Hypothalamus Flashcards
May be used in pulses to treat infertility caused by GnRH deficiency
Gonadotropin-releasing hormone (GnRH)
What can dopamine agonists tx?
hyperprolactinemia
Regulates IGF production in peripheral tissues
What drugs?
somatropin
mescasermin
Children indications of somatotropin
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
What 3 other clinical conditions do you use GH for?
GH definiciency in adults
wasting in HIV ps
short bowel syndrome
somatropin ADEs in children
Pseudotumor cerebri
slipped capital femoral epiphysis
scoliosis
hyperglycemia
somatropin drug interactions
glucocorticoids
concomitant admin of other hormones
what happens if you administer other hormones with somatropin?
(androgens, estrogens, thyroid hormones, anabolic steroids)
accelerate epiphyseal closure and compromise final height
Recombinant human IGF-1 (insulin like growth factor 1)
administered parenterally
which drug?
mecasermin
indications of mecasermin
children with growth failure unresponsive to GH therapy are deficient in IGF-1
ADEs of mecasermin
Hypoglycemia
Tonsillar/adenoidal hypertrophy, lymphoid hypertrophy
Coarsening facial features
What should you take mecasermin with and why?
a snack to prevent hypoglycemia
What two conditions does growth hormone-secreting pituitary adenomas cause?
acromegaly
gigantism
What is the main diagnostic tool for acromegaly?
OGTT
describe OGTT effects on body that leads to a + acromegaly dx
inc. OGTT –> inc. GH –> inc. IGF-1
in normal pts: OGTT should dec. GH
what are the dopamine agonists
bromociptine and cabergoline
normalize IGF-1 concentrations –> paradoxical decrease in GH production
which drug
dopamine agonists (bromocriptine, cabergoline)
Main ADE of dopamine agonists (bromocriptine, cabergoline)
thickening of bronchial secretions and nasal congestion
somatostatin analogs
Octreotide, Lanreotide and Pasireo_tide_
inhibit the release of : GH, glucagon, insulin, and gastrin
which drug?
somatostatin analogs (-tides)
uses of somatostatin analogs (-tides)
treat acromegaly
other neuroendocrine tumors
ADEs of somatostatin analogs (-tides)
Gallstones
Cardiac conduction abnormalities
Hypertension
Abnormalities in glucose metabolism
Subclinical hypothyroidism
Inhibits IGF-1 production
Blocks the physiologic effects of GH on target tissues
which drug?
Pegvisomant
use of pegvisomant
Acromegaly in patients who have failed to achieve normalization of IGF-1 serum concentrations with other treatments
main ADE of pegvisomant
inc. liver enzymes
Selective estrogen receptor modulator (SERM)
raloxifene
tamoxifen
use of SERM (raloxifene & tamoxifen)
persistent acromegaly in men and in women who are postmenopausal or who have had breast cancer
T/F: Estrogens more potent in IGF-1 reduction than are SERMS
TRUE
tx algorithm for acromegaly
- somatostatin analogs
- Dopamine agonists
- Pegvisomant
what is a prolacinoma
Benign prolactin-secreting pituitary tumors
Hyperprplactinemia tx
dopamine agonists (more effective than surgery)
transsphenoidal surg + radiation (for pts refractory to or cannot tolerate therapy with DA)
Hypothalamic release of dopamine inhibits the release of prolactin
MOA of which drug?
D2-recedptor agonists
main ADE of bromocriptine
infertility
“bros are infertile”
main ADE for cabergoline
mild-mod dec.in BP
complete or partial loss of pituitary function
panhypopituitarism
tx of panhypopituitarism
Replacement of
–Glucocorticoids
–Thyroid hormone preparations
–Sex steroids
_Will need lifelong replacement therapy and constant monitoring**_
