Hypothalamic & Pituitary Hormones

Question 1

Mention uses & adverse effects of GH

Answer 1

Used to promote growth in GH def and off label as antiaging & improve performance of atheletes
AE, hyperglycemia, edema, myalgia, enzyme inducer

Question 2

Why is somatostatin use limited? Name long-acting somatostatin analog and its uses

Answer 2

Because of short t1/2 & non-specificity
Octereotide
1. Bleeding esophageal varices
2. Acromegaly
3. Carcinoid syndrome
4. GIT tumors secreting VIP, gastrinoma, glucagonomas

Question 3

Enumerate AEs of octereotide

Answer 3

Gall stones, N&V, abdominal cramps
Injection site pain
B12 def

Question 4

Enumerate uses of bromocriptine

Answer 4

1. PRL-secreting adenoma
2. To stimulate ovulation & treat amenorrhea & galactorrhea in hyperprolactinema
3. Dec physiological lactation
4. Parkisonism
5. Acromegaly

Question 5

Mention AEs of bromocriptine & a long-acting substitute

Answer 5

Nausea, orthostatic hypotension, confusion
Cabergoline

Question 6

List therapeutic uses & side effects of Cosyntropin

Answer 6

1. Screening for adrenocortical insufficiency
2. Duchenne muscular dystrophy
3. Infantile spasm monotherapy or iwth vigabatrin
   Side effects of glucocorticoids ex growth retardation

Question 7

Enumerate therapeutic uses of Syntocinon

Answer 7

1. Induction of labour: uterine enertis, incomplete abortion (IV)
2. Postpartum hemorrahge, IM but ergometrine preferred
3. Induction & maintenance of labor

Question 8

Manifestations of syntocinon toxicity

Answer 8

1. Uterine rupture
2. Fetal asphyxia
3. Water retention & intoxication

Question 9

Name an oxytocin antagonist and its use

Answer 9

Atosiban
Premature labour (iv)

Question 10

Mention use of:
1. Terlipressin
2. Felypressin

Answer 10

1. Bleeding esophageal varices & during surgery in portal HTN, as it is long acting with less side effects
2. Prolong action of local anesthetics, safer than epinepherine in cardiac patients

Question 11

Mention uses and advatanges of desmopressin in renal diseases

Answer 11

ADH-sensitive diabetes inspidipus & nocturnal enuresis
It is long acting, V2 selective (more potent antidiuretic, minimal VC), given intra-nasally

Question 12

Mention extra-renal use of vasopressin

Answer 12

1. Hemophilia A
2. Von Willebrand disease
   Inc factor VIII & Von Willerbrand factor

Question 13

List AEs of vasopressin analogues

Answer 13

1. VC, marked facial palor, coronary spasm, inc BP
2. Colic
3. Allergic reaction
4. Water intoxication esp w/ carbamazepine

Question 14

List uses of vaptans and 2 members with specifying their target

Answer 14

SIADH, hypervolemic & euvolemic hyponatremia, CHF
Conivaptan (V1&V2), Tolvaptan (V2)

Question 15

Mention adverse effects of vaptans

Answer 15

Polyuria, thirst, hypernatremia, infusion site reactions