Drugs affecting Hypo, Pit, and Thyroid function

Question 1

Growth hormone antagonist

Answer 1

pegvisomant

Question 2

Somatostatin analogs

Answer 2

octreotide and lanretotide

Question 3

Dopamine receptor agonists

Answer 3

cabergoline, bromocriptine,

Question 4

GH agonists

Answer 4

Somatropin, somatrem (hGH+1 methionine)

Question 5

IGF-1 agonists

Answer 5

mecasermin

Question 6

GnRH receptor antagonists

Answer 6

ganirelix, cetrorelix, degarelix

Question 7

GH levels in the blood is meaningless. How do you diagnose GH deficiency?

Answer 7

Inject insulin. This will cause hypoglycemia and increase GH levels.

Question 8

GH ______ insulin effects.

Answer 8

opposes

Question 9

With regards to blood glucose, kids with GH deficiency are at risk for what?

Answer 9

hypoglycemia

Question 10

Why might a baby be born normal sized but still have GH deficiency?

Answer 10

GH is not needed for prenatal growth

Question 11

_____ is the generic name of all GH that is identical with hGH.

Answer 11

Somatropin

Question 12

_____ is the generic name of GH with one methionine.

Answer 12

Somatrem

Question 13

hGH therapy in children is most effective when?

Answer 13

first 2 years

Question 14

When should GH therapy be stopped in kids?

Answer 14

when growth stops

Question 15

What are side effects of GH therapy in children?

Answer 15

intracranial HTN, papilledema, visual changes, headache, N/V, leukemia

Question 16

When is GH contraindicated in children?

Answer 16

1-2 years following treatment of pediatric tumors

Question 17

What happens to men when they take hGH?

Answer 17

Dallas McCarver
increased muscle, bone
Decreased fat

Question 18

GH side effects in adults

Answer 18

peripheral edema, carpal tunnel, arthralgia, myalgia

Question 19

How do athletes abuse GH?

Answer 19

use hGH and sermorelin (hGHRH) which escapes drug testing.

Question 20

Does IGF-1 deficiency respond to hGH?

Answer 20

no

Question 21

What is given in IGF1 deficiency?

Answer 21

Mecasermin: complex of IGF1 and IGFBP3. The binding protein extends the half life.

Question 22

What is the best treatment for GH excess?

Answer 22

pituitary surgery. If not possible, use octreotide/lanreotide. Somatostatin analogs

Question 23

Administration of octreotide and lanreotid

Answer 23

oct: 3x daily injections
lan: once every 4 wks?

Question 24

Side effects of octreotide and lanreotide?

Answer 24

diarrhea, nausea, abdominal pain

Question 25

What is pegvisomat?

Answer 25

Growth hormone antagonist that is used in acromegaly and decreases IGF-1. PEG: decreases renal clearance, increases half-life

Question 26

Drugs used in the tx of hyperprolactinemia

Answer 26

cabergoline, bromocriptine

Question 27

MOA cabergoline

Answer 27

Dopamine agonist- high affinity for D2. Longer half life.

Question 28

MOA bromocriptine

Answer 28

dopamine agonist, not as well tolerated

Question 29

What are the diagnostic and therapeutic uses of synthetic GnRH?

Answer 29

Diagnostic: differentiate between pituitary and hypothalamic defects in pt with hypogonadoptropic hypogonadism. Tx pt with reproductive disorders secondary to deficiency of GnRH.

Question 30

How is synthetic GnRH administered? What are side effects?

Answer 30

IV pump in pulsatile pattern | Phlebitis

Question 31

Diagnostic uses of gonatdotropin

Answer 31

pregnancy kits (CG), time of ovulation (LH)

Question 32

Therapeutic uses of gonadotropins

Answer 32

CG--> used to tx infertility rFSH (a and b follitropin)--> infertility Menotropin (LH and FSH)--> infertility

Question 33

What is a risk in women using gonadotropins?

Answer 33

multiple pregnancy

Question 34

What is tx of male infertility?

Answer 34

1. Androgens to induce sexual development. Gonadotropins used when fertility is desired.

Question 35

MOA of cetrorelix and ganirelix

Answer 35

Antagonist of GnRH.

Question 36

Therapeutic uses of cetrorelix and ganirelis

Answer 36

in vitro fertilization. Delay premature LH surge and ovulation to allow collection of ova. Follows FSH therapy.

Question 37

MOA and therapeutic uses of degarelix

Answer 37

GnRH antagonist. used for men with advanced prostate cancer.

Question 38

What are the GnRH agonists?

Answer 38

goserelin, triptorelin, leuprolide , histrelin, nafarelin

Question 39

MOA and uses of goserelin, triptorelin, and leuprolide

Answer 39

GnRH agonists Tx of prostate cancer. Initially increases LH production, then decreases LH and testoseterone due to receptor down-regulatin.

Question 40

MOA and uses of histrelin

Answer 40

GnRH agonist, downregulates receptors, used in precocious puberty in boys and girls.

Question 41

MOA and uses of nafarelin

Answer 41

GnRH agonist used in precocious puberty and endometriosis

Question 42

MOA and uses of protirelin

Answer 42

stimulates TSH release from pituitary to test thyroid function

Question 43

MOA and uses of thyrotropin-a hTRH

Answer 43

used in diagnostics for thyroglobulin levels

Question 44

What are therapeutic uses of CRH?

Answer 44

diagnostics only- distinguish cushings from ectopic ACTH syndrome