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Therapeutics > 51: Pituitary Hormones II > Flashcards

51: Pituitary Hormones II Flashcards

1
Q

Hypothalmic-pituitary-endocrine gland axis

A

Slide 5

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2
Q

Growth hormone functions

A

-aka somatotropin
-req during childhood and adolescence for normal size
-inc production of insulin-like growth factor I in liver bone cartilage muscle
-anabolic in muscle = inc lean body mass
-catabolic in lipid cells = reduce central adiposity
-reduction in insulin sensitivity

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3
Q

Growth hormone reduction in insulin sensitivity

A

-compensated by insulin activity of IGF-1

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4
Q

Deficiency of GH

A

-failure to reach adult height
-disproportional body fat
-dec muscle mass

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5
Q

Growth Hormone structure

A

-191-amino acid protein w 2 disulfide bonds
-similar to that of prolactin
-recombinant form

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6
Q

Growth Hormone metabolism

A

-20-25 min half-life
-cleared by liver
-rhGH admin SC and active for 36 hrs

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7
Q

Growth Hormone clinical use

A

-GH deficiency
-treat short kids (Willi or Turner syndrome)
-performance enhancer in athletics
-anti-aging?
-antiobesity
-use of rbGH in dairy

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8
Q

GH deficiency causes

A

-genetic
-damage to pituitary or hypothalmus

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9
Q

GH deficiency leads to

A

-short and fat
-HYPOglycemia due to unopposed insulin

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10
Q

Mecasermin

A

-rhIGF-1
-treat SEVERE IGF-1 deficiency
-complexed with rhIGFBP-3 to maintain half-life
-HYPOglycemia may occur

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11
Q

IGF-1 deficiency

A

-not responsive to exogenous GH
-mutations in GH receptor or GH neutralizing antibodies

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12
Q

Mecasermin side effect

A

-maybe HYPOglycemia
-due to insulin activity of rhIGF-1

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13
Q

GH ANTAgonists use

A

-treat GH secreting pituitary adenomas
-acromegaly
-gigantism

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14
Q

GH ANTAgonist drugs

A

-Octreotide
-Lanreotide
-Pegvisomant

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15
Q

Somatostatin analogs

A

-Octreotide
-Lanreotide

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16
Q

Pegvisomant

A

-GH ANTAgonist
-PEG derivative
-binds GH but blocks signal

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17
Q

Prolactin structure

A

-198-aa
-anterior pituitary
-similar to GH

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18
Q

Prolactin function

A

-lactation

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19
Q

Prolactin inhibited by

A

dopamine

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20
Q

Prolactin deficiency

A

-rare pituitary abnormality
-no prep of prolactin is available

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21
Q

Hyperprolactinemia

A

-caused by prolactin-secreting adenomas
-inhibit GnRH release
-amenorrhea and galactorrhea
-loss of libido/fertility in men

22
Q

Hyperprolactinemia treatment

A

-dopamine agonists

23
Q

Vasopressin and oxytocin

A

-posterior pituitary hormones
-synthesized in neuronal cell bodies in hypothalmus
-transported to posterior pituitary

24
Q

Vasopressin and oxytocin structures

A

-9aa with disulfide bond
-aa diff at positions 3 and 8
-same cross activity

25
Q

Desmopressin

A

-long acting vasopressin analog
-mod at position I and D-amino acid at 8

26
Q

Vasopressin

A

-Antidiuretic hormone (ADH)
-arginine vasopressin (AVP)

27
Q

Vasopressin released by

A

-posterior pituitary in response to
-rising plasma tonicity
-falling blood volume

28
Q

Vasopressin function

A

-inc reabsorption of water (antidiuretic) (dec urine volume) (inc blood volume)
-constricts blood vessels (vasopressor)(raise BP)
-inc levels of Von Willebrand factor and coagulation factor VIII

29
Q

Vasopressin metabolism

A

-IM or IV
-15 min half-life
-metabolized in kidney or liver
-reduction of the disulfide bond and peptide

30
Q

Desmopressin metabolism

A

-admin IV, SC, intranasally, orally
-half-life 1.5-2.5hrs

31
Q

Vasopressin receptors

A

-V1 and V2

32
Q

V1 receptor

A

-GPCR that inc Ca2+
-found on vascular smooth
-mediates vasoconstriction

33
Q

V2 receptor

A

-GPCR that increases cAMP
-renal tubule cells
-inc number or aquaporins on cell membrane = inc water permeability = water resorption

34
Q

Desmopressin V receptor activity

A

-minimal V1 activity
-4000 times higher antidiuretic-to-vasopressor activity than vasopressin

35
Q

Clinical Uses of vasopressin

A

-pituitary diabetes insipidus
-nocturnal enuresis
-coagulopathy in hemophilia A and von Wilderbrand’s disease

36
Q

Pituitary diabetes insipidus

A

-deficiency of vasopressin
-polyuria
-polydipsia
-hypernatremia
-desmopressin as nasal spray, oral tablet, or by injection

37
Q

Nocturnal enuresis

A

-bedwetting
-intranasal or oral admin of desmopressin at night

38
Q

Adverse effects of vasopressin

A

-water intoxication
-vasopressin should be used with extreme caution in persons with CVD
-ab cramping
-allergic reaction (rare)

39
Q

Vasopressin ANTAgonists

A

-Conivaptan
-Tolvaptan

40
Q

Vasopressin ANTAgonist use

A

-treat hyponatremia (associated w heart failure)
-given in acute care settings

41
Q

Conivaptan

A

-non-peptide antagonist of V1 and V2 receptors
-IV

42
Q

Tolvaptan

A

-selective V2 receptor antagonist
-oral

43
Q

Oxytocin functions

A

-uterine contraction in labor and delivery
-milk ejection in lactating women
-bonding, trust, love

44
Q

Mech of oxytocin on uterine contraction

A

-contracts uterin smooth muscle
-stimulates release of prostaglandins and leukotrienes that augment uterine contraction

45
Q

Mech of oxytocin on milk ejection

A

-contracts myoepithelial cells surrounding mammary alveoli

46
Q

Oxytocin general mech

A

-GPCR
-inc Ca2+ –> smooth muscle constriction

47
Q

Oxytocin at high concentrations

A

-weak antidiuretic and vasopressor activity

48
Q

Clinical uses of oxytocin

A

-induction and stimulation of labor
-control of uterine hemorrhage after delivery (IV)
-enhancement of milk ejection (nasal spray 2-3 min prior to nursing)

49
Q

Oxytocin adverse effects

A

-excessive stimulation of contraction before delivery
-activation of vasopressin receptors by overdose of oxytocin

50
Q

Excessive stimulation of contraction before delivery

A

-fetal distress
-placental abruption
-uterine rupture
-trauma to birth canal

51
Q

activation of vasopresssin receptors by overdose of oxytocin

A

-excessive fluid retention
-water intoxication
-hyponatremia

52
Q

Oxytocin contraindications

A

-fetal distress
-abnoraml fetal presentation
-cephalopelvic disproportion

Therapeutics (78 decks)

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