Hypothalamic/Pituitary Drugs

Question 1

Somatropin/Somatotropin

Answer 1

Class: GH Analog
Mechanism: acts as agonist at GH receptors
Use: GH Deficiency, familial short stature
SE:
-kids: pseudotumor cerebri, scoliosis, edema, hyperglycemia (from insulin resistance)
-adults: edema, myalgias, arthralgias, carpal tunnel syndrome

Question 2

Mecasermin

Answer 2

Class: IGF-1 analog
Mechanism: stimulates IGF-1 receptors
Use: IGF-1 deficiency due to GH resistance
SE: Hypoglycemia

Question 3

Octreotide/Lantreotide

Answer 3

Class: Somatostatin agonists 
Mechanism: inhibit GH
Use: acromegaly (GH-secreting tumor)
SE:
-nausea/vomiting
-cramps/gas
-gallstones
-bradycardia
-conduction disturbances

Question 4

Pegvisomant

Answer 4

Class: GH antagonist
Mechanism: GH antagonist at receptor
Use: Acromegaly
SE: none

Question 5

Urofollitropin, Follitropin å and ß

Answer 5

Class: FSH agonists
Mechanism: act like FSH
Use:
-Women: IVF, second line to clomiphene
-Men: kallman syndrome (infertility due to hypogonadotropic hypogonadism)
SE: ovarian hyperstimulation syndrome, multiple pregnancy

Question 6

Lutropin å

Answer 6

Class: LH receptor agonist
MEchanism: acts like LH
Use: Used in IVF for LH deficient women
SE: OHSS, multiple pregnancy

Question 7

Choriogonadotropin å

Answer 7

Class: LH receptor agonist
Mechanism: acts like LH
Use:
-women: IVF, secondary to clomiphene
-men: infertility from kallman syndrome
SE: OHSS, multiple pregnancy

Question 8

Leuprolide, Goserelin, Histrelin, Nafarelin, Triptorelin

Answer 8

Class: GnRH agonists
Mechanism: GnRH agonists increase LH/FSH with intermittent administration, reduce with continuous administration
Use: IVF, endometriosis, uterine fibroids, prostate cancer, central precocious puberty
SE:
-Women: effects of decreased FSH/LH- menopause, depression, decreased libido, pain, vaginal dryness, breast atrophy, reduced bone density
-Men: effects of reduced testosterone- hot flashes, edema, gynecomastia, decreased libido, decreased hematocrit, reduced bone density, asthenia

Question 9

Ganirelix, Cetrorelix, Degarelix

Answer 9

GnRH antagonists
Mechanism: reduce endogenous LH/FSH production
Use: IVF, advanced prostate cancer
SE: androgen deprivation (hot flashes, edema)

Question 10

Bromocriptin/cabergoline

Answer 10

Dopamine agonists
Mechanism: suppress prolactin secretion
Use: hyperprolactinemia
SE: nausea, headache, lightheadedness, orthostatic hypotension, fatigue, psych, valvulopathy

Question 11

Oxytocin

Answer 11

Mechanism: oxytocin receptor agonist
Use: induction of labor, control uterine hemmorhage post-delivery
SE:
-fetal distress/placental abruption/uterine rupture
-accidental ADH-like effects- fluid retention, hyponatremia, CHF, seizures