Drugs affecting Hypo, Pit, and Thyroid function Flashcards
Growth hormone antagonist
pegvisomant
Somatostatin analogs
octreotide and lanretotide
Dopamine receptor agonists
cabergoline, bromocriptine,
GH agonists
Somatropin, somatrem (hGH+1 methionine)
IGF-1 agonists
mecasermin
GnRH receptor antagonists
ganirelix, cetrorelix, degarelix
GH levels in the blood is meaningless. How do you diagnose GH deficiency?
Inject insulin. This will cause hypoglycemia and increase GH levels.
GH ______ insulin effects.
opposes
With regards to blood glucose, kids with GH deficiency are at risk for what?
hypoglycemia
Why might a baby be born normal sized but still have GH deficiency?
GH is not needed for prenatal growth
_____ is the generic name of all GH that is identical with hGH.
Somatropin
_____ is the generic name of GH with one methionine.
Somatrem
hGH therapy in children is most effective when?
first 2 years
When should GH therapy be stopped in kids?
when growth stops
What are side effects of GH therapy in children?
intracranial HTN, papilledema, visual changes, headache, N/V, leukemia
When is GH contraindicated in children?
1-2 years following treatment of pediatric tumors
What happens to men when they take hGH?
Dallas McCarver
increased muscle, bone
Decreased fat
GH side effects in adults
peripheral edema, carpal tunnel, arthralgia, myalgia
How do athletes abuse GH?
use hGH and sermorelin (hGHRH) which escapes drug testing.
Does IGF-1 deficiency respond to hGH?
no
What is given in IGF1 deficiency?
Mecasermin: complex of IGF1 and IGFBP3. The binding protein extends the half life.
What is the best treatment for GH excess?
pituitary surgery. If not possible, use octreotide/lanreotide. Somatostatin analogs
Administration of octreotide and lanreotid
oct: 3x daily injections
lan: once every 4 wks?
Side effects of octreotide and lanreotide?
diarrhea, nausea, abdominal pain
What is pegvisomat?
Growth hormone antagonist that is used in acromegaly and decreases IGF-1. PEG: decreases renal clearance, increases half-life
Drugs used in the tx of hyperprolactinemia
cabergoline, bromocriptine
MOA cabergoline
Dopamine agonist- high affinity for D2. Longer half life.
MOA bromocriptine
dopamine agonist, not as well tolerated
What are the diagnostic and therapeutic uses of synthetic GnRH?
Diagnostic: differentiate between pituitary and hypothalamic defects in pt with hypogonadoptropic hypogonadism.
Tx pt with reproductive disorders secondary to deficiency of GnRH.
How is synthetic GnRH administered? What are side effects?
IV pump in pulsatile pattern
Phlebitis
Diagnostic uses of gonatdotropin
pregnancy kits (CG), time of ovulation (LH)
Therapeutic uses of gonadotropins
CG–> used to tx infertility
rFSH (a and b follitropin)–> infertility
Menotropin (LH and FSH)–> infertility
What is a risk in women using gonadotropins?
multiple pregnancy
What is tx of male infertility?
- Androgens to induce sexual development. Gonadotropins used when fertility is desired.
MOA of cetrorelix and ganirelix
Antagonist of GnRH.
Therapeutic uses of cetrorelix and ganirelis
in vitro fertilization. Delay premature LH surge and ovulation to allow collection of ova. Follows FSH therapy.
MOA and therapeutic uses of degarelix
GnRH antagonist. used for men with advanced prostate cancer.
What are the GnRH agonists?
goserelin, triptorelin, leuprolide , histrelin, nafarelin
MOA and uses of goserelin, triptorelin, and leuprolide
GnRH agonists Tx of prostate cancer. Initially increases LH production, then decreases LH and testoseterone due to receptor down-regulatin.
MOA and uses of histrelin
GnRH agonist, downregulates receptors, used in precocious puberty in boys and girls.
MOA and uses of nafarelin
GnRH agonist used in precocious puberty and endometriosis
MOA and uses of protirelin
stimulates TSH release from pituitary to test thyroid function
MOA and uses of thyrotropin-a hTRH
used in diagnostics for thyroglobulin levels
What are therapeutic uses of CRH?
diagnostics only- distinguish cushings from ectopic ACTH syndrome
