Chapter 62 Drugs R/t Hypothalamic and Pituitary Function Flashcards
Hypothalamic/Pituitary Fx - Hormones of the anterior pituitary? Hormones of the Posterior Pituitary? (review)
Hormones of the ANTERIOR PITUITARY
– Growth hormone (GH)
– Adrenocorticotropic hormone (ACTH)
– Thyroid-stimulating hormone (TSH)
– Follicle-stimulating hormone (FSH)
– Luteinizing hormone (LH)
– Prolactin (PRL)
Hormones of the POSTERIOR PITUITARY
– Oxytocin
– Anti-diuretic hormone (ADH)
HYPOTHALAMIC reelasing factors are? (review)
Gonadotrophic hormone (GnRH)
* Growth hormone-releasing hormone (GH-RH)
* Prolactin releasing factor (PRF)
* Corticotropin-releasing hormone (CRH)
* Thyrotropin-releasing hormone (TRH)
* Somatostatin
* Dopamine
Growth hormone deficiency is seen as? Excess?
GH Deficiency
Pede - short stature, slow growth, low mental fx, need of replacement tx
Adult reduce mm. mass
GH Excess
Pede - gigantism, tx is removal of pituitary gland
Adult acromegaly, tx is sx, rad, or drugs
Why would we use growth hormone?
Pede growth deficiency, short stature, adult growth hormone deficiency
A/e of growth hormone?
Hyperglycemia
Neutralizing anitbodies
Carpal tunnel syndrome
Fatality of pts w/ Prader Willi syndrome
Interactions w glucocorticoids
What tx is best for acromegaly?
Somatostatin analogs (octreotide and lanreotide) are the most effective
drugs for suppressing GH release given IM or SubQ
What does prolactin do? Hypersecretion effects on males or females?
Stimulate milk production after parturition (giving birth)
Males - delays puberty in boys, reduced libido, galactorrhea
Females - galactorrhea, infertility, delay puberty, amenorrhea
What is galactorrhea?
Galactorrhea is a condition where a milky discharge occurs from the breasts, usually from one or both nipples, even when the person is not pregnant or breastfeeding
Tx for hypersecretin of prolactin?
Suppression of prolactin release via…
* Cabergoline [Dostinex®] –> 2x weekly
* Bromocriptine [Parlodel®] –> daily
What does ADH (vasopressin) do? Produced where again?
Promotes renal conservation of water
Works on the collecting ducts of the kidney to increase their permeability to water by allowing water reabsorption
Produced in the hypothalamus, released by posterior pituitary gland
What is the therapeutic use of ADH (vasopressin)?
DI –> decreasing UO
Postop abd distention –> reduce gas
Enuresis (bedwetting) –> DDAVP (a synthetic ADH at bedtime!
What is diabetes insipidus? (review) Medication of choice?The medication can lead to what?
Deficiency of ADH leading to polydipsia –> increased thirst d/t volume depletion by excretion of large volumes of dilute urine
Tx is Desmopressin (does not affect BP as much) but can lead to water toxicity
Where is the hormone oxytocin released from?
Produced by hypothalamus and released from the posterior pituitary gland
Uterine contractions and stimulation of milk ejection during breast feeding
What 3 hypothalamic functions have clinical applications?
Gonadotropin-releasing hormone (GnRH) and its synthetic analogs (not mentioned in
chapter 62) –> inhibit production of androgens and estrogens
*Used to treat prostate cancer and endometriosis and to induce ovulation
Corticotropin-releasing hormone (CRH): Used to diagnose adrenal disorders
Somatostatin: Used to treat acromegaly
