Hypothalamic and Pituitary Flashcards
Somatropin \+1 What is it? Admin/times per week uses tox (peds vs adults)
Somatotropin
Recombinant GH
Subcut administration 6-7x/wk
GH def, Prader willi, turner, idiopathic short stature (GH def has much more robust effect)
Peds-Rare-pseudotumor cerebri (increase ICP), progression of scoliosis, hyperglycemia (induction of peripheral insulin resistance)
- GH def pts should check other anterior hormones that need trx
Adullts-more likely-peripheral edema, myalgias, arthalgias, carpel tunnel
Mecasermin
- use
- side fx
- special
recombinant IGF1
for growth failure children not responsive to exogenous GH
hypoglycemia (drug activates inuslin receptor)
require carbs 20 mins before or after admin
Octreotide
- class
- +1
- use
- side fx
- method
GH Antagnoists (long acting somatostatin analogs)
Lanreotide
usually GH secreting pituitary adenoma->acromegaly
oct-subcut injections, NV, gallstones, bradycardia, CONDUCTION PROBLEMS
Pegvisomant
- class
- use
- method
GH receptor antagnoist (oct/lanreo do not work)
acromegaly
subcut daily
Urofollitropin
- class
- +2
- use
Purified FSh
Follitropin alpha and beta->shorter t1/2 and much more expensive
making infertile women fertile with FH def
Lutropin
- class
- use
Recombinant LH
Used in comination with follitropin alpha for stimualtion of cfollicular development in infertile women with profound LH def
Choriogonadotropin alpha
- use (2)
- tox (2)
Recombinant hCG
Controlloed ovarian hyperstimulation->IVF
Trx infertility-stimualte spermatogenesis in men or ovulatio in women (if refractory)
Ovarian hyperstimulation syndrome->ovarian enlargemnt, ascites, hypovolemia->schock
Multiuple pregnancies
Leuprolide \+4 (but 1 common name) -mech -uses 4 and which are indicated -side fx (men vs women)
-relins
Nonpulsatile GnRH agonists that inhibit pituitary release of FSH and LH
endometriosis
Uterine Leiomyoma (fibroids)
Prostate cancer
Central preciocious puberty
Women-menopause sx (hot flashes, sweats, diminished libido, vaginal dryness, depressioN), ovarian cysts, reduced bone density and osteoporosis
Men-hot flashes, gynecomastia, decreased libido, reduced bone density
Ganirelix
+2
2 uses
side fx
- Relix drugs
- inhibit secretion of FSH and LH in more complete manner than do GnRH agonists
Ganirelix and cetrorelix-ovarian hyperstim with low risk of OHSS
Degarelix-advance porasate cancer
Degarleix->andorgen deprivation (hot flashes and edema)
Bromocriptine
- mech
- +1
- use
- side effect men vs women
- difference between the two
- side FX
dopamine agonists
cabergoline
prolactin-secreting adenoma causing no ovulation
amenorrhea and galactorhhea in women
Libido loss and infertility in men
Cabergoline has higher affinity for D2 receptors than bromociptine and has less N but has cardiac valvulopathy.
N,HA, Light headedness, orthohypothension, fatigue->patient’s discontinue
Oxytocin
- 3 uses
- tox (2)
- contraindications
small doses-increases freq and force of uterine contractions
synthetic-induce labor for conditions requiring early vaginal delivery-uncontrolled mom DM, worsenig preeclampsia, intrauterine infection
Control uternie hemorrhage in immediate postpartum period
usually rare-excessive stimulation of uterine contractions (fetal distres, placental abruption or uterine rupture) or inadvertent activation of ADH (excessive fluid retention)
fetal distress, abnL fetal presentation, small pelvis, predispotion for uterine rupture
TH Drugs
- when to use each
- mech
- side effects (3)
Methemazole and PTU
- use Meth unless pregnant
- both work same way (MPO inhibitors), but PTU also inhibits peripheral conversion of T4 to T3
Rash, hepatitis (PTU), agranulocytosis
