Flashcards in Chapter 26: Hypothalamus & Pituitary Gland Deck (28)
Somatropin or Somatrem MOA
Replaces or stimulates release of GH or ILF-1
*SOMA helps you GROW!
What would you use to treat growth failure in kids with GH deficiency, Turner's Syndrome, Prader-Willi syndrome, and chronic kidney disease?
Somatropin or Somatrem
What is a major contraindication for the use of somatrem / somatropin?
Epiphyses already closed. Adults requires CONFIRMED GH deficiency or panhypopituitarism
Sermorelin / Tesamorelin MOA
GHRH ...but no longer available in the US so don't worry about it too much
What drug would you use to treat a patient with Laron dwarfism? What is this drug's MOA? Risks?
Mecasermin - IGF-1 promotes growth in patients with closed epiphyses
Risks include elevated intracranial pressure
meCASErMIN - use in special CASES of MINimal height
Inhibits GH release because it is a somatostatin analogue
When would you prescribe octreotide?
Diarrhea from peptide-secreting tumors
Control GI bleeding
Competitive inhibitor of GH
Most effective at lowering IGF-1 but can also have rebound effects of increasing GH
What does bromocriptine do?
it is a synthetic dopamine receptor agonist --> dopamine inhibits lactotrophs --> lactotrophs usually make prolactin = inhibit pituitary prolactin release
twice a day dose
Why is vomiting/nausea a common side effect of bromocriptine?
The area postrema has significant numbers of dopamine receptors (and it is a dopamine agonist)
What dopamine receptor agonist also causes alcohol intolerance and should NOT be used to suppress postpartum lactation?
Bros have alcohol intolerance
What are the clinical applications of bromocriptine?
Acromegaly, amenorrhea/galatorhea due to HYPERPROLACTINEMIA
What is the advantage of cabergoline over bromocriptine?
Cabergoline results in less nausea
Cabergoline is used to treat hyperprolactinemia, but should not be used in what types of patients?
Patients with heart disease
TRH - test thyroid fxn
TSH - test thyroid fxn
ACTH 1-24 - test adrenal fxn
GnRH analogues can be given continuously or in a pulsatile fashion. What is the difference?
Continuous GnRH: suppressed LF and FSH release by desensitizing the pituitary gland
Pulsatile: stimulates LH and FSH release by anterior pituitary
What GnRH analogue could you use to both diagnose hypogonadism and stimulate ovulation? What is the stipulation with stimulating ovulation?
Must be pulsatile form to stimulate ovulation
"-relins" are GnRH analogues
Goserelin, histrelin, leuprolide, and nafarelin are used for gonadotropin suppression or stimulation?
These drugs (GnRH analogues) are given via DEPOT formulations so they work to suppress gonadal steroid production
What drugs (2) could you use to inhibit premature LH surges in women undergoing controlled ovarian hyperstimulation? What is the MOA?
X - is for GnRH receptor ANTAGONIST
-relins are analogues, -reliX are antagonists
Which drug is purified from the urine of post-menopausal women?
Uro = urine
Urofollitropin and follitropin MOA?
FSH - stimulate gonadal maturation and steroid production
uroFollitropin , Follitropin - F is for FSH
What is the ONLY clinical application for follitropin or urofollitropin?
Treat anovulation --> induce that shit, help ppl get pregnant
Follitropin has an adverse risk for what serious syndrome?
Ovarian hyperstimulation syndrome (important to know that FSH is leading cause of OHSS)
(FYI mild form can be just bloating, nausea, vomiting, but can progress to the serious or moderate forms which include serious weight gain, pleural effusion, lower abdominal pain, etc)
Vi V2 vasopressin antagonist used to treat HYPONATREMIA (like in SIADH)
V2 vasopressin antagonist used for either hyponatremia OR heart failure