GROWTH hormone (somatotropin/GH) + GH-inhibiting hormone

Question 1

GH → drug names:

Answer 1

1. somatropin (recombinant)
2. somatrem (added methionine)
3. somarelin (GHRH analog)
4. mecasermin (recombinant IGF-1)

Question 2

GH → some physiology:

Answer 2

1. released in pulses → highest conc. during sleep

2. secretion is inhibited by somatostatin

Question 3

GH → mechanism of action:

Answer 3

mediated through insulin-like growth factors 1 & 2 (IGF-1 & IGF-2)

Question 4

GH → indications:

Answer 4

1. GH deficiency
2. growth failure in children
3. growth failure due to Prader-Willi syndrome
4. managing of AIDS-waisting syndrome
5. “anti-aging”→ has led to off-label use by older people and athletes to enhance performance
6. administration in adults → leads to increased lean body mass, bone density & skin thickness + decreased adipose tissue

Question 5

indication of mecasermin:

Answer 5

used for long-term treatment of growth failure in children with severe primary IGF-I deficiency

Question 6

GH → CONTRAindications:

Answer 6

1. pediatric pat. with closed epiphyses
2. diabetic retinopathy
3. obese with Prader-Willi syndrome

Question 7

GH → side effects:

Answer 7

1. pain at injection site
2. edema
3. arthralgias, myalgias
4. flu-like symptoms
5. increased risk of diabetes
6. high cholesterol level
7. contribute to growth of cancerous tumors
8. carpal tunnel syndrome
9. nerve, muscle, joint pain
10. numbness & tingling

Question 8

GH-inhibiting hormone → drug names:

Answer 8

1. somatostatin
2. octreotide
3. lanreotide
4. pasireotide
5. pegvisomant → analogue of GH

Question 9

GH-inhibiting hormone → mechanism of action:

Answer 9

1. binds to receptors that suppress GH & TSH release

2. inhibit release of → insulin, glucagon & gastrin

Question 10

GH-inhibiting hormone → indications:

Answer 10

1. acromegaly
2. diarrhea & flushing ass. with carcinoid tumors
3. bleeding esophageal varices (IV octreotide)
4. cushing’s (pasireotide)

Question 11

GH-inhibiting hormone → side effects:

Answer 11

1. nausea
2. vomiting
3. abdominal cramps
4. flatulence
5. steatorrhea
6. gall stones
7. transient deterioration in glucose tolerance

Question 12

GH-inhibiting hormone → pharmacokinetics:

Answer 12

given once every 4th week

Question 13

pegvisomant → action & indication:

Answer 13

1. acts as a GH receptor ANTAGONIST
2. main indication = ACROMEGALY → normalizing serum insulin-like growth factor 1 (IGF-1) levels
3. may be effective in cases RESISTANT to somatostatin