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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
Desmopressin
-long acting vasopressin analog -mod at position I and D-amino acid at 8
26
Vasopressin
-Antidiuretic hormone (ADH) -arginine vasopressin (AVP)
27
Vasopressin released by
-posterior pituitary in response to -rising plasma tonicity -falling blood volume
28
Vasopressin function
-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
Vasopressin metabolism
-IM or IV -15 min half-life -metabolized in kidney or liver -reduction of the disulfide bond and peptide
30
Desmopressin metabolism
-admin IV, SC, intranasally, orally -half-life 1.5-2.5hrs
31
Vasopressin receptors
-V1 and V2
32
V1 receptor
-GPCR that inc Ca2+ -found on vascular smooth -mediates vasoconstriction
33
V2 receptor
-GPCR that increases cAMP -renal tubule cells -inc number or aquaporins on cell membrane = inc water permeability = water resorption
34
Desmopressin V receptor activity
-minimal V1 activity -4000 times higher antidiuretic-to-vasopressor activity than vasopressin
35
Clinical Uses of vasopressin
-pituitary diabetes insipidus -nocturnal enuresis -coagulopathy in hemophilia A and von Wilderbrand's disease
36
Pituitary diabetes insipidus
-deficiency of vasopressin -polyuria -polydipsia -hypernatremia -desmopressin as nasal spray, oral tablet, or by injection
37
Nocturnal enuresis
-bedwetting -intranasal or oral admin of desmopressin at night
38
Adverse effects of vasopressin
-water intoxication -vasopressin should be used with extreme caution in persons with CVD -ab cramping -allergic reaction (rare)
39
Vasopressin ANTAgonists
-Conivaptan -Tolvaptan
40
Vasopressin ANTAgonist use
-treat hyponatremia (associated w heart failure) -given in acute care settings
41
Conivaptan
-non-peptide antagonist of V1 and V2 receptors -IV
42
Tolvaptan
-selective V2 receptor antagonist -oral
43
Oxytocin functions
-uterine contraction in labor and delivery -milk ejection in lactating women -bonding, trust, love
44
Mech of oxytocin on uterine contraction
-contracts uterin smooth muscle -stimulates release of prostaglandins and leukotrienes that augment uterine contraction
45
Mech of oxytocin on milk ejection
-contracts myoepithelial cells surrounding mammary alveoli
46
Oxytocin general mech
-GPCR -inc Ca2+ --> smooth muscle constriction
47
Oxytocin at high concentrations
-weak antidiuretic and vasopressor activity
48
Clinical uses of oxytocin
-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
Oxytocin adverse effects
-excessive stimulation of contraction before delivery -activation of vasopressin receptors by overdose of oxytocin
50
Excessive stimulation of contraction before delivery
-fetal distress -placental abruption -uterine rupture -trauma to birth canal
51
activation of vasopresssin receptors by overdose of oxytocin
-excessive fluid retention -water intoxication -hyponatremia
52
Oxytocin contraindications
-fetal distress -abnoraml fetal presentation -cephalopelvic disproportion

Therapeutics (78 decks)

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