Hypothalamic and Pituitary Hormones Flashcards
(147 cards)
0
Q
dopamine aka
A
PROLACTIN-INHIBITING HORMONE
1
Q
GHRH or GROWTH HORMONE RELEASING HORMONE aka
A
SOMATROPIN-RELEASING HORMONE
2
Q
GROWTH HORMONE aka
A
SOMATROPIN
3
Q
ACTH or adrenocorticotropic hormone aka
A
CORTICOPTROPIN
4
Q
TSH aka
A
thyrotropin
5
Q
two distinct components of the pituitary gland
A
adenohypophysis
neurohypohysis
6
Q
connects hypothalamus and pituitary gland
A
hypothalamic or pituitary stalk
7
Q
hormones that pass thru the pituitary portal stalk to stimulate the pituitary gland to release or inhibit hormone production
A
hypophysiotrophic hormones secreted by neurosecretory cells in the hypothalamus
8
Q
hormones produced in the PPG will act
A
directly on target organs
9
Q
PPG hormones secreted in response to stimulus
A
VASOPRESSIN/ ADH
OXYTOCIN
10
Q
prolactin from APG acts
A
directly on mammary glands
11
Q
hormone that acts both directly and indirectly
A
GROWTH HORMONE
12
Q
hypothalamic and pituitary hormones are ALL
A
peptides
13
Q
hormones of the posterior pituitary are stored in
A
granules
14
Q
makes the hormone susceptible to destruction by proteolytic enzymes of the digestive tract
A
peptidyl nature
15
Q
TRH may
A
increase levels of PROLACTIN causing galactorrhea
16
Q
no pharmacologic preparation available
A
PROLACTIN
17
Q
hormones used for diagnosing pituitary insufficiency
A
GHRH CRH TRH TSH ACTH
18
Q
hormones released by the hypothalamus
A
TRH CRH GHRH GnRH Dopamine somatostatin
19
Q
anterior pituitary gland hormones
A
TSH ACTH GH FSH, LH PRL GH
20
Q
posterior pituitary gland relese the ff hormones
A
VASOPRESSIN / ADH
OXYTOCIN
21
Q
steroid or steroid-like hormones are _____ in the circulation
A
protein bound
22
Q
only the ____ form of steroid and steroid like hormones that is active and can enter the cell membrane
A
free
23
Q
peptides cannot enter the cell membrane therefore they are
A
hypdrophilic
24
receptor for GH and PRL
Jak STAT
| Januse kinase signal transducer and activator of transcription
25
receptor for GHRH, TSH, FSH, LH, ACTH, VASOPRESSIN
Gs
26
Gs function
stimulates adenylyl cyclase
27
receptor for SST and DOPAMINe
Gi
28
Gi function
inhibits adenylyl cyclase
29
GnRH, OXYTOCIN, VASOPRESSIN 1A & B receptor
Gq
30
Gq function
muscarinic receptor
| 2nd messenger for IP/DAG
31
SST or somatostatin aka
growth hormone-inhibiting hormone
32
SST is secreted by
the D cells of the stomach
| the delta cells of the islets of Langerhan
33
somatostatin moa
inhibits secretion of GH, TSH, INSULIN, GLUCAGON, GASTRIN, and other GI hormones
34
use of somatostatin is limited due to
short duration of action
multiple effects esp in cho metabolism
rebound hypersecretion
35
SST analogs
OCTREOTIDE (Sandostatin)
| LANTEOTIDE
36
receptors for OCTREOTIDE
SSt-2
37
selectivity of OCTREOTIDE to SST2 receptors have less
effect on insulin therefore less hyperglycemia
38
OCTREOTIDE preparation
50-200 mcg SC q8hr, once a month
39
indication for SST ANALOGS
acromegaly
GEP tumors such as carcinoid and gastrinoma
bleeding esophageal varices
40
SST analog dosage for acromegaly
initially 0.05 - 0.1 mg, SC q8-12 hr
| max of 1.5 mg per day
41
gep tumor tx of sst analog dosage
initially 0.05 mgOD/BID
| may gradually inc to 0.1-0.2mg TID
42
SST analog adverse effects
GIT 50%
Gallstones 20%
43
GH receptor antagonist
PEGVISOMANT
44
effect of PEGVISOMANT
blocks peripheral effects of GH ➡️ decrease IGF 1
45
PEGVISOMANT administration
daily via SC route
46
PEGVISOMANT Indication
px with acromegaly who do not respond to SST analogs
47
PEGVISOMANT AE
inc in tumor size- uncommon
| changes in liver fxn tests
48
physiological fxn of GnRH
released in PULSATILE manner that controls the synthesis and release of FSH and LH
49
pharmacological fxn of GnRH
pulsatile: every 4hrs, stimulates GONADOTROPIN release
continuously: via injection, inhibits GONADOTROPIN RELEASE
50
cause of iNhibitory release of gonadotropin when released continuously
receptor desensitization
downregulation
changes in signaling pathways
51
GnRH analogs
```
LEUPROLIDE
GOSERELIN
NAFRELIN
GONADORELIN HCL
BUSERELIN
```
52
LEUPROLIDE preparation
7.5mg per month IM for prostatic cancer
q3months
1mg/day SC
53
GOSERELIN preparations
3.6 mg SC q28days
54
NAFARELIN preparation
nasal spray 200 mcg BID
| not available!
55
uses (rare) of GnRH
pulsatile: pituitary stimulation in GnRH deficiency (male or female)
continuous: suppress gonadotropins
diagnostic
56
GnRH use for pituitary stimulation in GnRh deficiency addresses
male or female infertility or hypogonadism
57
suppression of gonadotropins through continous admin of gnRh is for
```
endometriosis
central precocious puberty
prostatic cancer and BPH
uterine leiomyoma
contraception
ART
```
58
form of GnRH analog for GnRH deficiency
GONADORELIN INFUSION PUMP, IV or SC
short half life
59
cause of GnRH use in assistied reproductive technology
prevent premature ovulation caused by FSH and LH injection
60
GnRH is a diagnostic tool for
delayed puberty in hypogonadism
61
GnRH analogs AE
flare or worsening of symptoms
headache, abdominal discomfort, hot flushes
decreased bone density with prolonged use
62
flare occurs during
first 7-10 days of treatment
63
GnRH antagonist moa
suppress gonadotropin release
potent mast cell degranulators
64
GnRH antagonists
CETRORELIX
GANIRELIX
DEGARELIX
65
CENTRORELIX (Cetrotide) preparation
250 mcg SC OD
66
use of GnRH antagonists
female infertility, ART
| advanced prostate cancer
67
specific GnRH antagonist drug for advanced prostate cancer
DEGARELIX
68
GnRH antagonist most common AE
nausea, headache
69
GnRH antagonist ae
nausea, headache
hot flushes, sweats, depression, decreased libido
NO FLARE SYMPTOOOOMS!
70
Dopamine action
reduces elevated PROLACTIN level caused by physiologic, pathogenic, iatrogenic conditions
71
PIH analogs are _____ agonists
D2
72
effect of PIH analogs on normal patients
increase GH release
73
PIH analogs effect on acromegaly patients
suppress GH release
74
PIH analogs are given
orally
75
only available PIH analog
BROMOCRIPTINE (parlodel)
76
PIH analogs
BROMOCRIPTINE
CABERGOLINE
PERGOLINE
QUINAGOLIDE
77
main use of PIH analogs
hyperprolactinemia in patients with prolactinoma or hypothyroidism
78
uses of PIH analogs
hyperprolactinemia
suppress physiologic lactation
Parkinson's dse
acromegaly
79
BROMOCRIPTINE is not recommended for physiologic lactation because
risk of thromboembolism
80
AE of PIH analogs
```
nausea, vomiting
headache, dizziness
constipation
fatigue
cramps
hair loss
hallucination
dyskinesia
dry mouth
```
81
direct effects of SOMATOTROPIN
increased lipolysis➡️increased fat utilization➡️increased FFA in plasma
mixed effect on CHO metabolism
82
somatotropin directly decreases sugar levels by
increasing IGF ➡️increased INSULIN
83
indirect effects of SOMATOTROPIN
skeletal growth
increased cell proliferation
increased protein anabolism
increased formation of HYDROXYPROLINE from PROLINE boosts cartilage synthesis
84
approved uses of SOMATOTROPIN
```
GH deficient children and adults
hypogonadism and growth failure in Turner's sx, Prader-Willi sx
CRF in pedia patients
SGA or small for gestational age
NGHDSS
```
85
approved uses of SOMATOTROPIN in adults without GH deficiency
wasting in AIDS px
short bowel sx in patients on parenteral nutrition
86
unapproved uses of SOMATOTROPIN
increase muscle mass in adult athletes
anti-aging
87
AE of SOMATOTROPIN
Creutzfeldt-Jakob dse
children: hypothyroidism,scoliosis,increased intracranial pressure
adults: peripheral edema,myalgia,arthralgia, new onste of Type 2 DM
88
CI of GH
acute critical illness ➡️ increased mortalities
evidence of neoplasm
closed epiphyses
89
GH on drug interaction
increases CYP450 activity, enzyme inducer
90
rHGH drugs
SOMATROPIN
SOMATREM
HUMAN GROWTH HORMONE
91
SOMATROPIN preparation
0.025-0.07 mg/kg/week IM/SC x 4 years or until epiphyses have fused
inc dose for px with Turner's sx and chronic renal insufficiency
92
highest level of GH are released in pulsatile manner during
SLEEP!
93
elevated GH levels in patients with acromegly are reflected by
increase in IGf-1
94
FSH stimulates
gametogenesis, folliculare development
| spermatogenesis
95
stimulated by FSH to provide nutrients to spermatogenic epithelium
Sertoli cells
96
FSH effect in women
responsible for early development and growth of ovarian follicles
97
LH regulates
gonadal steroid hormone production or steroidogenesis
98
LH in men
stimulates growth of Leydig cells which produce androgens causing ext sexual maturation
99
LH in women
responsible for final maturation of the ovarian follicles and estrogen secretion
for ovulation, the initial formation of corpus luteum, and secretion of progesterone
100
hCG function
stimulates ovaria corpeus luteum to produce progesterone and maintiain placenta
101
hCG is a substitute for
LH
102
hCG is derived from
syncytiotrophoblast of placenta
103
1st line of drug for women suffering anovulation
CLOMIFENE
104
gonadotropic hormone preparation for female infertility derived from urine of postmenopausal women
hMG or uFSH
| 75 iu IM OD, 7-12 days ➡️CG 5000-10000 IU im
105
oligospermia is treated with this gonadotropic hormone preparation
hCG+hMG x 4-6 months
| give both LH and FSH for sperm maturation
106
pregnancy diagnosis
hCG levels
107
ovulation diagnosis
LH level
108
ART day 1-11
hMG or uFSH with or without LH
stimulate follicular enlargement
109
ART day 7-11 n
give GnRH antagonist (CETRORELIX) to suppress premature ovulatio
110
ART day 12
give hCG
to mimic LH surge
111
ART after 34-46 hours - day 13?
egg retrieval or insemination either by ISCI or IVF
give PROGESTERONE to prime the uterus before implanting
112
gonadotropic hormones AE
multiple pregnancies 15-20%
113
multiple pregnancies as AE of gonadotropic tx result to
increased risk of premature delivery, gestational diabetes, preeclampsia, CS
114
ovarian hyperstimulation results to
ascites, hydrothorax, hypovolemic shock, thromboembolism, death
115
purified extract of FSH and LH
MENOTROPIN
116
Menotropin is derived from
urine of postmenopausal women
117
primarily FSH preparation with LH removed
UROFOLLITROPIN or uFSH
118
stimulates estrogen secretion more efficiently
| has short half life
rFSH
119
rFSH available as pen that can be injected
FOLLITROPIN alpha- Gonal-f
120
LH substitute that induces ovulation
hCG
121
may only be used with rFSH follitropin alpha for stimulation of follicular development in infertile women with LH deficiency
rLH/ LUTROPIN
122
LUTROPIN is NOT used
to induce ovulation
| to stimulate endogenous LH surge for follicular development and ovulation
123
not regulated by releasing hormones
posterior pituitary hormones
124
posterior pituitary hormone structure
nonapeptide with a circular structure due to disulfide bridges
125
effects of OXYTOCIN
milk ejection
induce uterine contraction
weak antidiuretc and pressor effects
126
onset of OXYTOCIN
fast
127
preparation for induction or augmentation
IV
128
prep for postpartum hemorrhage
IV, IM
129
half life of oxytocin
short, 3 mins
130
assess term or post-term pregnancy for fetal well being
oxytocin challenge test or contraction stress test
131
oxytocin AE
uterine overstimulation
hypertension
water retention
afibrogenemia
132
oxytocin CI
fetal distress
prematurity
abnormal fetal presentation
cephalopelvic disproportion
133
preparation of oxytocin
5 iu per mL , IV or IM
134
IV oxytocin
induction of labor
135
IM oxytocin
postpartum hemorrhages
136
induced by high plasma tonicity and low BP
vasopressin or ADH
137
v1 is found in
vascular smooth muscles ➡️ vasoconstriction
| Gq receptor
138
V2 is found in
renal tubular cells
| endothelium
139
v2 receptor activation
stimulate and inc cAMP➡️inc PKA➡️inc synthesis of aquaporin channel 2➡️inc water resorption
140
extrarenal v2 receptors regulate
release of factor 8 and vWF
141
uses of vasopressin
central diabetes insipidus
nocturnal enuresis
haemophilia A and vWF dse
variceal bleeding
142
central diabetes insipidus tx
0.1-0.2 mg TID DESMOPRESSIN
143
nocturnal enuresis tx
0.2mg at HS
144
AE of ADH
```
GIT disturbances
nausea and vomiting
hyponatremia
vasoconstriction- angina or MI
headache
```
145
parenteral ADH for pressor effect like septic shock
VASOPRESSIN
146
nasal spray, oral, parenteral preparation of ADH commonly used with more v2 effect
DESMOPRESSIN
