Drug Safety 2007; 30 (3): 215-245 REVIEW ARTICLE 0114-5916/07/0003-0215/$44.95/0  2007 Adis Data Information BV. All rights reserved. Drug-Induced Endocrine and Metabolic Disorders Ronald C.W. Ma, 1 Alice P.S. Kong, 1,2 Norman Chan, 3 Peter C.Y. Tong 1 and Juliana C.N. Chan 1 1 Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Shatin, New Territories, Hong Kong, China 2 Li Ka Shing Institute of Health Sciences, Faculty of Medicine, The Chinese University of Hong Kong, Shatin, New Territories, Hong Kong, China 3 Qualigenics Diabetes Centre, Hong Kong, China Contents Abstract .................................................................................... 216 1. Intermediary Metabolism ................................................................. 217 1.1 Insulin ............................................................................... 217 1.2 Counter-Regulatory Hormones ........................................................ 217 1.3 Free Fatty Acids and Glucose Metabolism .............................................. 218 1.4 The Hypothalamus-Pituitary Axis and Regulation of Appetite ............................. 218 1.5 Diabetes Mellitus, Obesity and Metabolic Syndrome .................................... 218 1.6 Drug-Induced Hyperglycaemia and Dyslipidaemia ...................................... 218 1.6.1 Antihypertensives .............................................................. 219 1.6.2 Corticosteroids ................................................................. 220 1.6.3 Sex Steroids .................................................................... 221 1.6.4 Antipsychotics ................................................................. 221 1.6.5 Protease Inhibitors and Highly Active Antiretroviral Therapy ......................... 222 1.7 Drug-Induced Hypoglycaemia ........................................................ 223 1.7.1 Insulin ......................................................................... 224 1.7.2 Sulphonylureas ................................................................. 225 1.7.3 Drugs that Enhance the Effects of Antihyperglycaemic Drugs ...................... 225 1.7.4 Renin-Angiotensin-Aldosterone System Inhibitors ................................... 225 1.7.5 β-Adrenoceptor Antagonists (β-Blockers) and Sympathomimetic Drugs .............. 225 1.7.6 Antimalarial Drugs .............................................................. 226 1.7.7 Pentamidine ................................................................... 226 2. Drug-Induced Electrolyte Abnormalities .................................................... 226 2.1 Homeostasis of Fluid and Electrolyte Balance ........................................... 226 2.2 Drug-Induced Hyponatraemia and Hypernatraemia .................................... 227 2.3 Drug-Induced Hypokalaemia and Hyperkalaemia ...................................... 228 2.4 Other Drug-Induced Electrolyte Abnormalities .......................................... 229 3. Drug-Induced Abnormalities in Calcium Balance ............................................ 229 3.1 Drug-Induced Hypocalcaemia ........................................................ 230 3.1.1 Antiepileptic Drugs ............................................................. 230 3.1.2 Bisphosphonates ............................................................... 230 3.1.3 Miscellaneous ................................................................. 231 3.2 Drug-Induced Hypercalcaemia ....................................................... 231 4. Drug-Induced Thyroid Disorders ............................................................ 232 4.1 Regulation of Thyroid Metabolism ..................................................... 232 4.2 Drug-Induced Hyper- and Hypothyroidism .............................................. 233