Endo: Pituitary Pharm Flashcards
Somatotropin
- What is it?
- Use? (4)
- Route?
- Stomatotropin is a GH analog
- Use: children with GH deficiency, Turner’s syndrome, Prader-Willi, wasting in AIDS patients
- Route: injection (SC or IM)
How do the following affect GH release?
- Exercise
- GHRH
- Hyperglycemia
- Dopamine
- Somatostatin
- Exercise: stimulates GH release
- GHRH: stimulates GH release
- Hyperglycemia: inhibits GH release
- Dopamine: Normally, DA stimulates GH release. But, DA inhibits GH release in acromegaly
- Somatostatin: inhibits GH release
What is Laron syndrome?
How is it treated?
ADR (1)
- Laron syndrome: GH receptor mutation
- Tx: Mecasermin (IGF-1 analog)
- ADR: hypoglycemia
Can you use GH off-label for treatment of aging?
No. Use of GH off-label is illegal
Somatotropin ADR (2)
- insulin resistane
- idiopathic intracranial HTN
Name 2 somatostatin analogs
How are they administered?
Octreotide
Lanreotide
Both injections
Name 3 medical treatments for acromegaly
- Octreotide (somatostatin analog)
- Pegvisomant (GH receptor blocker)
- Cabergoline (DA agonist)
What is the preferred medical tx for esophageal varice bleeding?
Octreotide
(it has fewer side effects than vasopressin)
ADR of octreotide (4)
- Steatorrhea/loose stools
- Cholelithiasis
- Hyperglycemia
- Cardiac effects
What type of receptor does Somatostatin use?
Gi
- PRL release is stimulated by ______
- PRL release is inhibited by __________
- PRL release itself inhibits ___________ release
- PRL release is stimulated by suckling
- PRL release is inhibited by dopamine
- PRL release itself inhibits GnRH release
What is the name of the pathway in which dopamine inhibits PRL release?
Tuberoinfundibular pathway
Tx for hypoprolactinemia
Tx for hyperprolactinemia
- HYPOprolactinemia: no tx
- HYPERprolactinemia: D2 agonists (Cabergoline is first line, then bromocriptine)
Compare cabergoline and bromocriptine
ADR (3)
Cabergoline is first line for prolactinoma
ADR of bromocriptine: N/V, headache, hypotension
What stimulates ADH release?
What inhibits ADH release?
ADH release is
- stimulated by increased plasma osmolality or decreased blood volume
- inhibited by ethanol (why you pee when you drink)
What is the treatment for central DI?
ADR (4)
- Treat central DI with desmopressin (DDAVP)
- ADR: Headache, GI symptoms, weakness, hyponatremia,
Compare administration of ADH and DDAVP
- DDAVP can be given orally or parenterally
- ADH can only be given parenterally
What drug can treat central DI if intolerant to desmopressin?
Chlorpropamide (sulfonylurea)
Tx of nephrogenic DI (2)
- Thiazide diuretics
- Indomethacin
*
4 Drugs that can cause SIADH
- Sulfonylureas
- Neuro drugs (SSRI’s, haloperidol, etc)
- Vincristine/vinblastine
- MDMA
Tx of SIADH (4)
- Water restriction, hypertonic saline
- demeclocycline
- Lithium
- Vaptans (V2 receptor blockers)
