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6. Drugs Used in the Treatment of Disorders of the Endocrine System

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6. Drugs Used in the Treatment of Disorders of the Endocrine System 6. Drugs used in the treatment of disorders of the Endocrine System 6.1 Drugs used in diabetes 6.1.1 Insulins 6.1.1.1 Short-acting insulins Soluble insulin - Human Actrapid® - Human Velosulin® - Humulin S® - Hypurin Neutral® - Insuman Rapid® - Pork Actrapid® Insulin aspart - NovoRapid® Insulin lispro - Humalog® 6.1.1.2 Intermediate- and long-acting insulins insulin detemir (initiated by Diabetologists only) insulin glargine (initiated by Diabetologists only ) insulin glulisine (initiated by Diabetologists only ) Isophane insulin - Human Insulatard® - Humulin I® - Hypurin Isophane® - Insuman Basal® - Pork Insulatard® Biphasic insulin aspart NovoMix 30® Biphasic insulin lispro Humalog® Mix25 Humalog® Mix50 Biphasic isophane insulin - Human Mixtard 10® - Human Mixtard 20® - Human Mixtard 30® - Human Mixtard 40® - Human Mixtard 50® - Humulin M3® - Insuman Comb® 6.1.2 Oral antidiabetic drugs - Pork Mixtard 30® Avandamet® (rosiglitazone/metformin) gliclazide glipizide metformin metformin MR (Diabetologists and Dr Staniland only) nateglinide pioglitazone 6.1.4 Treatment of hypoglycaemia rosiglitazone vildagliptin (only in line with NICE recommendations) glucagons 6.2 Thyroid and antithyroid drugs 6.2.1 Thyroid hormones liothyronine levothyroxine sodium/thyroxine sodium 6.2.2 carbimazole propylthiouracil 6.3 Corticosteroids 6.3.1 Replacement therapy fludrocortisone 6.3.2 Glucocorticoid therapy betametasone cortisone dexamethasone hydrocortisone methylprednisolone prednisolone 6.4 Sex Hormones 6.4.1 Female sex hormones 6.4.1.1 Estrogens and HRT - estradiol with progestogen Femoston Conti® tablets ( continuous ) Femoston® tablets - estradiol only estradiol implants estradiol transdermal patches ( FemSeven® ) estradiol vaginal ring ( Menoring® ) estradiol valerate (Elleste Solo® tablets) - ethinylestradiol ethinylestradiol raloxifene ( rheumatology and endocrinology only ) 6.4.1.2 Progestogens dydrogesterone hydroxyprogesterone caproate medroxyprogesterone acetate norethisterone progesterone 6.4.2 Male sex hormones and antagonists cyproterone acetate ( urology only ) testosterone & esters ( includes intramuscular injection, implants , Nebido ® - e ndocrinology only) Miscellaneous dehydroepiandrosterone ( endocrinology only - unlicenced) 6.5 Hypothalamic and pituitary hormones and anti-oestrogens 6.5.1 Hypothalamic and anterior pituitary chorionic gonadotrophin (hcg) hormones and anti-oestrogens clomiphene citrate gonadorelin (lhrh) menotrophin (lh & fsh) protirelin (trh) somatropin (in accordance with NICE guidance ) - Follow restricted high cost drug procedure when prescribing somatropin tetracosactide urofollitropin (fsh) 6.5.2 Posterior pituitary hormones and demeclocycline antagonists desmopressin terlipressin (Gastroenterology, A&E and EAU only ) vasopressin (Gastroenterology only ) 6.6 Drugs affecting bone metabolism 6.6.1 Calcitonin calcitonin salmon/salcatonin 6.6.2 Bisphosphonates alendronic acid (including once a week products ) disodium etidronate disodium pamidronate ibandronate IV ( Bonviva® ) (For use by consultant rheumatologists in the treatment of post-menopausal osteoporosis only) risedronate sodium (weekly risedronate is first line, except for male patients and patients with gastro-intestinal problems whereby alendronate should be considered first line) sodium clodronate strontium ranelate (Rheumatology and Elderly Care consultants only in accordance with Trust Guidelines for the Prevention and Management of Osteoporosis ) teriparatide (Dr T O'Neill only ) - Follow restricted high cost drug procedure when prescribing teriparatide tiludronic acid (Rheumatology only ) zoledronic acid (licensed indications only - for use by Urology and Haematology [Myeloma IX trial] directorates only) 6.7 Other endocrine drugs 6.7.1 Bromocriptine & other dopamine- bromocriptine receptor stimulants cabergoline ( obs & gynae only) 6.7.2 Drugs affecting gonadotrophins danazol Gonadorelin analogues buserelin goserelin (consultant only ) leuprorelin (Prostap® SR) (Obstetric and Gynaecology directorate only - a shared care protocol is required if care is to be continued in primary care ) 6.7.3 Metyrapone and trilostane metyrapone .
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