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Pharmacology > Hypothalamus and Pituitary > Flashcards

Hypothalamus and Pituitary Flashcards

1
Q

Where are the hormones of the posterior pituitary synthesized?

A

Hypothalamus

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2
Q

What pathway do GH and prolactin act through?

A

JAK/STAT Pathway

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3
Q

What pathway does LH, FSH, TSH and ACTH act through?

A

G-protein Coupled Receptors

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4
Q

What are the 5 releasing hormone axes?

A
  • GnRH
  • GHRH (activation) and Somatostatin (inhibition)
  • TRH
  • CRH
  • DOPA (inhibition)
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5
Q

What is long loop feedback?

A

Organ mediator (ex. cortisol) acts to inhibit hypothalamic release of CRH or to inhibit release of hormone from the anterior pituitary (ex. cortisol acting on ACTH)

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6
Q

What is short loop feedback?

A

Anterior pituitary hormone feeds back to hypothalamus

Ex. ACTH negative feedback on CRH

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7
Q

What is the major target organ of the GH axis?

A

Liver - IGF-1 mediates the effects of GH

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8
Q

Metabolic effects: increases protein synthesis and bone density; promotes lipolysis and inhibits lipogenesis; promotes gluconeogenesis and glucose release; opposes insulin-induced glucose uptake in adipose tissue, reduces insulin sensitivity.

A

Growth Hormone

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9
Q

What can be used to treat GH deficiency?

A

Sermorelin - synthetic GHRH

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10
Q

What are Somatropin and Somatrem examples of?

A

Recombinant human GH - used to replaced GH

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11
Q

Mecasermin

A

Recombinant IGF-1

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12
Q

Mecasermin Indications

A

Used in children where IGF1 deficiency is due to mutations of GH receptor (Laron dwarfism) or development of neutralizing antibodies against GH

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13
Q

Somatropin and Somatrem Indications

A
  •  Documented growth failure in pediatric patients associated with: GH deficiency, chronic renal failure, Prader-Willi syndrome, Turner syndrome
  •  Small-for-gestational-age condition with failure to catch up by age 2
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14
Q

Somatropin and Somatrem SE

A
  •  Leukemia, rapid growth of melanocytic lesions
  • Hypothyroidism
  • Insulin resistance
  • Arthralgia (joint pain)
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15
Q

Somatropin and Somatrem Contraindications

A
  • Pediatric patients with closed epiphyses 
  • Active underlying intracranial lesion
  •  Active malignancy
  •  Proliferative diabetic retinopathy
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16
Q

What is Octreotide used for?

A

It is a somatostatin analog and used to treat excess of GH

17
Q

Pegvisomant MOA

A

GH antagonist

18
Q

Octerotide Indications

A
  • Acromegaly
  • Pituitary Adenoma
  • Secretory diarrhea from VIPomas
19
Q

Octreotide SE

A
  • GI effects
  • Hypoglycemia
  •  Gallstones
20
Q

Pegvisomant Indications

A
  • Used for the treatment of acromegaly that is refractory
21
Q

Pegvisomant SE

A
  •  Increased pituitary adenoma size

-  Elevated serum aminotransferase levels

22
Q

What drug has the following considerations?

  •  Patients should have yearly MRI to exclude enlarging adenoma 
  • Liver function tests should be performed periodically
A

Pegvisomant

23
Q

Gonadotropin MOA

A

Replaces FSH and LH

24
Q

Gonadotropin SE

A
  •  Ovarian hyperstimulation syndrome (associated with ovarian enlargement, ascites, hydrothorax, hypovolemia, sometimes resulting in shock)
  •  Increase in multiple pregnancies
  •  Increased risk of gynecomastia in men
  •  Ovarian cancer
25
Q

What is the effect of a sustained GnRH agonist?

A
  1. There is a transient (7-10 days) increase in gonadal hormone levels (flare) – agonist effect
  2. Followed by a long-lasting suppression of gonadotropins and gonadal hormones – inhibitory action
26
Q

What drugs are used to treat hyperprolactinemia?

A

Dopamine Receptor Agonists

27
Q

DOPA Agonist MOA

A

They inhibit pituitary prolactin release by increasing DOPA

28
Q

What drug class are Ganirelix, Cetrorelix and Abarelix?

A

GnRH Receptor Antagonist

29
Q

How does GH affect response to insulin?

A

It increases insulin resistance

30
Q

What is a somatostatin analog?

A

Octreotide

Pharmacology (74 decks)

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