AP/PP/ HT pharm

Question 1

Hypothalmic-pituitary axis axis has which kind of receptors?

Answer 1

GPCR except GH and PRL (JAK/STAT)

Question 2

GnRH in pulses promotes…

Answer 2

LH and FSH

Question 3

GnRH continuous secretion gets….

Answer 3

Inhibition of LH and FSH

Question 4

Drug that Stimulate AP

Answer 4

Sermorelin

Question 5

Drugs that inhibit AP

Answer 5

Pasireotide
Octreotide
Lanreotide

Question 6

Drug that stimulates/acts like GH

Answer 6

Somatotropin

Question 7

Peripheral tissue growth is stimulated by which drugs

Answer 7

Mecasermin

Question 8

Somatotropin (MOA; C/u; S/E)

Answer 8

MOA:
+Synthetic forms of GHRH (tesamorelin) to secrete GH secretion to reduce abdominal fat in HIV-associated lipodystrophy
+IGF-1 is secreted by liver and mediates/promotes effects of GH onto target cells

c/u:
+CKD
+Prader-willis, turners, Noonan syndrome
+Idopathic short stature (pituitary dwarfism)
+GH defiency
+Short for gestation age at 2yo

S/e:
+Pseudotumor Cerebri,
+Slipped capital femral epiphysis
+scoliosis
+hyperglycemia,
+PWS- Otitis Media
+Pancretitis
+Gynocomastia
+nevis growth

DONT GIVE IF PERSION HAS:
Maligancy

Question 9

Mecasermin (MOA)

Answer 9

Recombinant IGF-1

Question 10

Mecasermin C/u

Answer 10

Severe IGF-1 deficiency when GH does no work (Laron Syndrome)

Question 11

Mecasermin (s/e)

Answer 11

+IC htn
+Lipohypertrophy
+Elevated Liver enz

Question 12

Drugs for Excessive GH (gigantism/acromegaly)

Answer 12

[Somatostatin analogs]:
+Lanreotide
+Octreotide

[GH receptor Antagonist]:
+Pegvisomant

Question 13

Octreotide, Lanreotide MOA

Answer 13

Somatostatin analog to inhibit
+GH
+IGF-1
+Insulin
+Glucagon
+Pancreatic Polypeptide
+TSH
+LH
+Serotonin
+VIP
+Secretin
+Gastrin

Question 14

C/U of Octreotide/Lanreotide

Answer 14

[High GH]:
Acromegaly, gigantism

[Tumors]:
Carcinoid tumor, gastrinoma, glucagonoma, Insulinoma, VIPoma, ACTH secreting tumor

[Other]:
Secretory diarrhea, Portal HTN
Esophageal variceal bleeding control

Question 15

S/E of Octreotide and Lanreotide

Answer 15

Steatorrhea
biliary sludge
gall stones
HTN/Bradycardia
peripheral edema

Question 16

MOA of Pegvisomant

Answer 16

GH Receptor Blocker

X- No GH binding
X- No Jak/stat

Question 17

C/U of Pegviosomant

Answer 17

Acromegaly Alternative for to Somatostatin (octreotide/Lanreotide)

Question 18

S/E of Pegvisomant

Answer 18

Liver Toxicity
AB formation
Lipohypertrophy

Question 19

Hypothalamic-Pituitary-Gonadal Axis pathway

Answer 19

GnRH –> Gq-IP3-PLC-DAG-Ca –> LH & FSH –> Ovaries & Testis –> androgens, estrogens & progesterone
Preovulatory surge of estrogen –> ↑ GnRH

Question 20

Drug for Gonadotropin on HYPOTHALMUS

Answer 20

GnRH

Question 21

Drug for Gonadotropin AGONIST

Answer 21

Gonadorelin

Question 22

Drug for GnRH receptor agonist

Answer 22

Leuprolide

Question 23

Drug for GnRH receptor antagonist

Answer 23

Ganirelix

Question 24

AP hormone fro GN

Answer 24

Gonadotropins

Question 25

FSH DRUG

Answer 25

Follitropin

Question 26

LH becomes

Answer 26

hCG

Question 27

FSH & LH combo drug

Answer 27

Menotropin

Question 28

FSH-LH-hCG similarities

Answer 28

+A subunit same +B allows interacting with different receptors +Signal Pathways (CAMP)

Question 29

Menotropins are used for...

Answer 29

Combo for FSH & LH for follicle development in women

Question 30

Follitropin alfa and beta is a

Answer 30

Activates FSH receptors for controlling ovulation stimulation for hypogonadotropic hypogonadism in men (MHH)

Question 31

hCG

Answer 31

LH receptor agonist for initiating oocyte maturation and ovulation during controlled ovarian stimulation, MHH

Question 32

Why use gonadotropins?

Answer 32

INCREASE F infertility regarding anovulation secondary to hypogonadotropic hypogonadism, POS, etc. via Low FSH and LH INCREASE M with increasing sperm count (menotropins) and Testosterone (hCG with LH) Cryptorchidism - hCG

Question 33

S/E of Gonadotropins

Answer 33

Multiple pregnancies ovarian hyperstimulation syndrome [OHSS]

Question 34

Name Gonadotropin Releasing Hormone Agonists

Answer 34

GnRH: +Gonadorelin +Leuprolide +Nafarelin +Histrelin ***GPCR – IP3 -> pulsatile administration -> ↑ FSH, LH --> continuous administration --> down regulation of GnRH receptors --> ↓ FSH, LH --> ↓ estrogen, testosterone

Question 35

C/U of GnRH Agonists

Answer 35

+Advance prostate cancer +Breast cancer +Endometriosis +Precoious puberty +Uterine Fibrinoids +Suppress premature LH surge in the treatment of infertility.

Question 36

GnHR agonist S/E

Answer 36

Hot flashes, depression, diminished libido, vaginal dryness, breast atrophy

Question 37

GnRH ANTAGonists

Answer 37

Ganirelix, Cetrorelix, & degarelix

Question 38

MOA of Ganirelix, Cetrorelix, & degarelix

Answer 38

antagonist at GnRH receptors; ↓ IP3 ; ↓ FSH & LH

Question 39

C/U of Ganirelix, Cetrorelix, & degarelix

Answer 39

F: Infertility inhibits premature LH surge in ovarian hyperstimulation M: ↓ Testosterone in prostate cancer

Question 40

S/E and Contraindications Ganirelix, Cetrorelix, & degarelix

Answer 40

[S/E]: +H/s +Anaphylaxis +Allergy [Contraindication]: +Pregancy

Question 41

Drugs for Prolacting antagonists

Answer 41

Cabergoline or bromocriptine (D2 receptor antagonists to decrease prolactin)

Question 42

Cabergoline or bromocriptine USES

Answer 42

Hyperprolactinemia, Acromegaly Parkinson disease

Question 43

S/E of Bromocriptine, Cabergoline

Answer 43

GI Orthostatic HypOTN Vasospasm Psychosis

Question 44

Drugs Affecting Prolactin Levels by....

Answer 44

block dopamine D2 receptors cause hyperprolactinemia by blocking the inhibitory effects of endogenous dopamine on the pituitary cells that release prolactin. Older anti-psychotics would more likely cause hyperprolactinemia Drugs or drug groups that cause hyperprolactinemia through mechanisms that are not well characterized include methyldopa (an antihypertensive), amphetamines, tricyclic and other types of antidepressants, and opioids.

Question 45

Oxytocin MOA; C/U; S/E

Answer 45

Exogenous usage for induce & augment labor Milk letdown reflex , and control of uterine hemorrhage after delivery Adverse effects: Excessive stimulation of uterine contractions before delivery can cause fetal distress, placental abruption, uterine rupture, fluid retention, hyponatremia, heart failure, seizures, and death Contraindications: Fetal distress, prematurity, cephalopelvic disproportion

Question 46

V1 and 2 receptor drugs

Answer 46

V1 antagonist- Conivaptan V2 antagonist- Conivaptan V2 agonist- Desmopressin

Question 47

MOA; C/U; S/E of Vasopressin (Antidiuretic Hormone; ADH)

Answer 47