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Pharm Final > Hypothal/Pit > Flashcards

Hypothal/Pit Flashcards

1
Q

Which two anterior pituitary hormones activate JAK/STAT receptors? What receptors do all the other ant pit hormones act on?

A

GH and prolactin (also DA but not ant. pit.)

others activate G-coupled receptors

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2
Q

Which pituitary hormone leads to the release of IGF-1 at its target tissue?

A

GH

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3
Q

How are the JAK/STAT receptors activated?

A

requires binding of two molecules (1 to two different receptors) which leads to receptor dimerization

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4
Q

Which pituitary hormone is important in the regulation of blood glucose due to its anti-insulin actions? If it is missing, how is blood glucose affected?

A

GH

lack of GH means you lose inhibition of insulin so you get hypoglycemia

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5
Q

two recombinant GH drugs are somatropin and somatrem. How are they different?

A

Somatropin: recombinant GH (identical to human hormone)
Somatrem: GH analog (modified to inc bioavailability etc)

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6
Q

How are most pituitary/hypopit replacement hormones given? why?

A

subcutaneously - cant give proteins orally, they get degraded in stomach

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7
Q

What drug can be given to improve wasting in HIV patients?

A

Somatropin (recombinant GH)

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8
Q

Intracranial HTN, otitis media, hypothyroidism, and scoliosis are important adverse effects of what hypothal/pit hormone? how do you get hypothyroidism?

A

Somatropin - hypothyroidism caused by negative feedback on other pit hormones

these are AE in children!

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9
Q

which hypothal/pit hormone can cause peripheral edema, myalgias, carpal tunnel, and proliferative retinopathy? this drug is contraindicated in what patients?

A

Somatropin (recombinant GH)

Contraindicated in patients with a known maligancy (WONT cause primary tumor, but can cause existing ones to grow)

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10
Q

Which drug can be used in growth hormone deficiency, has few adverse effects, and is less expensive than somatropin? why is it also less effective than somatropin?

A

Sermorelin - GHRH - wont work if the defect is in the anterior pituitary

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11
Q

Some kids with delayed growth have neutralizing antibodies to GH. What can be given to help these kids? what is an important side effect and how should it be given?

A

Mecasermin - IGF-1 analog

because it has some effect on insulin receptors, it can cause hypoglycemia so it needs to be given 20 min before or after a meal

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12
Q

What are two rare side effects of mecasermin and which is more important to watch out for?

A

Intracranial HTN - can be fatal!!
elevation of liver enzymes - asymptomatic

Mecasermin - IGF-1 analog (GH)

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13
Q

what cells in the pituitary are responsible for causing acromegaly in adults or gigantism in kids?

A

somatotrophs - secrete GH

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14
Q

Which drug can be used in acromegaly/gigantism because it blocks the GH receptor?

A

Pegvisomant

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15
Q

somatostatin inhibits the release of what 4 substances?

A

GH
Glucagon
Insulin
Gastrin

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16
Q

what drug can be given to reduce symptoms caused by hormone-secreting tumors? what kind of drug is it?

A

octreotide - somatostatin analog

acromegaly, carcinoid syndrome, gastrinoma, diabetic diarrhea etc

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17
Q

what drug can be given to control acute bleeding from esophageal varices?

A

octreotide - somatostatin analog

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18
Q

which hypothal/pit drug can cause nausea, vomiting, flatulence, gallstones, sinus bradycardia and vit B12 deficiency?

A

octreotide - somatostatin analog

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19
Q

what two drugs can be used to treat prolactinomas? what type of drugs are they? which has more adverse effects? why do they work?

A

Dopamine agonists: Bromocriptine (way more AEs) and Cabergoline

Most prolactinomas retain their ability to be inhibited by dopamine

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20
Q

chonic high-dose therapy of what hypothal/pit drugs leads to cold-induced peripheral digital vasospasm and pulmonary infiltrates?

A

Dopamine agonists: Bromocriptine (way more AEs) and Cabergoline

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21
Q

the menotropins are what?

A

Purified extract of BOTH FSH and LH

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22
Q

what two drugs contain purified FSH but no LH?

A

Follitropin and Urofollitropin

23
Q

which hypothal/pit drug is purified from urine and injected daily?

A

hCG

24
Q

name the two ways you can treat male infertility using gonadotropins

A

hCG alone or a combination of urofollitropin, rFSH, and rLH

25
Q

Name the two most important adverse effects in women taking gonadotropin drugs. Name the 1 in men.

A

Women: ovarian hyperstimulation syndrome and multiple pregnancies

Men: gynecomastia

26
Q

Woman presents with ovarian enlargement, ascites, hydrothorax and hypovolemia as a consequence of a drug reaction. What was she most likely taking?

A

gonadotropin (follitropin, urofollitropin, hCG, or menotropin)

27
Q

Name the synthetic GnRH. Name the 3 GnRH analogs.

A

Gonadorelin

Goserelin, Leuprolide, Nafarelin

28
Q

explain how GnRH given in pulsatile doses can evoke a difference reaction than when given continuously

A

pulsatile GnRH: stimulates release of LH and FSH

sustained: inhibits FSH and LH release

29
Q

when giving GnRH or its analogs, what is important to remember about the first few initial treatments if your goal is to inhibit FSH and LH release?

A

initial treatments, body can’t tell if the dose is pulsatile or sustained, LH and FSH are both released initially - give with a receptor antagonist at first (Cetrorelix or Ganirelix)

30
Q

which gonadotropin analog can be given as a nasal spray?

A

Nafarelin (N for nasal!)

31
Q

what drugs would you use to diagnose LH responsiveness to tell whether delayed puberty was due to constitutional delay or hypogonadotropic hypogonadism?

A

GnRH and analogs (Gonadorelin and Goserelin, Leuprolide, Nafarelin)

32
Q

what drugs are used to treat endometriosis?

A

Goserelin, Leuprolide, Nafarelin

33
Q

what drugs are used to treat uterine leiomyomata?

A

Goserelin, Leuprolide, Nafarelin

34
Q

what two drugs can be used to treat central precocious puberty?

A

leuprolide and nafarelin

35
Q

what drugs can be used to treat amenhorrhea and infertility in women with PCOD?

A

Goserelin, Leuprolide, Nafarelin

36
Q

Patient with a gonadotropin-secreting pituitary adenoma presents with sudden pituitary apoplexy and blindness - what drug was he being treated with?

A

Gonadorelin - GnRH

37
Q

What group should never receive GnRH analogs? name them

A

pregnant and breast-feeding women

Goserelin, Leuprolide, Nafarelin

38
Q

which hypothal/pit drugs can cause hot flushes, sweats, decreased libido, and reduced bone density in both men and women?

A

GnRH analogs - Goserelin, Leuprolide, Nafarelin

39
Q

what two drugs are used to prevent LH surge during controlled ovarian hyperstimulation?

A

GnRH receptor antagonists: Cetrorelix and Ganirelix

40
Q

which ant pit/hypothal hormone drugs (2) are used to differentiate between Addison’s disease and secondary adrenal insufficiency (ie dec ACTH secretion)?

A

ACTH analogs: corticotropin and cosyntropin

41
Q

which hypothal/pit drug can be used to treat infantile spasm? what kind of drug is it?

A

corticotropin - ACTH analog

42
Q

which pituitary hormone has its highest concentration at 6am and is lowest in the evening?

A

ACTH

43
Q

name the two posterior pituitary hormones - where are they produced?

A

ADH and oxytocin - made in hypothalamus (post pit just stores)

44
Q

explain when oxytocin would be given IV vs IM

A

IV: for initiation and augmentation of labor
IM: for control of postpartum bleeding

45
Q

woman in labor is experiencing sustain contractions. What drug was given incorrectly and how? what AE should you be concerned about?

A

they gave a high dose of oxytocin which can lead to fetal distress or placental abruption - smaller doses wont cause this

46
Q

bolus injection of oxytocin can lead to what?

A

hypotension

47
Q

what drug is used to treat preterm labor but is not available in the US due to the availability of many safer options?

A

Atosiban

48
Q

describe the actions of V1 and V2 receptors (ADH receptors)

A

V1: vasoconstriction
V2: water reabsorption in kidney

49
Q

which ADH agonist has minimal vasoconstriction effects? what receptor does it mainly act on? which ADH agonist acts on both?

A

desmopression (acts mostly on V2, little V1 effects)

vasopressin acts on V1 and V2

50
Q

name the two drugs of choice for diabetes insipidus

A

Vasopressin and desmopressin

51
Q

which ADH agonist can also help treat esophageal variceal bleeding and colonic diverticular bleeding?

A

Vasopressin

52
Q

which ADH agonist can also help treat coagulopathy in Hemophilia A and von Willebrands?

A

Desmopressin

53
Q

overdose of vasopressin agonists can lead to what 2 adverse effects?

A

Hyponatremia and seizures - too much of an affect

54
Q

what drug is approved for used in patients with hyponatremia due to elevated vasopressin - how does it work?

A

Conivaptan - vasopressin antagonist at both V1 and V2 receptors

Pharm Final (20 decks)

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