Drugs that affect the pituitary and hypothalamic hormones Flashcards

1
Q
Review the releasing factors or memorize for the following hormones-
– TSH
– ACTH
– LH and FSH
– GH
– Prolactin
A
– TRH (+)
– CRH (+)
– GnRH (+)
– GHRH (+), SRIH (‐), other (+)
– Dopamine (‐)
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2
Q

does somatostatin inhibit or increase pituitary release of hormones?

A

inhibit

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3
Q

IGF-1 is only used when?

A

in syndromes of GH resistance

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4
Q

What are the side effects of GH therapy?

A

mostly in adults

  • peripheral edema
  • carpal tunnel
  • impaired glucose tolerance
  • hypothyroidism
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5
Q

What are the side effects of GHRH?

A

injection site reactions an headaches

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6
Q

What are 2 syndromes of GH excess? what are their origins?

A
  1. Acromegaly (adult onset)
  2. Gigantism (childhood onset)

• Origins
– GH‐secreting adenomas (~80% of cases)
– Enhanced pituitary function (~20% of cases)

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7
Q

Why is it important for somatostatin agonists to be selective for receptor types 2 and 5?

A

This is important because other subtypes of
somatostatin receptors are present in the pancreas and
activation of these receptors results in the inhibition of
glucagon, insulin, and gastrin release.

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8
Q

What is the incidence of gallstones in somatostatin agonist use?

A

20-30%

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9
Q

how is pegvisomant able to block GH action?

A

Binds the receptor but does not allow dimerization

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10
Q

T-F–Prolactin is structurally homologous to
growth hormone, but the prolactin receptor
is not structurally homologous to the growth
hormone receptor.

A

False- both structurally homologous

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11
Q

What does prolactin stimulate? inhibit?

A
  1. lactation

2. reproductive functions

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12
Q

What is a very common cause of amenorrhea, galactorrhea, and female
infertility?

A

Hyperprolactinemia

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13
Q

What inhibits the release of prolactin?

A

hypothalamic dopamine

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14
Q

Vasopressin does what on V1 ? V2?

A
  1. V1 receptors in vascular smooth muscle:
    vasoconstriction.
  2. V2 receptors in renal tubule: increases
    resorption of water.
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15
Q

When is vasopressin used?

A

Used as replacement therapy in diabetes insipidus

of pituitary origin

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16
Q

Low Ca2+ or PTH leads to what?

A

skin/live/kidney creating more vitamin D and thus increasing Ca

17
Q

High Ca leads to what?

A

thyroid C cells releasing calcitonin and decreasing Ca

18
Q

T-F–glucocorticoids onGI tract decrease serum calcium and glucocorticoids on bone increase serum calcium?

A

true

19
Q

T-F–vitamin D is now associated with better prostate or breast health? how can it be administered?

A
  1. True

2. Oral or IM

20
Q

What does calcitonin do?

A

hormone made in the C cells of
the thyroid. It inhibits bone resorption and
causes decreased serum calcium

21
Q

How is calcitonin preparations given?

A

subQ, IM, nasal spray

22
Q

What are bisphosphates taken up by? what does etidronate do? what do the amino bisphosphates do?

A
  1. osteoclasts
  2. retards the dissolution of
    hydroxyapatite
  3. inhibitors of
    geranylgeranyl diphosphate synthase an enzyme
    involved in isoprenoid biosynthesis. This leads to
    an inhibition of bone resorption.
23
Q

What are the 2 classes of osteoporosis?

A
  1. age-related, postmeopause

2. drug induced (glucocorticoids)

24
Q

How do we prevent and treat osteoporosis?

A
  1. daily exercise
  2. diet and Ca intake, vit D
  3. prevent calcium mobilization from bone (bisphosphonates, calcitonin, raloxifene, estrogen/progestin combo post menopause)
25
Q

How is denosumab administered? PTH/teriparatide?

A

injection

injection

26
Q

What is the main difference between denosumab and PTH/teriparatide (forte)

A

the first stops osteoclasts, the 2nd stimulate`s osteoblasts

27
Q

What are the 4 causes of hypocalcemia?

A
  1. Dietary calcium deficiency
  2. Vitamin D deficiency (nutritional rickets)
  3. Other forms of vitamin D deficiency or
    resistance (metabolic rickets, osteomalacia)
  4. Hormonal imbalances (hypoparathyroidism,
    pseudohypoparathyroidism)
28
Q

What is vitamin D mainly used for?

A

increase Ca absorption with calcium salts

29
Q

What are the 4 causes of hypercalcemia?

A
  1. Hyperparathyroidism
  2. Ectopic PTH production
  3. Vitamin D excess
  4. Body immobilization