Sketchy Pharm: Growth Hormone, Mecasermin, Octreotide, Pegvisomant

Question 1

What kind of receptor does growth hormone bind to?

Answer 1

A JAK tyrosine kinase (like how JAcK has a TiRe swing on his house)

Question 2

The JAK-STAT pathway ultimately leads to the increased expression of ______________.

Answer 2

insulin-like growth factor 1 (IGF-1) from the liver

(Sketchy symbolizes this by the raised Welcome Inside mat –lifted by the beanstalk –that is emerging out of the liver-shaped rock.)

Question 3

Aside from inducing the release of IGF-1, GH also does what?

Answer 3

It causes an anabolic effect in striated muscle (symbolized by the muscle-like leaf on the GH vine) and a catabolic effect in adipose tissue (like the jar of doughnuts spilling off the roof in response to the growing vine).

Question 4

In what instances is growth hormone used?

Answer 4

• Growth hormone deficiency, either idiopathic or caused by trauma
• Idiopathic short stature (like the small, stunted kid)
• Turner syndrome (girl doing cartwheel)
• Prader-Willi syndrome (like the monk Padre Willy)

Question 5

Prader-Willi is caused by a missing part of ___________.

Answer 5

the paternal chromosome 15 (like the Father’s hidden arm)

Question 6

What can be given to kids with normal amounts of GH and low amounts of IGF-1?

Answer 6

Recombinant IGF-1, called mecasermin; this drug has to be given carefully, however, because IGF-1 alone can cause hypoglycemia without the hyperglycemic effects of GH.

(Think of the SERMoN with the church behind the large vine raising the IGF mat – the kid is spilling candy over the edge.)

Question 7

What three things can treat acromegaly?

Answer 7

Surgical resection (transsphenoidal resection), dopamine-2 agonists, or somatostatin (like the stop sign shown by the villager to the giant coming down the vine)

Question 8

Somatostatin can stop the diarrhea from _______________.

Answer 8

carcinoid tumors, insulinomas, glucagonomas, gastrinoma, and VIPomas

(Think of the VIP crab sign hanging on the vine, the giant glucagon bag, the lawnmower powered by gastrin, and the insulin mat.)

Question 9

By a poorly understood mechanism, somatostatin is able to ________________.

Answer 9

cause vasoconstriction of esophageal varices

Question 10

What are side effects of somatostatin?

Answer 10

Nausea, vomiting, and steatorrhea

(Think of the woman standing behind all the symbols for somatostatin –she’s green, vomiting, and standing on a yellow stool, like what occurs in steatorrhea.)

Question 11

Other than somatostatin, what two drugs inhibit the release of GH from the pituitary?

Answer 11

The D2 agonists cabergoline and bromocriptine (represented by the BuRGLer and the BROoM he’s absconding with down the dope-rope ladder)

Question 12

The drug _______________ blocks GH at its receptor.

Answer 12

pegvisomant

Think of the ANTs climbing up the TYRE swing rope.