Hypothalamic-Pituitary Hormones Flashcards
What is the function of ACTH?
Used to diagnose primary vs. secondary adrenal insufficiency and stimulates adrenal cortex to make cortisol, aldosterone, androgens.
What is Cosyntropin?
A synthetic form of ACTH with fewer allergies.
What is Somatotropin used for?
Used in children with growth hormone deficiency, Turner syndrome, Prader-Willi syndrome, chronic renal failure, and wasting in AIDS patients.
What are the adverse effects of Somatotropin?
Hypoglycemia, joint pain, hyperglycemia, edema, avoid in patients with malignancy.
What is Tesmorelin indicated for?
Stimulates the release of growth hormone (GH) and is indicated for HIV lipodystrophy.
What is the mechanism of Somatostatin?
Inhibits the release of GH, TSH, ACTH, glucagon, insulin, gastrin.
What is the use of Octreotide?
Used for acromegaly, carcinoid syndrome, pituitary adenomas, VIPoma, esophageal varices.
What are the adverse effects of Octreotide?
GI upset, fat in feces, gallstones, bradycardia.
What does Pegvisomant do?
Normalizes IGF-1 in patients with acromegaly.
What are the adverse effects of Pegvisomant?
Elevated LFTs, lipohypertrophy.
What are Menotropins composed of?
Contain FSH and LH.
What is the use of Chorionic gonadotropin (hCG)?
Increases ovulation and descent of testes; LH analog.
What are the adverse effects of Follitropin alfa?
Multiple births, Ovarian hyperstimulation syndrome (OHSS).
What is Clomiphene’s mechanism of action?
Partial estrogen agonist that interferes with negative feedback of estrogens on hypothalamus.
What are the adverse effects of Clomiphene?
Hot flashes, ovarian enlargement, cyst formation, multiple births.
What are GnRH agonists used for?
Prostate and breast cancer, endometriosis, precocious puberty, assisted reproduction.
What are the adverse effects of GnRH agonists?
Hot flashes, gynecomastia, osteoporosis, loss of libido, mood changes.
What do GnRH antagonists do?
Decrease LH surge for women with ovarian hyperstimulation and inhibit testosterone release in advanced prostate cancer.
What is Thyrotropin alfa used for?
Tests thyroid function after thyroid cancer treatment, diagnosis of thyroid conditions.
What is the role of dopamine in prolactin secretion?
Inhibits prolactin secretion.
What drugs treat hyperprolactinemia?
Dopamine agonists like bromocriptine and cabergoline.
What are the adverse effects of dopamine agonists?
Hypotension, psychosis, nausea/vomiting.
What is the action of oxytocin?
Increases receptors in late pregnancy, induces labor contractions, stops postpartum uterine hemorrhage.
What are the adverse effects of oxytocin?
Fluid retention, hyponatremia, CNS stimulation, excess uterine contraction.
What is Desmopressin used for?
Central diabetes insipidus, nocturnal enuresis, von Willebrand disease.
What are the adverse effects of Desmopressin?
Dilutional hyponatremia, vasoconstriction, seizures.
What do vasopressin antagonists treat?
Hyponatremia associated with elevated vasopressin (SIADH), CHF.
What is the mechanism of action of Demeclocycline?
Reversibly binds 30S, blocks aminoacyl t-RNA.
What are the adverse effects of Demeclocycline?
Similar to tetracycline.
What is the role of GH in the body?
Mediated by insulin-like growth factor 1 (IGF-1).
What IGF-1 recombinant is used for kids w/ severe IGF-1 deficiency, GH autoimmunity, and genetic mutations
mecasermin
why are pts. taking mecasermin advised to take a snack before each administration?
AE: hypoglycemia
T or F: somapacitan enhances GH activity.
True
activation of what system causes edema seen in pt. on GH enhancement drugs
increased RAAS activity
what GH inhibitor is used to treat Cushing’s Disease?
Pasireotide
what is the mechanism for octreotide-induced bradycardia?
weak agonist of M2 receptors
why are pts. on pegvisomant advised to rotate the injection site
prevents lipohypertrophy
what is the MOA for Letrozole?
aromatase inhibitor that stops estradiol production
list the GnRH agonists you need to know
goserelin
leuprolide
nafarelin
histrelin
why are testosterone blockers given in conjunction w/ a GnRH agonist
stimulates release of FSH and LH at first, which can cause a flare-up
list the testosterone blockers you need to kno
flutamide
bicalutamide
what is the MOA for ganirelix and cetrorelix
decreases LH surge for women w/ ovarian hyperstimulation
what is the MOA for degarelix
inhibits testosterone release and therefore used to treat advanced prostate cancer
what are AEs of GnRH antagonists?
hypersensitivity, androgen loss in males; well-tolerated for females
what drug class can be given to increase prolactin levels
D2 receptor antagonists
T or F: both GH and PRI work on the JAK-sTAT mechanims
true
what is the MOA of Atosiban
oxytocin receptor antagonist; not used in US
oxytocin antagonists are not used in the US, so what drug is commonly given to suppress labor
terbutaline (B2 agonists)
T or F: Vasopressin is only a V2 agoint
false
it is also a V1 agoinst
describe the mechanism of V1 agonits?
vasoconstriction via Gq
describe the mechanism of V2 agonits?
water conservation via Gs
list the vasopressin antagonists you need to know
conivaptan
tovapatan
what kind of hyponatremias are vasopressin antagonists used for
euvolemic hyponatremia
hypervolemic hyponatremia
What is demeclocycline used for
ADH antagonist; treats SIADH
