Flashcards in Hypothalamic and Pituitary Hormones 1.3 Deck (15):
Gonadotropins act through what?
Clinical applications of Gonadotropins
1) Ovulation Induction
2) Male infertility (req both FSH and LH)
AE of gonadotropins in Women
1) Ovarian hyperstimulation syndrome
2) Multiple pregnancies
3) Headache, depression edema, precocious puberty
AE of gonadotropins in Men
Gonadotropin-releasing hormone analogs
What type of GnRH secretion is required to STIMULATE release of LH and FSH?
What type of GnRH secretion is required to INHIBIT FSH and LH release (men & woman) leading to hypogonadism.
What is unique regarding GnRH analog administration?
- agonist flare in first 7 days
- chronic effects (> 1 week) = inhibitory action (due to receptor down-regulation & changes in signaling pathways
Clinical application of GnRH for males with infertility
In men with hypothalamic
hypogonadotropic hypogonadism (pulsatile gonadorelin)
Besides infertility, another stimulation application for GnRH analogs
Diagnosis of LH responsiveness: Whether delayed puberty is due to constitutional delay or hypogonadotropic
Indication for when GnRH and analogs are used for suppression:
1) Controlled ovarian hyperstimulation (leuprolide, nafarelin)
2) Endometriosis (Leuprolide, goserelin, nafarelin)
3) Central Precocious Puberty (leuprolide, nafarelin)
4) Advanced breast & ovarian cancer
5) Treatment of amenorrhea and infertility in women with PCOD
6) Thinning of endometrial lining
Notable AE of Gonadorelin
1) Generalized hypersensitivity dermatitis (long term administration)
2) Rare acute hypersensitivity reaction
3) Sudden pituitary apoplexy and blindness (reported in patients with gonadotropin-secreting pit. tumor)
Competitive antagonist of GnRH receptors