Hypothalamic-Pituitary Hormones

Question 1

What is the function of ACTH?

Answer 1

Used to diagnose primary vs. secondary adrenal insufficiency and stimulates adrenal cortex to make cortisol, aldosterone, androgens.

Question 2

What is Cosyntropin?

Answer 2

A synthetic form of ACTH with fewer allergies.

Question 3

What is Somatotropin used for?

Answer 3

Used in children with growth hormone deficiency, Turner syndrome, Prader-Willi syndrome, chronic renal failure, and wasting in AIDS patients.

Question 4

What are the adverse effects of Somatotropin?

Answer 4

Hypoglycemia, joint pain, hyperglycemia, edema, avoid in patients with malignancy.

Question 5

What is Tesmorelin indicated for?

Answer 5

Stimulates the release of growth hormone (GH) and is indicated for HIV lipodystrophy.

Question 6

What is the mechanism of Somatostatin?

Answer 6

Inhibits the release of GH, TSH, ACTH, glucagon, insulin, gastrin.

Question 7

What is the use of Octreotide?

Answer 7

Used for acromegaly, carcinoid syndrome, pituitary adenomas, VIPoma, esophageal varices.

Question 8

What are the adverse effects of Octreotide?

Answer 8

GI upset, fat in feces, gallstones, bradycardia.

Question 9

What does Pegvisomant do?

Answer 9

Normalizes IGF-1 in patients with acromegaly.

Question 10

What are the adverse effects of Pegvisomant?

Answer 10

Elevated LFTs, lipohypertrophy.

Question 11

What are Menotropins composed of?

Answer 11

Contain FSH and LH.

Question 12

What is the use of Chorionic gonadotropin (hCG)?

Answer 12

Increases ovulation and descent of testes; LH analog.

Question 13

What are the adverse effects of Follitropin alfa?

Answer 13

Multiple births, Ovarian hyperstimulation syndrome (OHSS).

Question 14

What is Clomiphene’s mechanism of action?

Answer 14

Partial estrogen agonist that interferes with negative feedback of estrogens on hypothalamus.

Question 15

What are the adverse effects of Clomiphene?

Answer 15

Hot flashes, ovarian enlargement, cyst formation, multiple births.

Question 16

What are GnRH agonists used for?

Answer 16

Prostate and breast cancer, endometriosis, precocious puberty, assisted reproduction.

Question 17

What are the adverse effects of GnRH agonists?

Answer 17

Hot flashes, gynecomastia, osteoporosis, loss of libido, mood changes.

Question 18

What do GnRH antagonists do?

Answer 18

Decrease LH surge for women with ovarian hyperstimulation and inhibit testosterone release in advanced prostate cancer.

Question 19

What is Thyrotropin alfa used for?

Answer 19

Tests thyroid function after thyroid cancer treatment, diagnosis of thyroid conditions.

Question 20

What is the role of dopamine in prolactin secretion?

Answer 20

Inhibits prolactin secretion.

Question 21

What drugs treat hyperprolactinemia?

Answer 21

Dopamine agonists like bromocriptine and cabergoline.

Question 22

What are the adverse effects of dopamine agonists?

Answer 22

Hypotension, psychosis, nausea/vomiting.

Question 23

What is the action of oxytocin?

Answer 23

Increases receptors in late pregnancy, induces labor contractions, stops postpartum uterine hemorrhage.

Question 24

What are the adverse effects of oxytocin?

Answer 24

Fluid retention, hyponatremia, CNS stimulation, excess uterine contraction.

Question 25

What is Desmopressin used for?

Answer 25

Central diabetes insipidus, nocturnal enuresis, von Willebrand disease.

Question 26

What are the adverse effects of Desmopressin?

Answer 26

Dilutional hyponatremia, vasoconstriction, seizures.

Question 27

What do vasopressin antagonists treat?

Answer 27

Hyponatremia associated with elevated vasopressin (SIADH), CHF.

Question 28

What is the mechanism of action of Demeclocycline?

Answer 28

Reversibly binds 30S, blocks aminoacyl t-RNA.

Question 29

What are the adverse effects of Demeclocycline?

Answer 29

Similar to tetracycline.

Question 30

What is the role of GH in the body?

Answer 30

Mediated by insulin-like growth factor 1 (IGF-1).

Question 31

What IGF-1 recombinant is used for kids w/ severe IGF-1 deficiency, GH autoimmunity, and genetic mutations

Answer 31

mecasermin

Question 32

why are pts. taking mecasermin advised to take a snack before each administration?

Answer 32

AE: hypoglycemia

Question 33

T or F: somapacitan enhances GH activity.

Answer 33

True

Question 34

activation of what system causes edema seen in pt. on GH enhancement drugs

Answer 34

increased RAAS activity

Question 35

what GH inhibitor is used to treat Cushing's Disease?

Answer 35

Pasireotide

Question 36

what is the mechanism for octreotide-induced bradycardia?

Answer 36

weak agonist of M2 receptors

Question 37

why are pts. on pegvisomant advised to rotate the injection site

Answer 37

prevents lipohypertrophy

Question 38

what is the MOA for Letrozole?

Answer 38

aromatase inhibitor that stops estradiol production

Question 39

list the GnRH agonists you need to know

Answer 39

goserelin leuprolide nafarelin histrelin

Question 40

why are testosterone blockers given in conjunction w/ a GnRH agonist

Answer 40

stimulates release of FSH and LH at first, which can cause a flare-up

Question 41

list the testosterone blockers you need to kno

Answer 41

flutamide bicalutamide

Question 42

what is the MOA for ganirelix and cetrorelix

Answer 42

decreases LH surge for women w/ ovarian hyperstimulation

Question 43

what is the MOA for degarelix

Answer 43

inhibits testosterone release and therefore used to treat advanced prostate cancer

Question 44

what are AEs of GnRH antagonists?

Answer 44

hypersensitivity, androgen loss in males; well-tolerated for females

Question 45

what drug class can be given to increase prolactin levels

Answer 45

D2 receptor antagonists

Question 46

T or F: both GH and PRI work on the JAK-sTAT mechanims

Answer 46

true

Question 47

what is the MOA of Atosiban

Answer 47

oxytocin receptor antagonist; not used in US

Question 48

oxytocin antagonists are not used in the US, so what drug is commonly given to suppress labor

Answer 48

terbutaline (B2 agonists)

Question 49

T or F: Vasopressin is only a V2 agoint

Answer 49

false it is also a V1 agoinst

Question 50

describe the mechanism of V1 agonits?

Answer 50

vasoconstriction via Gq

Question 51

describe the mechanism of V2 agonits?

Answer 51

water conservation via Gs

Question 52

list the vasopressin antagonists you need to know

Answer 52

conivaptan tovapatan

Question 53

what kind of hyponatremias are vasopressin antagonists used for

Answer 53

euvolemic hyponatremia hypervolemic hyponatremia

Question 54

What is demeclocycline used for

Answer 54

ADH antagonist; treats SIADH