Pituitary And Thyroid Drugs Flashcards
(27 cards)
GH usage and mechanism
GH regulates IGF1 for normal growth, lipid and carbohydrate metabolism
Used for children that fail to grow (renal insufficiency, small for gestational age case), for adults having AIDs, malabsorption problems bcz of intestinal resection, for athelets to gain muscle mass
Adverse effects of somatotropin or GH
In children: pseudotumor cerebri, progression of edema, scoliosis, hyperglycemia, slipped capital femoral epiphysis
In adults: peripheral edema, migraine, arthralgia
Somatotropin usage
GH deficiency in children or genetic disorders like Turner’s, Noonan and prader willi
If children have growth failure and are unresponsive to GH, we give them
Mecasermin a recombinant of IGF1 is taken parenterally
Side effects: hypoglycemia ( prevented by eating before taking it)
Normal function of somatostatin
Inhibits Glucagon, gastrin, insulin and GH
Octreotide and lanreotide
Somatostatin analog used for acromegaly, gastrinoma, glucagonoma and carnoid tumors, variceal bleeding
Taken subcutaneously 2-4 times daily or slow release IM every 4 weeks
Side effects: GI distrubances, gallstones, bradycardia
Bromocriptine
Inhibits prolactin in hyperprolactinemia or galactorrhea
In high doses causes GH secrting tumors
Pegvisomant
Mutant GH that can cross link receptors but cannot activate them and is used for acromegaly
Normal LH function
Released by the anterior pituitary, in men leads to testosterone release and in women forms androsteinidone from cholesterol in theca cells to help in synthesis of estradiol
Normal FSH function
Released by anterior pituitary, in men stimulates spermatogenesis regulation, in women forms estradiol from androsteinidone in granulosa cells
Ovulation induction protocol using gonadotropins
-administration of GnRH agonist or antagonist for inhibition of gonadotropin production
-daily injections of a preparation with FSH activity (menotropin or FSH analogs) for follicles development
-injection of LH or LH analog human chorionic gonadotropin (hCG) for oocyte maturation
All administered parenterally
Menotropin
FSH+LH purified from urine of postmenopausal women
Urofollitropin or follitropin alpha and beta
FSH and analogs
Purified from urine or recombinant of human FSH respectively
Lutropin or hCG
Recombinant of LH or placental protein supporting the corpus luteum during early pregnancy actuvating LH receptors (purified or recombinant) respectively
In ovulation induction, we can use GnRH agonist or antagonists what are they?
Leuprolide agonist also used for endometriosis, uterine leiomyomata and in men for prostate cancer
Ganirelix, cetrorelix, degarelix (used for prostate cancer) antagonists
Side effects: hot flushes, sweats, headache and in men also gynecomastia induced libido, decreased hemantocrit, reduced bone density
2 hormones secreted by posterior pituitary
Oxytocin and vasopression ADH
Oxytocin can be given by IV for inducing labor or reinforcing it
ADH creats aquaporin channels to reabsorb water and cause vasoconstriction
Atosiban
Antagonist of oxytocin used as tocolytic (for preterm labor)
Desmopressin
Agonist of V2 receptor activation (causing water reabsorbtion) taken orally, nasally or parenterally for diabetes inspidus, mild hemophilia A (van willerband disease)
Conivaptan/tolvaptan
Drugs given to onset the fluid retention associated with excess of vasopressin because of acute HF or hyponatremia
Thyroid function regulation
Thyroid functions with iodine availability and thyrotropin (TSH)
TSH release is inhibited by high levels of thyroid hormones (- feedback)
Mechanism and effects of T3 and T4
They bind to to intracellular receptors controlling expression of genes
They affect normal growth and development of nervous, skeletal and reproductive systems, control metabolism of fats, carbs, proteins and vitamins
T3 and T4 drugs
Liothyromine and synthetic levothyroxine respectively
Thyrotoxicosis symptoms
It is the hyperthyroidism syndrome seen with warm, moist skin, sweating, tachycardia, increased stroke volume, cardiac output and pulse pressure. Dyspnea, increased apetite, nervousness, weakness, increased deep tendon reflexes, menstrual irregularity, decreased fertility, weight loss and exophthalmous in graves’ disease
Hypothyroidism symptoms
Pale, cool, puffy skin, srnsation of being cold, bradycardia, decreased stroke volume, cardiac output and pulse pressure.
Pleural effusions, hypoventilation and CO2 retention, reduced appetite, lethargy, slowing mental processes, stiffness, decreased deep tendon reflexes, infertility, decreased libido, impotence and oligospermia, weight gain.
