Hypothalamic/Pituitary Pharm

Question 1

Somatotropin and somatropin

Answer 1

Recombinant form of GH that binds the GH receptors and activates IGF-1 production.
Used in people with GH deficiency or short stature by other mechanisms.
Rarely toxic in children (may induce insulin resistance)
In adults toxicity leads to carpel tunnel, edema, myalgia, etc.

Question 2

Mecasermin

Answer 2

IGF-1 analogue that stimulates IGF-1 receptors.
Used in those with IGF-1 defects who are resistant to GH treatment.
Toxicity can lead to HYPOglycemia due to potentiation of insulin’s actions)

Question 3

Octreotide and Lanreotide

Answer 3

Agonist at Somatostatin Receptor site to inhibit the production of GH.
Used in acromegaly patients caused by GH secreting tumors.
Toxicity causes nausea, vomiting, cramps, flatulence, Gallstones, sinus Brady, conduction issues.

Question 4

Pegvisomat

Answer 4

GH receptor Antagonist to combat the effects of excess GH production. Used to treat Acromegaly just like the somatostatin analogues and is better tolerated by patients.

Question 5

Urofollitropin

Follitropin alpha and beta

Answer 5

FSH receptor agonist.
In Men, treats infertility due to hypogonadism.
In woman, used to control ovarian hyperstimulation in reproductive procedures…also used to stimulate ovulation in patients who fail to respond to other treatments like clomiphene.
Toxicity can lead to multiple pregnancies (twins, trips, quads)

Question 6

Lutropin alpha

Answer 6

LH receptor Agonist. Used in combination therapy with follitropin alpha in controlled ovarian hyperstimulation.

Can lead to multiple pregnancies.

Question 7

Choriogonadotropin alpha

Answer 7

Human Chorionic Gonadotropin (hCG) Analog that mimics the effects of endogenous LH.
Same uses as FSH Agonists.

Question 8

GnRH Agonists

Answer 8

Leuprolide, Goserelin, Histrelin, Nafarelin, Triptorelin.
Increases LH and FSH with intermittent administration.
Decreases LH and FSH with prolonged administration.
Used in prostate cancer, central precocious puberty, undermine fibroids, endometriosis.
Continuous treatment in women: menopausal symptoms, depression, decreased libido, vaginal dryness, Breast atrophy, OVarian cysts.
Continuous treatment in men: hot flashes, gynecomastia, decreased libido, decreased hematocrit and bone density.

Question 9

GnRH Antagonist

Answer 9

Reduces endogenous production of LH and FSH
Ganirelix, Cetrorelix, Degarelix.
TReats symptomatically advanced prostate cancer.
Can cause hot flashes and edema with continuous use.

Question 10

Bromocriptine

Cabergoline

Answer 10

Dopamine D2 Receptor agonist.
Suppresses pituitary secretion of prolactin.
Treats hyperprolactimnemia.
Toxicity can cause Nausea, headache, orthostatic hypotension, fatigue,
Cabergoline is associated with incidence of cardiac valvulopathy

Question 11

Oxytocin

Answer 11

Agonist of oxytocin receptors.
Increases uterine contractions.
Induces labor. Controls uterine hemorrhage after delivery.
Can cause fetal distress, placental abruption, uterine rupture.
Inadvertent activation of vasopressin receptors can cause fluid retention, hyponatremia, heart failure, seizures.