chapter 26- pharm of hypothalamus and pituitary gland Flashcards
what growth hormone replacement can be used to treat prader-willi and turner’s syndrome
somatotropin and somatrem
what are the common side effects of somatropin and somatrem use
increased intracranial pressure, pancreatitis, rapid growth of nevi
what are the contraindications for somatropin and somatrem use
patients with closed epiphyses, active underlying intracranial lesion, active malignancy, proliferative diabetic retinopathy
what inhibits the growth-promoting effect of somatotropin
glucocorticoids
what medication is used as diagnostic evaluation of decreased plasma growth hormone
sermorelin
what are the adverse effects of sermorelin use
transient flushing, chest tightness, antibody development
what are the adverse effects of tesamorelin use
arthralgia, peripheral edema, myalgia
what are the contraindications for tesamorelin use
active malignancy, pregnancy
what can be used to monitor IGF-1 and glucose level during therapy
tesamorelin
what medication can be used to treat laron dwarfism
mecasermin
what are the adverse effects of mecasermin
hypoglycemia, slipped upper femoral epiphysis, raised intracranial pressure, seizure, tonsillar hypertrophy
what is the mechanism of action of octreotide
inhibits GH release
what are the clinical applications for octreotide
esophageal varices, acromegaly, TSH-producing adenomas
what are the side effects of octreotide use
hypoglycemia, gallstone formation, diarrhea, lightheadedness
what is the clinical application of pegvisomant
acromegaly
what are the adverse effects of pegvisomant
elevated LFTs, HTN, peripheral edema, paresthesias, dizziness
what is the mechanism of action of pegvisomant
antagonizes GH receptor
what is the mechanism of action of bromocriptine
inhibits lactotroph growth
what are the clinical applications of bromocriptine
amenorrhea and galactorrhea from hyperprolactinemia, acromegaly, parkinson’s disease, premenstrual syndrome
what are the adverse effects of bromocriptine
dizziness, hypotension, abdominal cramps, nausea
what are the contraindications of bromocriptine
hypersensitivity to ergot derivatives, uncontrolled HTN, toxemia of pregnancy
what prolactin inhibitor may cause alcohol intolerance
bromocriptine
what is the clinical application of cabergoline
hyperprolactinemia
what are the adverse effects of cabergoline
MI, heart failure, pulmonary fibrosis, pleural effusion, hallucinations
what are the contraindications of carbergoline
pregnancy, uncontrolled HTN
what is the clinical application of protirelin
diagnosis of thyroid function
what are the adverse effects of protirelin use
seizure, amaurosis faux in patients with pituitary tumors, anxiety, diaphoresis
what medications decrease protirelin-mediated TSH release
cyproheptadine and thioridazine
what are the contraindications for thyrotropin (TSH)
adrenal insufficiency, coronary thrombosis
what is the main reason for thyrotropin
used to stimulate radioactive iodine uptake in the treatment of thyroid cancer
what drug is used to diagnose adrenocortical function, especially primary vs secondary
cosyntropin
what is the response to cosyntropin in primary adrenocortical deficiency
failure to increase plasma cortisol concentration
what are the adverse effects of cosyntropin use
increased intracranial pressure with papilledema, pseudo tumor cerebri, seizures, necrotizing vasculitis, induction of latent DM, bronchospasm
what are the contraindications for cosyntropin use
its with PUD, scleroderma, osteoporosis, systemic fungal infections, ocular herpes simplex, cushings syndrome
what is the clinical application of gonadorelin
diagnosis of hypogonadism, stimulate ovulation
what are the side effects of gonadorelin
anaphylaxis with multiple administrations, lightheadedness
what GnRH analogues can cause DVT
goserelin and leuprolide
what GnRH analogues can cause pituitary apoplexy
leuprolide
what are the clinical applications of ganirelix and cetrorelix
inhibition of premature LH surges in women undergoing control of ovarian hyper stimulation
what are the adverse effects of ganirelix
ectopic pregnancy, thrombotic disorder, spontaneous abortion
how do you get urofollitropin
isolated from urine of post-menopausal women
what are the clinical applications for follitropin and urofillitropin
ovulation induction, male hypogonadotropic hypogonadism
define primary endocrine disorder
caused by target organ pathology
define secondary endocrine disorder
reflects pituitary disease
define tertiary endocrine disorder
results from hypothalamic pathology
what does dopamine inhibit
lactotroph activity and prolactin
what does increased prolactin levels do to estrogen synthesis
surpasses it
what is CRH used for a diagnostic tool in
petrosal sinus sampling for ACTH
what is the most commonly used GnRH agonist
leuprolide
what produces ADH
magnocellular cells of hypothalamus
what drug is mainly used for GH insensitivity
mecasermin
what drug prevents GH receptor dimerization
pegvisomat
what drug is used for HIV lipodystrophy
tesamorelin
who is tolvaptan used in
people with heart failure
who is convaptan used in
people who are euvolemic or hypervolemic hyponatremia
what do LH and FSH share with TSH and hCG
alpha subunit
where are V2 receptors located
nephron
how is nephrogenic diabetes insidious treated
amiloride or hydrochlorothiazide
