Hypothalamic & Pituitary Hormones

Question 1

Recombinant human GH

Answer 1

Somatropin

Question 2

Indications for using recombinant human GH

Answer 2

1. Replacement in GH deficiency
2. Increased final adult height in children with certain conditions associated with short stature (e.g., Turner syndrome, Noonan syndrome, Prader-Willi syndrome).
3. Wasting in HIV infection
4. Short bowel syndrome

Question 3

Toxicities of recombinant human GH in children

Answer 3

pseudotumor cerebri
slipped capital femoral epiphysis
progression of scoliosis
edema
hyperglycemia

Question 4

Toxicities of recombinant human GH in adults

Answer 4

peripheral edema
myalgia
arthralgia

Question 5

IGF-1 agonist

Answer 5

Mecasermin

Question 6

What condition is mecasermin indicated for?

Answer 6

Replacement in IGF-1 deficiency that is not responsive to exogenous GH

Question 7

Toxicities associated with mecasermin

Answer 7

hypoglycemia
intracranial hypertension
increased liver enzymes

Question 8

Somatostatin receptor agonists

Answer 8

Octreotide, Lanreotide (long-acting formulation for acromegaly)

Question 9

What is octreotide used for?

Answer 9

1. Acromegaly and several other hormone-secreting tumors

2. Acute control of bleeding from esophageal varices

Question 10

Toxicities related to octreotide

Answer 10

GI disturbances, gallstones, bradycardia, cardiac conduction anomalies

Question 11

GH receptor antagonist

Answer 11

Pegvisomant

Question 12

What is pegvisomant used for?

Answer 12

Acromegaly

Question 13

Toxicities associated with pegvisomant

Answer 13

Increased liver enzymes

Question 14

FSH agonists

Answer 14

Follitropin alfa and beta (recombinant FSH; differ in carbohydrate side chains only)
Urofollitropin (human FSH purified from the urine of postmenopausal women)

Question 15

Extract of the urine of postmenopausal women that contains both FSH and LH activity

Answer 15

Menotropins

Question 16

Clinical uses of FSH analogs (follitropin, urofollitropin, menotropin)

Answer 16

1. In women: Controlled ovulation hyperstimulation

2. In men: Infertility due to hypogonadotropic hypogonadism

Question 17

Toxicities of follitropins

Answer 17

1. Ovarian hyperstimulation syndrome and multiple pregnancies in women
2. Gynecomastia in men
3. Headache, depression, edema in both sexes

Question 18

What is hCG used as?

Answer 18

An LH receptor agonist (the structure of hCG is nearly identical to LH)

Question 19

Recombinant LH

Answer 19

Lutropin

Question 20

Uses for LH analogs

Answer 20

1. Initiation of ovulation during controlled ovulation hyper stimulation
2. Women: Ovarian follicle development in women with hypogonadotropic hypogonadism
3. Male hypogonadotropic hypogonadism

Question 21

Toxicities associated with LH analogs

Answer 21

1. In women: Ovarian hyperstimulation syndrome and multiple pregnancies
2. In men: gynecomastia
3. Both: headache, depression, edema

Question 22

GnRH receptor agonist

Answer 22

Leuprolide

Question 23

Clinical applications of leuprolide

Answer 23

1. Ovarian suppression
2. Controlled ovarian hyperstimulation
3. Central precocious puberty
4. Block of endogenous puberty in transgender early pubertal adolescents
5. Advanced prostate cancer

Question 24

Toxicities associated with leuprolide

Answer 24

Headache, light-headedness, nausea, injection site reaction

*NB: with continuous treatment, symptoms of hypogonadism

Question 25

Gonadorelin

Answer 25

synthetic human GnRH

Question 26

Goserelin

Answer 26

GnRH analog

Question 27

Histrelin

Answer 27

GnRH analog

Question 28

Nafarelin

Answer 28

GnRH analog

Question 29

Triptorelin

Answer 29

GnRH analog

Question 30

GnRH receptor antagonist

Answer 30

Ganirelix

Question 31

Similar to ganirelix, approved for controlled ovarian hyperstimulation

Answer 31

Cetrorelix

Question 32

GnRH antagonist approved for advanced prostate cancer

Answer 32

Degarelix

Question 33

Clinical uses for Ganirelix

Answer 33

Prevention of premature LH surges during controlled ovulation hyperstimulation

Question 34

Side effects of Ganirelix

Answer 34

Nausea, headache

Question 35

D2 agonist used for hyperprolactinemia and Parkinson's disease

Answer 35

Bromocriptine

Question 36

Toxicities associated with bromocriptine

Answer 36

GI disturbances, orthostatic hypotension, headache, psychiatric disturbances, vasospasm and pulmonary infiltrates at high doses

Question 37

Clinical uses of oxytocin

Answer 37

Induction and augmentation of labor | Control of uterine hemorrhage after delivery

Question 38

Toxicities of oxytocin

Answer 38

Fetal distress, placental abruption, uterine rupture, fluid retention, hypotension

Question 39

Oxytocin receptor antagonist

Answer 39

Atosiban

Question 40

Clinical use of atosiban

Answer 40

Tocolysis (prevention of preterm labor). | *NB: Atosiban is not FDA approved. Concerns about the rates of infant death.

Question 41

Agonist of vasopressin V2 receptors

Answer 41

Desmopressin

Question 42

Treatment of diabetes insipid us and sometimes used to control bleeding from esophageal varices

Answer 42

Vasopressin, acting through V1 receptors

Question 43

Clinical uses for desmopressin

Answer 43

pituitary (central) D.I. | Hemophilia A and von Willebrand disease (extra renal V2-like receptors regulate the release of FVIII and vWF)

Question 44

Toxicities associated with desmopressin

Answer 44

GI disturbances, headache, hyponatremia, allergic reactions

Question 45

Vasopressin receptor antagonist at V1a and V2 receptors

Answer 45

Conivaptan

Question 46

Clinical use of conivaptan

Answer 46

Hyponatremia in hospitalized patients

Question 47

Toxicities associated with conivaptan

Answer 47

infusion site reactions