The pituitary-hypothalamic axis
b.
Pituitary hormones and their regulation
c.
Hypo and hyperpituitarism: aetiology, pathogenesis and clinical manifestations
d.
Aims of treatment; pharmacotherapy and adverse effects

3.

The thyroid (Lecture 1 hr)

a.
Structure and function
b.
Thyroid hormone and calcitonin synthesis, secretion, regulation and action
c.
Monitoring thyroid function

4.

Hypo and hyperthyroidism and their management (Lecture 1 hr; Guided Reading 2
hrs)
a.
Aetiology, clinical manifestations and natural progression
b.
Aims of treatment; pharmacotherapy and adverse effects

Intake B1/07 [Sem 5]

Module Guide
International Medical University

c.

Monitoring

5.

Hormonal regulation of bone mineral homeostasis (Lecture 1 hr)

a.
Structure and function of the parathyroid glands
b.
Regulation of parathyroid hormone secretion
c.
Actions of parathyroid hormone and calcitonin
d.
Action of vitamin D
Vitamin D is described in Complementary Medicine BPH2022, Semester 4. The
Musculoskeletal System BPH3027, Semester 6, reviews bone mineral homeostasis and
describes metabolic bone disease (osteomalacia; osteopenia & osteoporosis) and
discusses corticosteroid-induced osteoporosis. Renal bone disease, which includes a
secondary parathyroidism, is discussed in the Renal System BPH2016, Semester 3

6.

The adrenal glands (Lecture 1 hr)

a.
Gross structure and histology
b.
The cortex: glucocorticoid and mineralocorticoid secretion and function
c.
The medulla: catecholamines and steroidal hormone secretion and function
Aspects of steroidal hormones are covered in Natural Products in Medicine BPH2012,
Semester 3

7.

Adrenocortical hormone disorders (Lecture 1 hr)

a.
Disorders of hyper- and hyposecretion
b.
Aims of treatment
c.
Pharmacotherapy; adverse effects and interactions

8.

The endocrine pancreas (Lecture 1hr)

a.
Structure and function of the endocrine pancreas
b.
Insulin and glucagon secretion and effects
c.
Regulation of glycaemia

9.

Diabetes mellitus (Lecture 1 hr)

a.
Aetiology; types and prevalence
b.
Clinical manifestations and natural progression, including longer-term vascular and
other complications
c.
Cardiovascular risk
d.
Aims of management and evidence base

10.

Management of type 1 (insulin dependent) diabetes (Lecture 1 hr; Guided Reading

2 hrs)
a.
Insulin and recombinant analogues
b.
Insulin regimens
c.
Adjunctive treatment
d.
Hypoglycaemia, ketoacidosis and their management
e.
The evidence base

11.

Management of type 2 diabetes (Lecture 1 hr; Guided Reading 2 hrs)

a.
Oral hypoglycaemic agents: types and mechanisms of action
b.
Clinical uses; adverse effects and interactions

Intake B1/07 [Sem 5]

Module Guide
International Medical University

c.

Hypoglycaemia and hyperosmolar non-ketotic hyperglcyaemia and their

management
d.
The evidence base
Risk factors for associated cardiovascular disease, such as dyslipidaemia, are described
in the Cardiovascular System BPH1021

12.

Insulin injection devices (Practical 2 hrs; Open access CSU Students own time)
Familiarisation with the handling, care and care of insulin and injecting devices, for
example manufactured by Novo Nordisk or Eli Lilly. The objective is to acquire familiarity
with the use of theses devices so as to be able to demonstrate, teach and assess their use
by patients. Further practice is normally available on request in the Clinical Skill Unit
(CSU) and in (timetabled) pharmacy skills development (PSD) sessions.

13.

The metabolic syndrome or gestational diabetes (PBL 2 x 1.5 hrs; Portfolio 2 hrs)
The trigger is normally a clinical vignette involving the metabolic syndrome or gestational
diabetes. At the end of session 2, a concise (usually word-limited) summary is written

14.

Diabetes education and health promotion (Workshop 3 hrs)

Educational and other relevant measures to address diet; associated cardiovascular risk
factors (dyslipidaemia, blood pressure, weight, smoking); foot care; eye care
Risk factors for cardiovascular disease are discussed in the Cardiovascular System BPH
1021 Semester 2, and smoking cessation in the Respiratory System BPH2017, Semester
3

15.

Endocrine disorders (Workshop 3 hrs)

Case problems involving endocrine disorders alone or in combination with any disease
condition encountered so far, that is from Semester 2 to 5. The focus is the interpretation
of clinical and laboratory findings, treatment and monitoring, and the identification of
pharmaceutical care issues and their resolution.

16.

Stress physiology (Lecture 1hr)

a.
Stressors & the response to stress; hormonal response stress
Stress management
b.
Stressors are also discussed in Understanding the Patient BPH1027, Semester 2

17.

Pharmacy skills development (PSD 1.5 hrs)

This session provides practice in counselling on diabetic management issues, such as
dietary control and other interventions (Item 14); and counselling, demonstration and
assessment of the use of the insulin injection devices (Item13). Competence in these skills
is expected before graduation. In the PSD session students can expect to encounter
scenarios combining elements from any Body System encountered up to Semester 5.
Feedback is provided, and skills and knowledge are examinable in the Semester 8 OSCE.

READING LIST:
1.
Marieb, E.N. & Hahn, J. (2006) Human Anatomy and Physiology, 7th Edition, The
Benjamin/Cummings Publishing Company.
2.
Widmaier E.P., Raff, H., & Strang, K.T. (2007) Vanders Human Physiology, The
Mechanisms of Body Function with ARIS, 11th Edition, McGraw Hill.
3.
Martini, F.H. (2004) Fundamentals of Anatomy & Physiology 6th edition, Pearson,
Benjamin Cummings Publishing Company, San Francisco.
Intake B1/07 [Sem 5]
Module Guide
International Medical University

4.
5.
6.
7.
8.
9.
10.
11.
12.
13.
14.
15.

Rang, H.P., Dale M.M. & Ritter, J., & Flower, R. (2007) Pharmacology 6th Edition, Churchill
Livingstone
Katzung, B.G. Basic & Clinical Pharmacology, (2007) 10th edition, Appleton and Lange
Brunton, L., Lazo, J. & Parker, K. (2006). Goodman and Gilmans The Pharmacological
Basis of Therapeutics, 11th edition, McGraw-Hill
Kumar, V., Cottran, R.S. & Robbines, S.L. (2004) Basic Pathology 7th Edition, WB
Saunders Company
Chandrasoma, P., & Taylor, C.R. (2000) Concise Pathology 6th. Edition, Appleton & Lange
Rubin, E. (2008) Essentials of Rubin's Pathology 5th Edition, Lippincott Williams & Wilkins.
Underwood, J.C.E. (2000) General and Systemic Pathology 3rd Edition, Churchill
Livingstone
DiPiro, J.T., Talbert, R.L., Yee, G.C., et al (2007) Pharmacotherapy: A Pathophysiologic
Approach 6th Edition, McGraw Hill
Koda-Kimble, M.A., Young, L.Y., Kradjan W.A., et al (2008) Applied Therapeutics: The
Clinical Use of Drugs 9th Edition, Applied Therapeutics Inc.
Walke, R., & Edwards, C.R.W. (2004). Clinical Pharmacy and Therapeutics, 3rd edition,
Churchill Livingstone.
Gaw, A., Cowan, R.A., OReilly, D. St.J. et al (2008) Clinical Biochemistry An Illustrated
Colour Text, 3rd Edition, Churchill Livingstone
Chew, S.L., Leslie, D (2006) Clinical Endocrinology and Diabetes An Illustrated Colour
Text. Churchill Livingstone

EVIDENCE BASED TREATMENT GUIDELINES

International Diabetes Federation

Clinical Guidelines Task Force (2005) Global Guideline for Type 2 Diabetes
Available at http://www.idf.org/webdata/docs/IDF%20GGT2D.pdf
National Institute for Health & Clinical Excellence, 2008
CG66- Diabetes -type 2 (update)
Available at http://www.nice.org.uk/nicemedia/pdf/CG66diabetesfullguideline.pdf
For patients and carers:
CG66 Diabetes - type 2 (update): understanding NICE guidance
Available at http://www.nice.org.uk/Guidance/CG66/PublicInfo/pdf/English
The American Diabetes Association
Position Statement. Diagnosis and Classification of Diabetes Mellitus. Diabetes Care 2007; 30
(Supplement 1): 542-547
2007 Clinical Practice Recommendations
Available via http://care.diabetesjournals.org/content/vol30/suppl_1/
Physical Activity / Exercise and Type 2 Diabetes. A consensus statement from the American
Diabetes Association. Diabetes Care 2006; 29 (6): 1433-1438

Intake B1/07 [Sem 5]

Module Guide
International Medical University

Intake B1/07 [Sem 5]

Module Guide
International Medical University