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Pharmacology-Exam #1 (Summer) > Hypothalamic-Pituitary > Flashcards

Hypothalamic-Pituitary Flashcards

1
Q

When would you use Gonadotrophin-Releasing Hormone (GnRH) Analogs to INHIBIT gonadal function?

A
  1. Precocious Puberty
  2. Transgender/gender variant
  3. Prostate CA
  4. Women undergoing assisted reproductive technology (ART)
  5. Women requiring ovarian suppression
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2
Q

Dopamine Agonist Indications

A

Hyperprolactinemia

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3
Q

What inhibits Growth Hormone (GH)?

A

Somatostatin

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4
Q

What does GH stimulate in the primary target organs/peripheral tissue?

A

Insulin-like growth factor-1 (IGF-1)

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5
Q

What are the functions of GH?

A
  1. Required for normal growth
  2. Regulates lipid and carbohydrate metabolism and lean body mass
  3. Regulates production in peripheral tissues of IGF-1
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6
Q

Indications for Somatotropin (GH) in children

A
  1. Short Stature: Turner syndrome
  2. Failure to thrive
  3. Small for gestational age
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7
Q

Why is Somatotropin controversial in children with idiopathic short stature?

A

May only add 1.5-3 inches

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8
Q

Indications for Somatotropin (GH) in Adults

A
  1. GH deficiency
  2. Wasting in HIV pt’s
  3. Short Bowel Syndrome
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9
Q

Somatotropin ADE’s in Children

A
  1. Pseudotumor cerebri
  2. Slipped capital femoral epiphysis
  3. Scoliosis progression
  4. Hyperglycemia
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10
Q

What do you need to monitor in children with GH deficiency?

A

Deficiency of other anterior pituitary hormones

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11
Q

What may inhibit the growth-promoting effects of Somatotropin (recombinant GH)?

A

Glucocorticoids

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12
Q

What may accelerate epiphyseal closure and compromise the final height of children?

A

Concomitant administration of other hormones with Somatropin:

  1. Androgen
  2. Estrogen
  3. Thyroid hormones
  4. Anabolic steroids
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13
Q

List the Recombinant IGF-1

A

Mecasermin

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14
Q

Indications for Mecasermin ?

A

Children with growth failure unresponsive to GH therapy are deficient in IGF-1

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15
Q

What is imperative patient education when starting a pt’ on Mecasermin?

A

Must eat a snack/meal shortly before dose to avoid hypoglycemia

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16
Q

Other Mecasermin ADE’s

A
  1. Tonsillar/adenoidal hypertrophy
  2. Lymphoid hypertrophy
  3. Coarsening facial features
17
Q

List the Dopamine Agonist

A

Bromocriptine

Cabergoline

18
Q

Dopamine Agonist MOA in ACROMEGALY

A
  1. Paradoxical decrease in GH production

2. Normalize IGF-1 concentrations

19
Q

Dopamine agonist ADE in ACROMEGALY

A

Thickening of bronchial secretions and nasal congestion

20
Q

List the Somatostatin Analogs

A
  1. Octreotide
  2. Lanreotide
  3. Pasireotide
21
Q

Somatostatin Analog MOA

A

Inhibit the release of:

  1. GH
  2. Glucagon
  3. Insulin
  4. Gastrin
22
Q

Somatostatin Analog Clinical applications

A
  1. Acromegaly

2. Tx other neuroendocrine tumors

23
Q

Somatostatin Analog ADE’s

A
  1. Gallstones
  2. Cardiac conduction abnormalities
  3. HTN
  4. Abnormalities in glucose metabolism
  5. Subclinical Hypothyroidism
24
Q

List the GH antagonist

A

Pegvisomant

25
Q

GH antagonist (Pegvisomant) MOA

A
  1. Inhibits IGF-1 production

2. Blocks the physiological effects of GH on target tissues

26
Q

GH antagonist (Pegvisomant) Clinical application

A

Failed to achieve normalization of IGF-1 with other tx’s

27
Q

GH antagonist (Pegvisomant) ADE

A

Increased liver enzymes

28
Q

List the two selective estrogen receptor modulators (SERM)

A

Raloxifene

Tamoxifen

29
Q

Who would selective estrogen receptor modulators (SERM) be useful in?

A

Men and Women w/ persistent acromegaly who are postmenopausal OR
who have had breast CA

30
Q

Hyperprolactinemia etiology

A
  1. Prolactin-secreting PITUITARY tumors (prolactinoma)

2. Medications: Prolactin Stimulators OR Dopamine antagonize

31
Q

What is the treatment of choice of hyperprolactinemia?

A

Dopamine Agonist: Bromocriptine, Cabergoline

32
Q

D2-receptor agonist MOA in HYPERPROLACTINEMIA

A

Inhibit the release of prolactin

33
Q

Bromocriptine ADE in HYPERPROLACTINEMIA

A

Infertility

34
Q

Cabergoline ADE in HYPERPROLACTINEMIA

A

Mild-to-moderate decrease in BP

35
Q

Define Panhypopituitarism

A

Complete or partial loss of pituitary function

36
Q

Panhypopituitarism treatment

A

Will need lifelong replacement of multiple hormones (glucocorticoids, thyroid hormone, sex steroids) and constant monitoring

Pharmacology-Exam #1 (Summer) (6 decks)

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