Growth Hormone Mecasermin , Octreotide , Cabergoline/Bromocriptine/Pegvisomant

Question 1

GH MOA

Answer 1

-The GH receptor is associated with JAK tyrosine kinase “jackin up that cell growth”

• GH stimulates the liver to produce IGF-1 insulin-like growth factor which mediates the growth promoting effects of GH
  (“Vine sprouting from the Liver rock”)
• IGF-1 is responsible for long bone growth​
  (pubertal growth spurt) think of a child shooting up just like the vine off the ground
  (“Tall growing vine”)

-GH has anabolic effects in muscle
(“Striated muscle leaf”)

-GH has catabolic effects in adipose tissue
(“Falling fatty donut jar”)

(“Tyrosine tire”)

Question 2

GH therapy can treat …

Answer 2

-useful in GH deficiency and idiopathic short stature (controversial)
(“Short kid”)

-GH therapy is useful for increasing growth in Prader-willi syndrome
(“Pradre willi”)

• for increasing growth in turner syndrome,
• transmittance of a single X chromosome (XO)

(“Turning X girl”)

Question 3

in cases in which the body doesn’t respond to GH treatment (GH Receptor defects etc.. ),what other treatment can be useful ?

Answer 3

Mecasermin-Recombinant IGF-1

• treats growth failure due to severe IGF-1 deficiency
  (“sermon”)

Question 4

Mecasermin [recombinant IGF-1] Side Effects

(“Sermon”)

Answer 4

-can cause hypoglycemia
(“Falling candy”)

Question 5

GH secreting pituitary adenoma can cause gigantism in children and acromegaly in adults , what drug can be used to treat this condition?

(“Giant hanging on the Vine”)

Answer 5

Octreotide

• somatostatin analog treats acromegaly and gigantism by inhibiting secretion of GH
  (“Giant hanging on the Vine”)

(“Octagon stop sign”)

Question 6

Octreotide is a Somatostatin analog used to treat…

(“Octagon stop sign”)

Answer 6

-treats acromegaly and gigantism

• inhibits secretion of GH
  (“Giant”)

-octreotide treats VIPoma

• neuroectoderm tumor secreting VIP
  (“VIP Customers only”)
• treats carcinoid tumors
• ileal tumor with hepatic mets secreting serotonin flushing, wheezing, and secretory diarrhea
  (“Customers only”)

-Octotreotide treats insulinoma

• fasting hypoglycemia
  (BIG “welcome inside mat”)

-octreotide treats glucagonoma

• manifests as weight loss and necrolytic migrator erythema affecting limbs and skin surrounding the lips
  (“Giant glucagon packet”)

-octreotide treats gastrinoma

• Zollinger ellisson syndrome
  (“Giant gas tank”)

-can control bleeding of esophageal varices

• decreased portal blood flow and variceal pressure
  (“Exposed variceal pipes”)

Question 7

Octreotide side effects

(“octagon stop sign”)

Answer 7

-AE’s include GI side effects, N&V, abdominal pain
(“Nauseated and pointing up”)

-octreotide can cause steatorrhea
(“Yellow stool”)

• decreased pancreatic secretions and gall bladder contractility

Question 8

Name the D2 receptor agonists used in treatment of acromegaly

(“Double rope ladder”)

Answer 8

Reinforcing the inhibition of secretion of GH at the pituitary

(“Pituitary sack at the end of the broomstick holding in the beans”)
——————————————————————————–
Cabergoline
(“Burglar”)

Bromocriptine
(“broomstick”)

Question 9

GH receptor antagonist used in treatment of acromegaly

Answer 9

Pegvisomant

(“Ants on a tire swing”)