Chapter 26: Hypothalamus & Pituitary Gland Flashcards Preview

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Flashcards in Chapter 26: Hypothalamus & Pituitary Gland Deck (28)
1

Somatropin or Somatrem MOA

Replaces or stimulates release of GH or ILF-1

*SOMA helps you GROW!

2

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

3

What is a major contraindication for the use of somatrem / somatropin?

Epiphyses already closed. Adults requires CONFIRMED GH deficiency or panhypopituitarism

4

Sermorelin / Tesamorelin MOA

GHRH ...but no longer available in the US so don't worry about it too much

5

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

6

Octreotide MOA?

Inhibits GH release because it is a somatostatin analogue

Long acting

7

When would you prescribe octreotide?

Acromegaly, gigantism
Diarrhea from peptide-secreting tumors
Control GI bleeding

8

Pegvisomant

Competitive inhibitor of GH

Most effective at lowering IGF-1 but can also have rebound effects of increasing GH

$$$$$$

9

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

10

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)

11

What dopamine receptor agonist also causes alcohol intolerance and should NOT be used to suppress postpartum lactation?

Bromocriptine

Bros have alcohol intolerance

12

What are the clinical applications of bromocriptine?

Acromegaly, amenorrhea/galatorhea due to HYPERPROLACTINEMIA

Prolactinomas

13

What is the advantage of cabergoline over bromocriptine?

Cabergoline results in less nausea

14

Cabergoline is used to treat hyperprolactinemia, but should not be used in what types of patients?

Pregnant patients

Patients with heart disease

15

Protirelin MOA?

TRH - test thyroid fxn

16

Thyrotropin MOA?

TSH - test thyroid fxn

17

Cosyntropin MOA?

ACTH 1-24 - test adrenal fxn

18

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

19

What GnRH analogue could you use to both diagnose hypogonadism and stimulate ovulation? What is the stipulation with stimulating ovulation?

Gonadorelin

Must be pulsatile form to stimulate ovulation

"-relins" are GnRH analogues

20

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

-RELINS

21

What drugs (2) could you use to inhibit premature LH surges in women undergoing controlled ovarian hyperstimulation? What is the MOA?

Ganirelix
Cetrorelix

X - is for GnRH receptor ANTAGONIST

-relins are analogues, -reliX are antagonists

22

Which drug is purified from the urine of post-menopausal women?

Urofollitropin

Uro = urine

23

Urofollitropin and follitropin MOA?

FSH - stimulate gonadal maturation and steroid production

uroFollitropin , Follitropin - F is for FSH

24

What is the ONLY clinical application for follitropin or urofollitropin?

Treat anovulation --> induce that shit, help ppl get pregnant

25

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)

26

Conivaptan

Vi V2 vasopressin antagonist used to treat HYPONATREMIA (like in SIADH)

27

Tolvaptan

V2 vasopressin antagonist used for either hyponatremia OR heart failure

28

Leuprolide clinical application?

depot formulations of GnRH

breast cancer, prostate cancer, endometriosis, porphyria, precocious puberty