HORMONES Flashcards
rhGH somatropin
pituitary dwarfism tuner's syndrome renal failure catabolic states AIDS related wasting
GH 191 aa functions
increase glucose
increase lipolysis
decrease glucose utilisation
increase igf1 - increase lipogenesis and glucose utilisation
ADR GH
hypothyroidism
lipodystrophy
glucose intolerance
water salt retention, intracranial hypertension
somatostatin 14 aa
inhibit GH, TSH and PRL, INSULIN, GLUCAGON
antisecretory
constricts gut, liver, renal vessels
somatostatin analogues
octreotide - acromegaly, secretory diarrheas (adr- steatorrhoea, diarrhea, gall stones)
lanreotide
pegvisoment - peg bound mutant gh
prolactin 199 aa
growth and development of breast
induce milk secretion
inhibit GnRH
act on t lymphocytes
prolactin
JAK STAT activation
Dopamine
inhibit lactotrope D2 receptors
Dopamine agonists
bromocriptine, cabergoline
hyperprolactenemia
chlorpromazine, haloperidol, metoclopramide
trh, prolactin releasing peptide, vip
hyperprolactenemia
galactorrhoea amenorrhea infertility
loss of libido and depressed fertility
bromocriptine
uses - hyperprolactenemia, acromegaly, Parkinson’s, DM, hepatic coma, neonatal death
excreted in bile - half life 3-6 hours D2 agonist, d1 agonist, alpha adrenergic blocker decrease PRL, GH, Parkinson CTZ stimulation inhibit postural reflexes- hypotension decrease gastric motility
cabergoline
D2 agonist
half life >60 hours
uses - hyperprolactenemia, acromegaly
glycoprotein gonadotropin
alpha chain 92 aa
beta chain: 111 aa fsh, 121aa lh
LH
progesterone secretion
FSH and LH RECEPTOR
GPCR - increase cAMP
- gametogenesis
- conversion cholesterol into pregnenolone
regulation of secretion of gonadotrophin
secretion: gonadorelin GnRH
secreted in pulses - frequency and amplitude varies - determine fsh/lh release
follicular phase - high frequency
luteal phase - low frequency
inhibition- feedback
LH- dopamine
FSH- inhibin
gonadotropin disturbances cause
delayed puberty precocious puberty sterility amenorrhea oligozoospermia impotence infertility polycystic ovaries
gonadotropins im, sc
menotropins urofolitropin hCG recombinant folitropin recombinant LH rHCG
induce ovulation
clomiphene
polycystic ovaries
LH/FSH ratio increased
gonadotropin use
amenorrhea infertility hypogonadotrphic hypogonadism cryptorchidism to aid in vitro fertilization
hypogonadotrphic hypogonadism
androgen- for sexual maturation
hcg im 2-3 x a week
add fsh and lh after 3-4 months
fsh lh dose
75 IU/day im
ADR gonadotropin
ovarian hyperstimulation
precocious puberty
allegric reaction malignancies
gonadorelin agonist - long acting but short term use
nasal, sc
initially increase gn
then - reversible pharmacological oophorectomy/orchidectomy
nafarelin
GnRH agonist
downregulate GnRH in 10 days
use- ovarian hyperstimulation, utetine fibroids, endometriosis, central precocious puberty
adverse effect- vaginal dryness, emotional liability
goserelin
sc/im
endogenous gn suppression before ovarian induction - 3.6 mg depot inj anterior abdominal wall 3 weeks prior
endometriosis
prostate cancer
triptorelin
sc- infertility
im depot- prostrate cancer, endometriosis, precocious puberty, leiomyomas
prostate cancer treatment
goserelin
triptorelin + androgen antagonists
androgen antagonist
flutamide, biclutamide
leuprolide
gn suppression
prostate cancer
GnRH
sc inj
low histamine releasing potential
ceterorelix
ganirelix
TSH
stimulate all steps of thyroid hormone synthesis and release
TSH RECEPTORS
GsPCR
also Gq sometimes - produce H2O2 for iodide oxidation
TSH stimulation
TRH (GqPCR)
TSH inhibition
dopamine
somatostatin
thyroid hormones
Graves disease
IgG antibody stimulate TSH receptors
ACTH 39 aa
endorphin, lipotropins, msh
GPCR
increase cAMP- INCREASE CHOLESTEROL, hyperplasia and hypertrophy of adrenal cortex
function- steroidogenesis
zona glomerulosa
stimulated by acth and ang ii
ACTH
stimulated by- CRH (stimulated by stress, arginine vasopressin)
Inhibition - negative feedback
increased acth -basophil pituitary tumors - Cushing’s
decreased acth - hypocorticism
use - diagnosis of pituitary adrenal axis
