Endocrines Flashcards
Pit:
What are the IGF-1 Agonists and Antagonists?
Ago: Mecasermin
Antago: None
Pituitary:
What are the Growth Hormone Agonists? Antagonists?
Agonist: Somatotropin
Antagonist: Octreotide, Pegvisomant
IGF-1 Agonist is Mecasermin
Pit:
What are the Gonadotropin Agonists and Antagonists?
Ago: Follitropin, Lutropin, hCG
Antago: Ganirelix, Leuprolide
Pit:
Prolactin Antagonist?
Antagonist: Bromocriptine
No agonist
Pit:
Oxytocin Agonist and Antagonist?
Ago: Oxytocin
Antagonist: Atosiban
Pit:
Vasopressin Ago and antago?
Ago: Desmopessin
Antago: Conivaptan
Thyroid
Thyroid Hormone Agonist and Antag?
Ago: Levothyroxine
Antag: Propylthiouracil
Bone:
All Agonists?
ACCCDRT
Alendronate Raloxifene Teriparatide Cholecalciferol Calcitonin Cinacalcet Denosumab
What is GnRH Agonist and Antagonist?
Ago: Leuprolide
Antago: Ganirelix
What is FSH agonist?
Follitropin, no antagonist
Used to promote multiple follicles for in vitro fertilization
Treat men for infertility
Adv effects: Ovarian Hyperstimulation syndrome sudden enlargement of ovaries pain, ascites, pleural effusion, sob can only give supportive treatment Multiple births Gynecomastia Headache, depression, edema
What is LH agonist?
Lutropin and hCG. No antagonist
Used for initiation of ovulation during controlled ovarian hyperstimulation
sperm production
What are menotropins and waht are they used for?
Its a hormonal prep of equal FSH and LH activity from urine
Promotes follicular maturation in women, infertility in men
IM admnin
GnRH Antagonists
the relix…
Ganirelix, cetrorelix, degarelix
Block GnRH receptors in pit so this decreases LH and FSH release
SC injection
SEs:
n/v ha weight gain
Ganirelix used for?
women: those taking drugs to promote follicle maturation. it blocks LH release so there isnt premature ovulation
Men: prostate cancer bc it reduces testost production
GnRH Agonists may be used to stimulate or inhibit FSH and LH. What are they?
Leuprolide, Naferin, Goserlin (analogs)
stimulates pit/gonadal axis by delivering GnRH in a pulsatile at a LOW DOSE
At a HIGH DOSE it will have an inhib effect. at first stims FSH and LH, but then there is so much GnRH (or its analog) that the receptors become downregulated and desensitized which leads to no FSH and LH
What are the treatments used for controlled ovarian hyperstimulation in prep for in vitro fertilization?
Gonadotropins to stimulate the follicles
hCG to trigger oocyte release
GnRH agonist/antag: PREVENT premature LH surge or spontaneous ovulation
What is another use of GnRH agonists to suppress gonadatropin production?
malignancies that are dependent upon gonadal steroids
ie advanced prostate cancer
combine with flutamide
also breast cancer
Precocious Puberty
Leuprolide for Endometriosis
Reduces pain and reduces lesions
Prolactin
Hyperprolactinemia
Elevated prolactin due to a prolactin secreting adenoma
may cause infertility
Use a Dopamine Agonist
BROMOCRIPTINE orally or vaginally…may cause orthostatic htn
What is an oxytocin antagonist and what is it used for?
Atosiban: Blocs oxy receptors, decrease uterine contractions so used for preterm labor
given iv
What is desmopressin used for?
Vasopressin agonist, work on V2 in kidney
replacement therapy in central diabetes insipidus (ADH deficiency)
What is conivaptan used for?
Conivaptan:
Blocks V1 & V2 receptors,
Used for Hyponatremia in hospital patients, IV
What is a somatostatin agonist?
Octreotide
If you have a GH deficiency, what hormone is given?
Somatotropin
Can be given to short stature/growth failure children
not for adults
How is adult GH deficiency syndrome treated?
Treat with growth hormone to reverse abnormalities and restore functional capacities, need lower doses than children
What is mecasermin?
Recombinant IGF-1. used for deficiency of GH signaling. so when exogenous GH has no effect, use this
can cause intracranial htn
What does Octreotide do?
Somatostatin Agonist, inhibits release of GH
can cause GI, gallstones, bradycardia
What is Pegvisomant and what does it do?
Its a GH Receptor Antagonist
Blocks GH receptors
But you get increased liver enzymes…
What are the two hormones that inhibit TSH
Somatostatin and dopamine
the only two inhibitory hormones
What are the inhibitors of thyroid hormone synthesis? Basically what are hyperthryoid treatments
Thioamides
Methimazole-blocks thyroid peroxidase reaction, iodine organification. use rt before thyroid resection, graves, with radiation, crisis
watch out for fever or sore throat bc of agranulocytosis
Propylthiouracil (severe liver toxicity)
Propranolol
Used in SEVERE thyrotoxicosis (thyroid storm), inhibits conversion of T4 –>T3
What are the most common treatments for osteoporosis? How doe they work?
Bisphosphonates: work by binding to ca PO4 in bone and incorporates itself into the bone matrix for months to years.
also inhibit osteoclasts, and their nbrs.
Can also treat Pagets in bone and osteop in men and women
ALENDRONATE (fosamax)
Ibandronate (Boniva) (useful with esophageal disorder)
Risedronate (Actonel)
Zoledronic Acid (Reclast)
SEs: Alondronate
BRON-biphosphate related osteonecrosis of the jaw (local bone death due to hypoperfusion, usu after dental procedures)
SERMs (again…)
How are they used to protect against osteoporosis?
Raloxifene (Evista)
acts on estrogen receptors to preserve bone density
prevent osteoblast death
no uterine or breast cancer, but increased risk of thrombophlebitis
PTH agonist?
TeriPARATide
for severe osteoporosis
What is a calcimimetic and what is it used for?
Cinacalcet
Neg feedback on PTH gland
Use in hyperPTH
can cause hypocalcemia
What is DENOSUMAB?
It is a MAB that binds to RANKL and prevents its activity
Inhibits osteoclast formation
Prevents fractures in those with bone mets from solid tumors
for postmenopausal women
