Hypothalamic Hormones

Question 1

Somatotropin (recombinant GH)

Somatrem (GH analog)

Answer 1

Physiological effects:

• ⬆️ longitudinal bone growth, bone density, muscle mass, GFR, lipolysis
• improves metabolic state, GI fxn & immune system fxn
• adipocyte differentiation
• anti-insulin action —> ⬆️ lipolysis

USES:

• GH deficiency
• Growth failure associated with Turner, Noonan or Prader-Willi syndrome, chronic renal failure, short stature
• Wasting in HIV pts
• Short bowel syndrome

MOA:
-mediated by IGF-1 via JAK/STAT pathway —> up-regulation of GLUT-1 & 4

CYP-inducer

AE:
Children-
-hypothyroidism 
-scoliosis (dt rapid growth)
-otitis media (⬆️ risk in TS)
-diabetic syndrome ( chronic use)
Adults-
- carpal tunnel
-retinopathy
-arthralgia (hands, wrists)

CONTRAINDICATIONS
-pts w/ known malignancy & CYP inducers

Question 2

Mecasermin

Answer 2

IGF-1 analog

USE: Growth failure d/t ⬇️ IGF-1 d/t GH receptor mutation or anti-GH antibody

AE: hypoglycemia (eat 20 min before/after admin), intracranial HTN, ⬆️ liver enzymes