Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

E2T1 > Hypothalamic and Pituitary Hormones DSA > Flashcards

Hypothalamic and Pituitary Hormones DSA Flashcards

1
Q

GH

A

(somatropin)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

IGF-1 agonist

A

mecasermin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Somatostatin analogs

A
  • octreotide

- Lanreotide

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

GH antagonists

A

pegvisomant

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

dopamine agonists

A
  • bromocriptine

- cabergoline

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

vasopressin R agonists

A
  • vasopressin

- desmopressin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

vasopressin R antagonists

A
  • conivaptan

- tolvaptan

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

anterior lobe

A
  • positively regulated by hypothalamic release Hs (Via the hypothalamic-adenohypophyseal portal system)
  • neg regulated by hypothalamic peptides (somatostatin) and catecholamines (dopamine)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

posterior lobe

A
  • H’s are syn in neuronal cell bodies in the hypothalamus- transported via axons in the stalk of the pit to the posterior lobe
  • vasopresson and oxytocin
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

GH and PRL- act what?

A

JAK/STAT

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

TSH, FSH, LH, ACTH- act what?

A

GPCRs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

TSH release reg by?

A

TRH

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

LH and FSH release reg by?

A

GnRH

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

ACTH release reg by?

A

CRH

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

TSH, FSH, LH, ACTH- feedback inhibitory regulation

A
  • TSH and TRH- inhibited by T3 and T4
  • FSH, LH, GnRH- inhibited by estrogen/progesterone and androgens
  • ACTH, CRH- inhibited by cortisol
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

GH production stim and inhibited by?

A
  • stim by GHRH
  • inhibited by somatostatin
  • GH and IGF-1 feedback to inhibit GH release
17
Q

prolactin- inhibited by?

A
  • inhibited by dopamine via D2 Rs
  • secretion is under inhibitory control by the hypothalamus (dopamine R coupled to Gi)- disruption of pit stalk- inc PRL levels!!
18
Q

recombinant human form of GH- pharmacokinetics

A

somatotropin

  • metabolized by liver
  • lasts 36 hrs (vs endogenous GH- t1/2 is 20 min)
  • induces P450s
19
Q

GH (somatotropin)- pharmacodynamics

A
  • GH Rs dimerize after binding to GH- act JAK/STAT
  • inc in IGF-1 prod- growth promoting effects
  • stim longitudinal bone growth
  • anabolic effects in m and catabolic effects in lipid cells
20
Q

GH- effects on carbohydrate metabolism

A
  • GH and IGF-1 have opp effects on insulin sensitivity
  • GH reduces insulin sensitivity
  • IGF-1- lowers serum glucose and reduce insulin
21
Q

GH- clinical uses

A
  • GH def in children- to achieve normal height
  • GH def in adults- present with obesity, reduced m mass, asthenia, reduced CO- tx help reverses these sx’s!
  • GH tx of pediatric pts with short stature
  • wasting in pts with AIDS
  • short bowel syndrome who are dep on parenteral nutrition
22
Q

GH toxicity and contraindications

A
  • well tolerated in kids- rare: intracranial HTN, scoliosis, otitis media in pts w/ Turner syndrome, hypothyroidism, pancreatitis, gynecomastia
  • adults have more adverse effects- peripheral edema, myalgias, arthralgias, carpal tunnel syndrome
  • contraindicated in pts with a malignancy!!!
23
Q

Mecasermin

A

recombinant IGF-1 and IGFBP-3 (insulin-like growth factor-binding protein)

  • some children w/ growth failure have IGF-1 def that isnt responsive to exogenous GH
  • subcutaneous admin
  • adverse effect- hypoglycemia
24
Q

GH antagonists- treat what?

A

ant pit adenomas that secrete GH

  • suppress GH secretion (somatostatin analog, dopamine R agonist)
  • antagonize the GH R (pegvisomant)
25
Q

GH Antagonists- types

A
  • somatostatin analogs- Octreotide, Lanreotide

- GH R antagonist- pegvisomant

26
Q

Octreotide

A
  • most widely used SST analog
  • 45x more potent than SST in inhibiting GH release; 2x more potent in reducing insulin secretion
  • subcutaneous admin- t/12 is 80 min
  • reduces the sx’s of H-secreting tumors!
27
Q

Lanreotide

A

-tx acromegaly

28
Q

SST analogs- adverse effects

A
  • GI (diarrhea, nausea, abd pain)- 50% of pts
  • gallbladder sludge and gallstones- dec GB contraction and bile secretion
  • cardiac effects (sinus bradycardia, conduction disturbances)
  • Vit B12 def
29
Q

Pegvisomant

A
  • GH R antagonist
  • tx acromegaly
  • allows R to dimerize but doesnt act the JAK-STAT pathway or stim IGF-1 secretion
30
Q

for pts with symptomatic hyperprolactinemia- tx?

A

(women- amenorrhea and galactorrhea; men- loss of libido, infertility)
-inhibition of PRL secretion via dopamine agonist

31
Q

Dopamine agonists

A

Bromocriptine and Cabergoline

  • D2 R agonist!
  • oral or vaginal suppository
32
Q

Dopamine agonists- clinical use

A
  • hyperprolactinemia
  • shrink pit PRL-secreting tumors, lower circulating PRL levels, and restore ovulation in 70% of women with microadenomas and 30% of women with macroadenomas
  • can be used with pit surgery, radiation tx, or octreotide admin to treat acromegaly
33
Q

Dopamine agonists- toxicity and contraindications

A
  • Nausea, HA, light-headedness, orthostatic hypotension, fatigue- most common
  • psychiatric manifestations
  • pulm infiltrates- high-dose tx
  • pts with macroadenomas who are pregnant continue tx
  • pts with microadenomas who are pregnant discontinue tx (growth of tumor during pregnancy is rare)
  • dopamine agonists are not recommended to suppress postpartum lactation- inc risk of stroke or coronary thrombosis
34
Q

Vasopressin (ADH)- clinically what is sued

A
  • vasopressin- admin IV or IM
  • desmopressin- long-acting synthetic analog of vasopressin; admin IV, subcutaneously, intranasally, or PO
  • desmopressin t1/2 is 1.5-2.5 h vs vasopressin t/12 15 min
35
Q

Vasopressin- moa

A
  • act GPCR V1 Rs (smooth m- vasoconstriction) and V2 Rs (renal tubule cells- inc water permeability and resorption in CTs)
  • extrarenal V2-like R- reg release of coag factor 8 and vwF
36
Q

Vasopressin and Desmopressin- clinical use

A
  • pituitary (central) diabetes insipidus!
  • desmopressin is preferred- selectivity of V2 Rs!!
  • admin of treatment will help to delineate a diagnosis of CENTRAL DI (effective in inc urine osmolality) or NEPHROGENIC DI (ineffective in inc urine osmolality)
  • desmopressin- used to tx coagulopathy in hemophilia A and von willebrand dz
37
Q

Vasopressin and Desmopressin- toxicity and contraindications

A
  • HA, nausea, abd cramps, agitation, allergic rxns- rarely
  • overdose- hyponatremia and seizures
  • vasopressin- use in caution in pts with CAD due to vasoconstriction
38
Q

Vasopressin antagonists- moa

A

Conivaptan and Tolvaptan

  • antagonists of vasopressin Rs
  • Tolvaptan- selective for V2 Rs
  • Conivaptan- V1 and V2 Rs
  • known as “aquaretics”- inc renal free water excretion with little change in electrolyte excretion
39
Q

Vasopressin antagonists- clinical use

A
  • euvolemic and hypervolemic hyponatremia (ex- in CHF and SIADH
  • tolvaptan- in short-term clinical trials with CHF- reduced ejection fraction, dec body weight, and improved dyspnea; but long-term there was no effect on all-cause mortality, CV death, or hospitalization for HF

E2T1 (6 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions