Pituitary/Hypothalamic Pharm Flashcards
How does Leuprolide work and why do we use it?
This is a GnRH agonist . GnRH is normally released in a pulsatile fashion by the hypothalamus and stimulates the release of FSH and LH from the anterior pituitary.
This agonist can do whatever you want. If you give it in a pulsatile fashion, it will actually increase LH and FSH since it has a longer half life. But if you just give it continuously, it will decrease FSH and LH since they won’t respond to a non-pulsatile administration of a GnRH
Who gets pulsatile vs continuous leuprolide?
Pulsatile treats women with amenorrhea who desire fertility.
Continuous is used to suppress the growth of prostate cancer, leiomyomas, and endometriosis. Also useful for halting precocious puberty
Side effects of leuprolide
Bone pain, feet/ankle swelling
What do we use somatotropin for and how does it work?
GH analog that increases lean muscle mass
Use it in dwarfism and for wasting secondary to AIDS or malignancy
Side effects of somatotropin?
Hand/foot edema, thickening of bones/jaw, carpal tunnel syndrome, increased organ growth, decreased insulin sensitivity, hyperglycemia
What is octreotide and how does it work?
A somatostatin analog. Somatostatin is a hypothalamic hormone that normally inhibits the release of GH, glucagon, insulin, gastrin, and vasoactive intestinal peptide (VIP). Octreotide has a longer half life than somatostatin.
We use it to treat esophageal varices, VIPomas, acromegaly, Zollinger Ellison (increased gastrin secretion) and carcinoid syndrome
Side effects of octreotide
Gallblader disease, pancreatitis,, hypo or hyperthyroidism, cardiac arrhythmias
What are our dopamine agonists and what do we use them for?
Bromocriptine and Cabergoline
PRL secretion is normally inhibited by Dopamine from the hypothalamus. So we use this for prolactinomas and Parkinsons (much higher dosage for this)
Side effects of dopamine agonists
Psychotic symptoms, dizziness, headache, nausea, lightheadedness, confusion
What is desmopressin and what do we use it for (bear with me, I know these cards are dry, this content can’t be done much differently)
This is a Vasopressin analog that has minimal V1 activity (minimal effect on vascular smooth muscle) and more of an effect on V2 receptors (act on the renal collecting tubules to increase water resorption). Also stimulates the release of vWF from the endothelium in platelet dysfunction disorders
We use this for Central DI and von Willebrand disease
Side effects of desmopressin
Hyponatremia, transient headache, flushing
What is Oxytocin and what do we use it for?
This is a posterior pituitary hormone that stimulates milk secretion and induces uterine contractions during labor. We use it to induce labor (big stretch there), which will also decrease postpartum bleeding. We also use it to stimulate breast milk letdown in new mothers
Side effects of Oxytocin
Chest pain, confusion, excessive vaginal bleeding (that’s interesting), palpitations, seizures.
