Hypothalamus And Pituitary Flashcards
Growth-hormone releasing hormone causes release of?
Growth Hormone (somatotropin)
Thyrotropin Releasing Hormone causes release of?
Thyroid Stimulating Hormone
Corticiotropin releasing hormone causes release of?
Adrenocorticotropic Hormone
Gonadotropin releasing hormone causes release of?
Follicle stimulating hormone AND luteinizing hormone
Growth hormone inhibiting hormone is also called?
Somatostatin
Prolactin inhibiting hormone is called?
Dopamine
Growth hormone (somatotropin) effects:
Liver, muscle, bone, kidney - IGF-1
Thyroid stimulating hormone effects:
Thyroid
T3, T4
Adrenocorticotropic hormone effects:
Adrenal cortex
Glucocorticoids, mineralocorticoids, androgens
Follicle-stimulating hormone and lutenizing hormone effects?
Gonads
Estrogen, progesterone, testosterone
Vasopressin (ADH) - effects?
Kidney
Oxytocin - effects?
Uterus, breast
Clinical use for Corticotropin Releasing Hormone?
Diagnostic - differentiate between Cushing’s Disease (pituitary problem) and ectopic production of ACTH
Synthetic analogues of GnRH - MOA?
Sustained non-pulsatile administration results in suppression of ovarian and testicular steriodogenesis due to decreased LH and FSH
GnRH analogues - clinical use?
- In pulses, treats infertility (rare)
- Inhibit precocious puberty
- Prostate CA tx
- Endometriosis
- Uterine fibroids
In men, LH stimulates _____ cells of the testes, causing release of _______.
Leydig’s
Testosterone
What circulating hormone promotes the growth of existing prostate CA:
Testosterone
Gonadorelin - MOA and notable features
Synthetic GnRH - for veterinarian use ONLY
Goserelin - MOA and use?
Synthetic GnRH, monthly implant
Prostate CA
Endometriosis
Leuprolide - MOA and use?
Synthetic GnRH, SubQ injections
Prostate CA
Endometriosis
Nafarelin - MOA and use?
Synthetic GnRH nasal spray
Central Precocious Puberty
GnRH (synthetic) - clinical uses?
- Prostate CA
- Endometriosis
- Precocious puberty
Ganirelix and Cetrorelix - MOA and use?
GnRH receptor antagonists, inhibits premature LH surges in women undergoing controlled ovarian hyperstimulation procedures
Degarelix - MOA and use?
GnRH receptor antagonist (acts on pituitary, prevents release of LH/FSH)
Inhibits stimulation of Leydig cells, preventing testosterone release, to treat advanced prostate CA
What is acromegaly?
Adenoma causing increased secretion of growth hormone
Octreotide - MOA and use?
Somatostatin - blocks growth hormone secretion, inhibits insulin, glucagon, and gastrin secretion
Acromegaly, esophageal varices bleeding
Lanreotide - MOA and use?
Synthetic Growth Hormone Inhibiting Hormone (Somatostatin) blocks growth hormone secretion, also inhibits insulin, glucagon, and gastrin secretion
Acromegaly only
Pegvisomant - MOA and use?
Growth Hormone Receptor Antagonist
Blocks growth hormone receptors on cell surfaces, decreased IGF-1
Acromegaly
Prader-Willi Syndrome - treated with?
Growth hormone
Adrenocorticotropic Hormone (Cosyntropin) - clinical use?
Differentiate between primary adrenal insufficiency (Addison’s Disease) and secondary adrenal insufficiency caused by inadequate ACTH secretion (pituitary disorder)
Follicle-stimulating hormone (FSH) and Luteinizing hormone - clinical use in women?
Ovulation induction
Follicle stimulating hormone (FSH) - clinical use in men?
Treat male infertility (induce spermatogenesis)
Hyperprolactinemia caused by deficiency of?
Prolactin-inhibiting hormone (Dopamine)
Tx for hyperprolactinemia?
Dopamine (D2) Agonists
Bromocriptine
Cabergoline
Bromocriptine - class and use?
Dopamine (D2) agonist
Tx of hyperprolactinemia
Cabergoline - class and use?
Dopamine (D2) agonist
Tx of hyperprolactinemia
What is the target organ of ADH?
The kidney
Vasopressin - MOA?
Increased water resorption in the collecting ducts
Vasoconstriction effects, as well
Vasopressin - clinical use?
Diabetes insipidus
Esophageal varices
Management of vasodilatory shock
Desmopressin - MOA?
Synthetic analogue of vasopressin
WAY stronger than vasopressin
Desmopressin - use? (*DIHANE)
- (DI) Diabetes insipidus
- (HA)Control of bleeding associated with hemophilia A and von Willebrand’s disease
- (NE) Nocturnal enuresis
Syndrome of Inappropriate Antidiuretic Hormone Secretion (SIADH) - describe
- Inability to suppress secretion of ADH
2. Hyponatremia/Hypo-osmolality (too much H2O retention)
In SIADH, why does hyponatremia happen?
Too much H2O, NOT a sodium deficiency
Treatment of SIADH - emergent?
Raise serum sodium to correct hyponatremia
Loop diuretics
ADH antagonists
Water restriction
Treatment of SIADH - chronic?
Fluid restriction
Vasopressin-2 receptor antagonists
Conivaptan - MOA and use?
V1 and V2 (Vasopressin) receptor antagonist
Tx of hypervolemic hyponatremia in SIADH
Tolvaptan - MOA and use?
V1 and V2 (Vasopressin) receptor antagonist
HIGHER AFFINITY FOR V2
Approved for SIADH AND HF
Conivaptan - black box?
Must be administered in hospital - risk of osmotic demyelination of correction of hyponatremia is too rapid
NOT for HF
Oxytocin - clinical use?
- Stimulate lactation
- Induce labor
- Postpartum hemorrhage
Metoclopramide - MOA and use?
Dopamine antagonist
Off-label to stimulate lactation in women
Clinical use for Somatotropin?
Growth deficiencies