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xD3 Pharm Exam 2 > Endocrine GH and Prolactin (Welch) > Flashcards

Endocrine GH and Prolactin (Welch) Flashcards

1
Q

What is the only place Growth Hormone binds as unchanged growth hormone?

A
  1. Fat tissue
  2. Muscle tissue
  3. Liver
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2
Q

What does the binding of GH in fat tissue cause?

A
  1. Decrease glucose uptake
  2. Increase lipolysis
  3. Overall decrease Adiposity
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3
Q

What does the binding of GH in the muscle tissue cause?

A
  1. Decrease glucose uptake
  2. Increase amino acid uptake
  3. Increase protein synthesis
  4. Overally increase lean body mass
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4
Q

What are 5 things that increase when GH binds to Liver?

A
  1. RNA Synthesis
  2. Protein Synthesis
  3. Gluconeogenesis
  4. Insulin-like growth factor binding protein (IGFBP)
  5. Insulin-like growth factor
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5
Q

The insulin like Growth Factors (IGF) produced by the liver and excreted to the rest of the body have what general effect on the lungs, heart, and bone?

A
  1. Increase organ size

2. Increase organ function

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6
Q

he insulin like Growth Factors (IGF) produced in the liver and excreted to the rest of the body have what general effect on the chondrocytes?

A

Increase linear growth

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7
Q

What does IGF specifically increase in the lungs heart and bone that results in increased organ size and organ function?

A
  1. increase protein synthesis
  2. Increase RNA synthesis
  3. Increase DNA synthesis
  4. Increase cell size
  5. Increase cell number
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8
Q

What does IGF specifically do in the chondrocyte to give the overall effect of increase in linear growth?

A 
increase amino acid uptake 
Increase protein synthesis 
Increase RNA synthesis 
Increase DNA synthesis
Increase collagen 
Increase chondroitin sulfate 
Increase cell size 
Increase cell number
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9
Q

What starts the cascade for the release of Growth hormone?

A

Growth hormone releasing hormone (GHRH) from hypothalamus

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10
Q

Onto what structure is GHRH from hypothalamus released and what is subsequently released?

A

Anterior pituitary Growth Hormone (GH) release

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11
Q

What inhibits GH production?

A

Somatostatin

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12
Q

What is a growth hormone releasing hormone analogue used as a diagnosis for idiopathic growth hormone deficiency in order to characterize pituitary responsiveness?

A

Sermorelin

GHRH44

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13
Q

When is Growth hormone most active?

A

Sleep

More active in youth

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14
Q

What does GH do for metabolism?

A

Converts body over for lipolysis for energy during times of fasting

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15
Q

What can stimulate Growth Hormone releasing hormone?

A
  1. Exercise
  2. Stress
  3. Sleep
  4. Excitement
  5. Insulin
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16
Q

Increased in Growth hormone causes release of what else?

A

GHRIH

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17
Q

Besides the excretion of Growth Hormone, what else stimulates Growth Hormone Release Inhibiting Hormone?

A
  1. FFA
  2. Hyperglycemia
  3. Glucagon
  4. ACTH
  5. Glucocorticoids
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18
Q

What is the only Growth Hormone inhibitor?

A

Somatostatin

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19
Q

What are 3 pharmacological effects of Somatostatin (GHRIH)?

A
  1. inhibits secretion of insulin and glucagon from pancreas
  2. Inhibits gastrin secretion from pancreas
  3. Inhibits secretion of TSH, ACTH
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20
Q

Somatostatin (GHRIH) inhibition of secretion of insulin and glucagon from pancreas leads to what?

A

increase in FFA and decrease in glucose

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21
Q

Long acting Somatostatin (GRHIH) analogue to treat acromegaly and as a full body scan to look for tumors growing in the body?

A

Octreotide

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22
Q

Why would a somatostatin analogue be used to scan for tumors?

A

Because most tumors have GH

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23
Q

What is a better treatment for Acromegaly to suppress high levels of GH?

A

Bromocryptine (DA agonist)

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24
Q

Is GH high or low in Diabetes mellitus patient?

A

High. If insulin is low, GH is high converting fats to glucose for energy

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25
Q

What will GHRIH (somatostatin) given to a Type I diabetic help prevent ?

A

Ketoacidosis

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26
Q

What part of Growth Hormone (Somatotropic / GH) binds to one of the 3 receptors in the body for GH?

A

Only the active one

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27
Q

The following are characteristics of what GH excess :
Osteoarthritic vertebral changes
Visual field changes (bitemporal hemianopia) Prognathism
Hirsutism
Gynecomastia and lactation
Enlarged hands and feet

A

Acromegaly

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28
Q

What are 4 ways to slow or stop GH release from anterior pituitary at the anterior pituitary?

A
  1. Surgery
  2. Radiotherapy
  3. Dopamine agonists
  4. Somatostatin analogues
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29
Q

What can you use to slow GH from releasing IGF from liver, or acting directly on adipose tissues or muscle?

A

GH Receptor Antagonists

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30
Q

For GH active core to stimulate its receptor what must occur?

A

GH site A and GH site B must bind to their individual receptor site which pull together to form a dimer

31
Q

Once the GH active core has dimerized what must occur for it to act on its target cell?

A

Must anchor into the plasma membrane

32
Q

What does the dimerized active core Growth hormone do once it is inserted into the cell membrane?

A

Stimulates tyrosine kinase that will eventually cause transcription factors to express genes

33
Q

Are the anabolic and growth promoting effects of growth hormone due to growth hormone itself or IGF-1?

A

IGF-1

34
Q

Is GH a hyperglycemia or hypoglycemic inducing drug?

A

Hyperglycemic drug. Will increase blood sugar.

35
Q

What is the metabolic effect of GH on proteins?

A

Anabolic

36
Q

What is the metabolic effect of GH on fat?

A

Lipolysis in adipose tissue

37
Q

What is the metabolic effect of GH on carbohydrates?

A

Hyperglycemia, if given long-term

38
Q

What is the metabolic effect of GH on calcium?

A

Lipolysis in adipose tissue

39
Q

IGF-1 binds to what type of receptor?

A

Looks like half of an insulin like receptor and is associated with tyrosine kinases

40
Q

IGF-1 promotes growth in every organ except what 2?

A
  1. Brain

2. Eye

41
Q

IGF-1 will promote growth in long bones until when?

A

Until epiphyseal plates close

42
Q

What is retained during protein synthesis caused by IGF-1?

A

Nitrogen

43
Q

IGF-1 stimulate the uptake of what compound into cartilage

A

Sulfate

44
Q

What is the main difference between GH and insulin?

A

Insulin does not induce lipolysis

GH will increase blood sugar level

45
Q

What are 2 substances that antagonize GH and insulin?

A
  1. Glucocorticoids

2. Catecholamines

46
Q

Insulin and GH both do what with respect to sugar?

A

Promote sugar storage

47
Q

Can GH antagonize Insulin?

A

Yes

48
Q

In a diabetic with low insulin, what will be elevated to account for the inability of the body to use glucose for energy?

A

Increase growth hormone, and increase glucagon

49
Q

In a non-diabetic how do Insulin and GH work?

A

Work in opposition based on sleep cycle, but both work to store glucose as glycogen

50
Q

Why are Type I diabetic children not extremely tall seeing as they have a higher than average level of growth hormone to compensate for their lack of insulin?

A

Because their epiphyseal plates will close with increased GH, and they can only grow when epiphyseal plates are open

51
Q

What will happen in a person lacking GH ?

A

Glucose will be used up too rapidly

52
Q

What will be induced if a normal adult is taking GH for enhancement?

A

Diabetes

53
Q

Can GH be administered orally?

A

No. It is a peptide.

54
Q

What is the only clinical use for administration of human pituitary GH?

A

Hypopituitary dwarf with open epiphyseal plates

55
Q

Of the 2 synthetic GH used for the treatment of hypopituitary dwarfism or GH-deficient patients with hypoglycemia, which drug is longer acting: Somatrem or Somatropin?

A

Somatrem

56
Q

Patients on GH replacement therapy (Somatrem or Somatropin) should be evaluated yearly for what side effect?

A

Hypothyroidism

57
Q

What is an anterior pituitary hormone that is structurally similar to GH (Its levels rise during pregnancy and reach maximum levels at term)?

A

Prolactin

58
Q

What are 2 hormonal controls of Prolactin release from anterior pituitary?

A

Prolactin Releasing hormone (PRH)

Thyrotropic Releasing hormone (TRH)

59
Q

What is the stimulation in nursing mothers for prolactin?

A

Suckling

60
Q

Why is it thought that prolactin decreases chance of getting pregnant in a nursing mother?

A

Prolactin decreases leutenizing hormone (LH) and Follicle stimulating hormone (FSH)

61
Q

What 2 things that cause the release of Prolactin Release Inihibiting Hormone?

A

Dopamine and dopamine agonists

62
Q

What treatment would be indicated to stop lactation?

A

Prescribe dopamine agonist to increase PRIH

63
Q

What blocks the action of prolactin during pregnancy?

A

Estrogen and progesterone

64
Q

What does prolactin do in the mammary glands?

A

Promoting proliferation and differentiation of mammary ductal and alveolar epithelium

65
Q

What effect does prolactin have on the ovaries and gonads?

A

Inhibits LH and FSH release and their action on the ovaries or gonads

66
Q

What is the most common physiologic condition causing hyperprolactinemia?

A

Pituitary tumor

67
Q

What are other causes of hyperprolactinemia?

A
  1. Dopamine antagonist (reserpine)
  2. Goiter causing increased TRH
  3. Oral contraceptives (will increase TRH)
68
Q

What are 5 consequences of hyperprolactinemia?

A
  1. Galactorrhea
  2. Amenorrhea
  3. Infertility
  4. Impotence
  5. Possibly mammary tumors
69
Q

What is the drug of choice for the treatment of hyperprolactinemia?

A

Bromocriptine, a dopamine agonist (ergot alkaloid)

70
Q

What is a side effect of bromocriptine?

A

Postural hypotension due to systemic vasoconstriction

71
Q

Is bromocriptine for the treatment of hyperprolactinemia orally active?

A

Yes

72
Q

In what patient population is bromocriptine contraindicated?

A

Pregnancy. Ergot alkaloid will induce abortion.

73
Q

Estrogens and progesterone are regulators of what hormone?

A

Prolactin

xD3 Pharm Exam 2 (5 decks)

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