Hypothalamic and Pituitary Hormone Drugs

Question 1

• circulating endogenous growth hormone lasts _____ minutes

- recombinant growth hormone peaks at 2 to 4 hours and persists for ____ hours

Answer 1

25

36

Question 2

-GH promotes longitudinal bone growth until _______ closure

Answer 2

epiphyseal

Question 3

• primary growth hormone insufficiency characterized by severe postnatal growth failure
• caused by homozygous or compound heterozygous mutations in the GH receptor gene
• affect extracellular GH binding region of receptor
• Ecuador
• increased circulating levels of GH, low IGF-1 and IGFBP-3 levels
• tx: mecasermin (recombinant IGF-1)
• side effect is hypoglycemia, give with meal

Answer 3

Laron dwarfism

Question 4

• deletion of genes on paternal copy of chromosome 15, associated with growth failure, obesity, and carbohydrate intolerance
• GH replacement decreases body fat, increases lean body mass

Answer 4

Prader-Willi syndrome

Question 5

• 45X karyotype with mosaicism

- GH must be used to achieve max height

Answer 5

Turner syndrome

Question 6

• recombinant human IGF-1

- causes hypoglycemia, take carb containing meal 20 min before medication

Answer 6

mecasermin

Question 7

• large hands and feet, frontal bossing, coarse facial features
• carb intolerance, LVH, hypertension, colon polyps, GI malignancy
• dx: with somatomedin C (IGF-1), confirm with postprandial growth hormone
• transphenoidal surgery is primary treatment, octreotide normalizes GH

Answer 7

acromegaly

Question 8

• ischemic necrosis in an enlarging adenoma
• compression of superior hypophyseal artery against sellar diaphragm
• hemorrhage into the necrotic area
• rapid enlargmement and edema, acute pain, cranial nerve palsies, pituitary insufficiency

Answer 8

pituitary apoplexy

Question 9

• needs to be taken in empty stomach, should be taken an hour away from food
• calcium and iron supplements bind to medication and decrease absorption

Answer 9

levothyroxine

Question 10

contraindications to ______ therapy:

• young men who wish to bear children should not be placed on exogenous, which will lower sperm count and decrease testicular size
• known prostate or breast cancer
• untreated sleep apnea
• erythrocytosis
• urinary obstruction

Answer 10

testosterone

Question 11

dopamine receptor agonists, more selective for D2 receptor,lower prolactin secretion

Answer 11

cabergoline

Question 12

inhibit spontaneous and TRH induced release of prolactin, used to treat small prolactinoma, adverse n/v/headache/postural hypotension

Answer 12

bromocriptine

Question 13

• responsible for regulating body’s retention of water by increasing water absorption in collecting ducts of renal nephron, increases peripheral vascular resistance, which increases arterial blood pressures
• stimulators of vasopressin release: increased osmolarity, decrease in BP

Answer 13

vasopressin