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1. Pharm II > Hypothalamus and Pituitary > Flashcards

Hypothalamus and Pituitary Flashcards

1
Q

Hormones released from the anterior pituitary do what?

A

stimulate the production of hormones by a peripheral endocrine gland, the liver, or other tissues

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2
Q

Hormones released from the posterior pituitary act how?

A

act directly on target tissues

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3
Q

what do hypothalamic factors do?

A

regulate the release of anterior pituitary hormones

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4
Q

what are the positive and negative feedback hypothalamic hormones affecting Growth hormone?

A

positive: Growth hormone releasing hormone
negative: somatostatin

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5
Q

what are the functions of growth hormone? (3)

A

Required for normal growth

Regulates lipid and carbohydrate metabolism and lean body mass

Regulates production of insulin-like growth factor 1 (IGF-1) in peripheral tissues

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6
Q

what is Somatropin?

A

recombinant form of Human growth hormone

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7
Q

what are some indications for use of somatropin?

A
  • short stature
  • failure to thrive
  • small-for-gestational-age
  • HIV wasting
  • short bowel syndrome= improves GI function
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8
Q

Adverse effects of Somatropin in children?

A
  • pseudotumor cerebri
  • slipped capital femoral epiphysis
  • progression of scoliosis
  • hyperglycemia
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9
Q

If given glucocorticoids in addition to GH, what might you find?

A

it may inhibit the growth-promoting effects of GH

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10
Q

If you give GH in addition to other hormones, what might happen?

A

may accelerate epiphyseal closure and compromise final height

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11
Q

what is mecasermin?

A

recombinant human IGF-1

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12
Q

when do you use mecasermin?

A

children w/ growth failure unresponsive to GH therapy and are deficient in IGF-1

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13
Q

ADE of mecasermin?

A
  • hypoglycemia
  • tonsillar/adenoidal hypertrophy, lymphoid hypertrophy
  • coursing facial features
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14
Q

what are the dopamine agonists?

A

bromocriptine

cabergoline

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15
Q

what are GH antagonists?

A

Octreotide, Lanreotide, Pasireotide

Pegvisomant

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16
Q

If a pt has a growth hormone-secreting pituitary adenoma, what is it called in adults? children?

A 
adults= acromegaly
children= gigantism
17
Q

what diagnostic tool can be used to test IGF-1?

A

oral glucose tolerance test

18
Q

what would you find after giving the glucose in OGTT?

A

Oral glucose load would be expected to suppress GH concentrations
Patients with acromegaly continue to secrete GH during the OGTT

19
Q

rank the effectiveness of dopamine agonists, somatostatin analogs, and GH-receptor antagonist in lowering GH concentrations

A

(least) dopamine agonists < somatostatin analogs < GH-receptor antagonist (most)

20
Q

what happens in pts with acromegaly when using dopamine agonists?

A

paradoxical decrease in GH production

normalize IGH-1 concentrations

21
Q

Unique ADEs of dopamine agonists

A

thickening of bronchial secretions and nasal congestion

22
Q

how do somatostatin analogs work?

A

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

23
Q

ADEs of somatostatin analogs

A
  • Gallstones (inhibition of CCK release)
  • Cardiac conduction abnormalities
  • Hypertension
  • Abnormalities in glucose metabolism
  • Subclinical hypothyroidism
24
Q

What is Pegvisomant and how does it work?

A

GH antagonist

  • Inhibits IGF-1 production
  • Blocks the physiologic effects of GH on target tissues
25
Q

What is a unique ADE of pegvisomant?

A

Increased liver enzymes

26
Q

what is the primary treatment of acromegaly?

A

surgery

27
Q

Causes of hyperprolactinemia?

A

prolactin stimulators (lots of types of drugs)

dopamine antagonists (mostly from antipsychotics)

28
Q

what are treatment options for hyperprolactinemia? What is most effective?

A
  • dopamine agonists (more effective than surgery)
  • radiation therapy
  • transsphenoidal surgical removal of the tumor
29
Q

How do dopamine agonists work in pts w/ hyperprolactinemia?

A

Hypothalamic release of dopamine inhibits the release of prolactin

30
Q

ADE of Bromocriptine

A

infertility

31
Q

ADE of Cabergoline

A

Mild-to-moderate decreases in blood pressure

32
Q

If you lose your pituitary gland due to a tumor, what do you have? What does it require?

A

panhypopituitaryism

replacement of all hormones exogenously

33
Q

What 2 hormones are released by the posterior pituitary?

A

oxytocin

vasopressin

34
Q

What is used to dx TRH or TSH deficiencies?

A

Thyrotropin-releasing hormone

35
Q

What are dopamine agonists used for?

A

Tx of hyperprolactinemia

36
Q

What are GnRH analogs used for?

A

Inhibiting gonadal function in precocious puberty, transgender/gender variant, prostate CA, & in women undergoing assisted reproductive technology (ART)

1. Pharm II (11 decks)

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