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P2 E3 Shea > Hypothalamus > Flashcards

Hypothalamus Flashcards

1
Q

May be used in pulses to treat infertility caused by GnRH deficiency

A

Gonadotropin-releasing hormone (GnRH)

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2
Q

What can dopamine agonists tx?

A

hyperprolactinemia

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3
Q

Regulates IGF production in peripheral tissues

What drugs?

A

somatropin

mescasermin

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4
Q

Children indications of somatotropin

A

Short stature:

Turner syndrome, Noonan syndrome, Prader-Willi syndrome

Failure to thrive due to chronic renal failure

–Small-for-gestational-age condition

Controversial use: children with idiopathic short stature

May add 1.5-3inches

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5
Q

What 3 other clinical conditions do you use GH for?

A

GH definiciency in adults

wasting in HIV ps

short bowel syndrome

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6
Q

somatropin ADEs in children

A

Pseudotumor cerebri

slipped capital femoral epiphysis

scoliosis

hyperglycemia

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7
Q

somatropin drug interactions

A

glucocorticoids

concomitant admin of other hormones

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8
Q

what happens if you administer other hormones with somatropin?

(androgens, estrogens, thyroid hormones, anabolic steroids)

A

accelerate epiphyseal closure and compromise final height

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9
Q

Recombinant human IGF-1 (insulin like growth factor 1)

administered parenterally

which drug?

A

mecasermin

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10
Q

indications of mecasermin

A

children with growth failure unresponsive to GH therapy are deficient in IGF-1

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11
Q

ADEs of mecasermin

A

Hypoglycemia

Tonsillar/adenoidal hypertrophy, lymphoid hypertrophy

Coarsening facial features

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12
Q

What should you take mecasermin with and why?

A

a snack to prevent hypoglycemia

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13
Q

What two conditions does growth hormone-secreting pituitary adenomas cause?

A

acromegaly

gigantism

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14
Q

What is the main diagnostic tool for acromegaly?

A

OGTT

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15
Q

describe OGTT effects on body that leads to a + acromegaly dx

A

inc. OGTT –> inc. GH –> inc. IGF-1

in normal pts: OGTT should dec. GH

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16
Q

what are the dopamine agonists

A

bromociptine and cabergoline

17
Q

normalize IGF-1 concentrations –> paradoxical decrease in GH production

which drug

A

dopamine agonists (bromocriptine, cabergoline)

18
Q

Main ADE of dopamine agonists (bromocriptine, cabergoline)

A

thickening of bronchial secretions and nasal congestion

19
Q

somatostatin analogs

A

Octreotide, Lanreotide and Pasireo_tide_

20
Q

inhibit the release of : GH, glucagon, insulin, and gastrin

which drug?

A

somatostatin analogs (-tides)

21
Q

uses of somatostatin analogs (-tides)

A

treat acromegaly

other neuroendocrine tumors

22
Q

ADEs of somatostatin analogs (-tides)

A

Gallstones

Cardiac conduction abnormalities

Hypertension

Abnormalities in glucose metabolism

Subclinical hypothyroidism

23
Q

Inhibits IGF-1 production

Blocks the physiologic effects of GH on target tissues

which drug?

A

Pegvisomant

24
Q

use of pegvisomant

A

Acromegaly in patients who have failed to achieve normalization of IGF-1 serum concentrations with other treatments

25
Q

main ADE of pegvisomant

A

inc. liver enzymes

26
Q

Selective estrogen receptor modulator (SERM)

A

raloxifene

tamoxifen

27
Q

use of SERM (raloxifene & tamoxifen)

A

persistent acromegaly in men and in women who are postmenopausal or who have had breast cancer

28
Q

T/F: Estrogens more potent in IGF-1 reduction than are SERMS

A

TRUE

29
Q

tx algorithm for acromegaly

A
  1. somatostatin analogs
  2. Dopamine agonists
  3. Pegvisomant
30
Q

what is a prolacinoma

A

Benign prolactin-secreting pituitary tumors

31
Q

Hyperprplactinemia tx

A

dopamine agonists (more effective than surgery)

transsphenoidal surg + radiation (for pts refractory to or cannot tolerate therapy with DA)

32
Q

Hypothalamic release of dopamine inhibits the release of prolactin

MOA of which drug?

A

D2-recedptor agonists

33
Q

main ADE of bromocriptine

A

infertility

“bros are infertile”

34
Q

main ADE for cabergoline

A

mild-mod dec.in BP

35
Q

complete or partial loss of pituitary function

A

panhypopituitarism

36
Q

tx of panhypopituitarism

A

Replacement of

–Glucocorticoids

–Thyroid hormone preparations

–Sex steroids

_Will need lifelong replacement therapy and constant monitoring**_

37
Q
A

P2 E3 Shea (9 decks)

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