E4: Hypothalamic & Pituitary

Question 1

What is the treatment strategy when dealing with Endocrine disorders?

Answer 1

Either synthetic hormones (made by recombinant DNA technology which mimic effects of endogenous hormones, or drugs which block the effects of endogenous hormones

Question 2

Describe the hormones & associated gland/organs for the HP-Thyroid axis

Answer 2

Hypothalamus: Thyrotropin-Releasing Hormone (TRH) release

stimulates

Anterior Pituitary: Thyroid Stimulating Hormone (TSH) (aka Thyrotropin) release

stimulates

Thyroid Gland: Thyroid hormone (T3 & T4) release

Question 3

Describe the hormones & associated gland/organs for the HP-Adrenal axis

Answer 3

Hypothalamus: Corticotropin-Releasing Hormone (CRH) release

stimulates

Anterior Pituitary: Adrenocorticotropic Hormone (ACTH) release

stimulates

Adrenal Gland: Corticosteroid (Cortisol, aldosterone, androgens) release

Question 4

Describe the hormones & associated gland/organs for the HP-Gonadal axis

Answer 4

Hypothalamus: Gonadotropin-Releasing Hormone (GnRH) release

stimulates

Anterior Pituitary: Follicle-Stimulating Hormone (FSH) & Luteinizing Hormone (LH) release

stimulates

Gonads: Sex-Hormones (Estrogen/progesterone, & Testosterone) release

Question 5

Growth Hormone

Target organs?

Effects?

Answer 5

Target organs:

• Liver
• Bone
• Cartilage
• Muscle
• Fat

Effect:

Stimulates growth & repair in all tissues, but especially in target organs

Question 6

Thyroid-Stimulating Hormone (TSH)

Target organs?

Effects?

Answer 6

Target organs: Thyroid Gland

Effect:

Stimulates thyroid growth; synthesis & secretion of Thyroxine

Question 7

Adrenocorticotropic Hormone

Target organs?

Effects?

Answer 7

Target organs: Adrenal Cortex

Effect:

Stimulates Synthesis & Secretion of glucocorticoids (Cortisol)

Question 8

Follicle Stimulating Hormone

Target organs?

Effects?

Answer 8

Target organs:Gonads

Effect:

Stimulates synthesis of sperm & ova; Secretion of estrogen & testosterone

Question 9

Luteinizing Hormone

Target organs?

Effects?

Answer 9

Target organs:Gonads

Effect:

Controls synthesis of sex hormones (estrogen & testosterone)

Female: Ovulation & maintenance of corpus leutum

Male: Testosterone secretion

Question 10

Prolactin

Target organs?

Effects?

Answer 10

Target organs: Mammary glands & Testes

Effect:

Stimulates milk production & testosterone secretion

Question 11

Antidiuretic Hormone (ADH)

Target organs?

Effects?

Answer 11

Target organs: Kidneys

Effect:

Water retention

Question 12

Oxytocin

Target organs?

Effects?

Answer 12

Target organs: Uterus & mammary glands

Effect:

Labor contractions, milk release, mother-infant bonding

Question 13

What are the positive feed back loops within the endocrine system?

Answer 13

1. Nursing reflex
2. Labor contractions

Both are associated with Oxytocin release

Question 14

Acromegaly:

What is the cause?

What is the treatment?

Answer 14

Acromegaly is cause by hypersecretion of Growth Hormone in adulthood

Pharmaceutical treatment:

Octreotide: Somatostatin analogue; inhibits Growth hormone

Question 15

What is Cosyntropin?

Answer 15

Synthetic corticotropin analogue used to diagnose Adrenal Insufficiency

Question 16

What is Corticorelin Ovine Triflutate?

Answer 16

Corticotropin-Releasing Hormone used as a diagnostic tool to distinguish Adrenal & pituitary origins of Cushing Syndrome.

Question 17

What is Somatropin?

Answer 17

Recombinant somatropin is a recombinant growth hormone prep used to treat GH deficiency in children w/ low growth rate

Question 18

What is Octreotide?

Answer 18

Octreotide is a synthetic growth hormone-inhibiting hormone (somatostatin) analogue used in the treatment of;

• Acromegaly
• Carcinoid syndrome
• Pituitary adenomas that secrete thyrotropin
• Tumors that secrete vasoactive intestinal polypeptide.

Question 19

What is pegvisomant?

Answer 19

Pegvisomant is a growth hormone analogue and growth hormone receptor antagonist used to treat acromegaly

Question 20

Which drugs discussed are associated with Growth-Hormone?

Answer 20

1. Somatropin
2. Octreotide
3. Pegvisomant

Question 21

What are Menotropins and chorionic gonadotropin?

Answer 21

•Menotropins and chorionic gonadotropin are human gonadotropin preparations used to induce ovulation in infertile women.

Chorionic gonadotropin is also used to stimulate spermatogenesis in men with hypogonadotropic hypogonadism and to treat cryptorchidism in prepubertal boys

Question 22

What are Goserelin & leuprolide?

Answer 22

Goserelin & leuprolide are synthetic GnRH preparations

Administered continuously to suppress gonadotropin secretion in children with precocious puberty and in adults with prostate cancer, breast cancer, and endometriosis

Question 23

What is Nafarelin?

Answer 23

Nafarelin is a GnRH preparation

Administered as a nasal spray to treat precocious puberty in children and endometriosis in women

Question 24

What are the Gonadotropin-related drugs discussed?

Answer 24

1. Menotropins & chorionic gonadotropin
2. Goserelin & Leurpolide
3. Nafarelin

Question 25

What are Cabergoline & Bromocriptine?

Answer 25

Cabergoline & Bromocriptine (Dopamine agonists)

Used to suppress prolactin secretion in women with hyperprolactinemia

This condition is often associated with galactorrhea, hypogonadism, and infertility

Cabergoline may also reduce excessive growth hormone secretion in some persons with acromegaly and hyperprolactinemia.

Question 26

What is Desmopressin?

Answer 26

Desmopressin is a synthetic vasopressin analogue that retains the antidiuretic activity of the natural hormone but has less vasoconstrictive effect.

• It is administered parenterally and intranasally to treat diabetes insipidus resulting from deficient vasopressin secretion.
• Desmopressin is also used to control gastrointestinal bleeding by causing vasoconstriction and to treat hemophilia A and von Willebrand disease

Question 27

What are Conivaptan & tolvaptan?

Answer 27

Conivaptan & tolvaptan are arginine vasopressin receptor antagonists

used to treat hypervolemic and euvolemic hyponatremia.