Exam 4 Non-steroid Pharmacology

Question 1

GHRIH aka SST or SRIH

Answer 1

SST14 or SST28 bind SSTR1 to inhibit release of PRL, TSH, insulin, glucagon and GI secretions

Question 2

Growth hormone (somatotropin)

Answer 2

stim IGF1 secretion and inhibits GHRH secretion. increase fat metabolism. increase production and release of glucose from the liver.

Question 3

IGF1

Answer 3

insulin like growth factor. stim growth of bones and muscle. increase uptake of plasma glucose into liver and muscle.

Question 4

GH deficiency in adults

Answer 4

obese, asthenia, low CO, impaired psychosocial. from pit damage

Question 5

GH in kids

Answer 5

GHRH def, Turners, IGF1 def, GHIS (laron dwarf). s/s-slow growth and hypoglycemia

Question 6

test GH def if GH too low, give insulin to induce hypoglycemia

Answer 6

if GH doesnt rise= pit

if GH rises= hypo

Question 7

give GHRH to test GH def

Answer 7

if GH rises=hypo

if GH doesnt rise=pit

Question 8

if no response to GH when testing def

Answer 8

IGF1 def or GHIS

Question 9

somatropin

Answer 9

activates GH receptors, restore normal glucose and increase IGF1 release. use for GH def, osteoporosis, cachexia and AIDs wasting

Question 10

mecasermin (increlex)

Answer 10

activate IGF1 receptors. used in kids with IGF def or GH def. used in adults with Lou Gehrigs. (insulin like effects)

Question 11

mecasermin rinfabate (iplex)

Answer 11

activates IGF1 receptors, IGFBP binds up IGF1 slowing metabolism and lowering free IGF1 plasma concentrations. used for IGF def, GHIS, severe burns or severe insulin resistance.

Question 12

test for excess GH with oral glucose

Answer 12

if GH decreases=pit

if GH doesnt decrease=ectopic

Question 13

octreotide (sandostatin), lanreotide (somatulin depot), pasireotide (signifor LAR)

Answer 13

SST receptor agonists. activates SST receptors. used for gigantism or acromegaly, or GH/VIP secreting tumors, or XS TSH/GI secretions, cushings

Question 14

bromocriptine for acromegaly

Answer 14

activated D2/antagonizes D1 receptors. used for hyperprolactinemia, parkinsons and DM2

Question 15

pegvisomant (somavert)

Answer 15

analog of human GH. binds one GH receptor with high affinity, but cannot bind a second. used for acromegaly or to monitor IGF1 (should lower)

Question 16

hypoprolactinemia

Answer 16

dysf or damage of pituitary, smoking

Question 17

hyperprolactinemia

Answer 17

PRL secreting tumor, dopamine antagonists, primary hypothyroid.

Question 18

bromocriptine, cabergoline

Answer 18

dopamine agonist for hyperprolactinemia. activates D2 receptors on lactrotrophs, decrease PRL release, shrink PRL tumor. used for acromegaly, parkinsons, DM2

Question 19

if oxytocin ineffective

Answer 19

try ergot alkaloids ergonovine or methylergonovine.

Question 20

DI

Answer 20

insuff water retention leads to dilute urine, thirst, nocturia

Question 21

SIADH

Answer 21

caused by CA or injury or drugs, hypoosmolality, treated with loop diuretics or ADH antagonists

Question 22

hyponatremia

Answer 22

euvolemic-SIADH, hypothyroid, adrenal insuff

hypervolemic- CHF, cirrhosis, nephrotic syndrome

Question 23

vasopressin

Answer 23

activates V1/2 receptors. for central DI or GI bleed

Question 24

desmopressin

Answer 24

activates V2 receptor. for central DI, hemophilia or von willebrands.

Question 25

convaptan, tolvaptan

Answer 25

antagonize V2 receptors. for hyponatremia without hypovolemia (SIADH).