Hypothalmic and pituitary Flashcards
Corticorelin Ovine Triflutate is what class/type of drug? Why do we give it?
Corticotropin Releasing Hormone (CRH)
Diagnostic drug to diff between Cushings and Ectopic production of ACTH
Gonadorelin, Goserelin, Leuprolide, Naferalin, Histrelin, and Triptorelin are all what class/type of drug? What are they generally used for?
GnRH/LHRH agents (-elin and one lide)
Prostate cancer : Goserelin and Leuprolide continuous
Endometriosis : Goserelin, Leuprolide and Naferelin Acetate continous x 6 months
Central Precocious Puberty: Naferalin continous
Ganirelix, Cetrorelix and Degarelix are what class/type of drug, what do they do?
GnRH receptor ANTAGONIST (-relix)
Inhibit LH surge in ovarian hyperstim procedure : Gani and Cetro
Advanced prostate cancer: Degarelix
Octreotide and Lanreotide are what class/type of drug, what do they do?
GHIH (Somatostatin, -otide)
Acromegaly /VIP secratory diarrhea/Esophageal varices bleed : Octreotide
Acromegaly only : Lanreotide
Pegvisomant is what class/type of drug, what do they do?
Gh Receptor ANTAGONIST
Treat Acromegaly that is resistant to/ unable to tolerate other treatments
Somatropin is what class/type of drug, what do they do?
Growth hormone
Tx:
(Kids) Growth failure, Growth failure due to CHronic Renal Inssuff, Prader-Willi syndrome
(Adults) HIV w/ wasting, Gh deficiency, Short BOWEL syndrome
Thyrotropin Alfa is what class/type of drug, what do they do?
Thyroid stimulating hormone
Diagnostic: detect blood levels of thyroglobulin to exclude diagnosis of thyroid CANCER following thyroidectomy.
Corsyntropin is what class/type of drug, what do they do?
Adrenocorticotropic hormone (ACTH)
Diagnostic: Diff b/t primary adrenal insuff (Addisons) ad secondary
Follitropin alfa and beta, urofollitropin and Lutropin alfa are what class/type of drug, what do they do?
FSH/LH
Induce ovulation and Male infertility (FSH)
Bromocriptine and Cabergoline are what class/type of drug, what do they do?
Dopamine (D2) Agonists
Tx: Hyperprolactinemia, Prolactin secreting Adenoma, Acromegaly**
Vasopressin and Desmopressin are what class/type of drug, what do they do?
Anti-Diuretic Hormone
Vaso: Used to treat diabetus insipidus but no more
Vaso Tx: Esophageal varices and Vasodilatory shock
Desmo: Diabetes Insipidus, Polyuria and Dipsia surg and head trauma, *Control bleed in von Willebrands, Bed wetting
Conivaptan and Tolvaptan are what class/type of drug, what do they do?
Vasopressin ANTAGONIST
Con V1a and V2, Tol V2»V1
Conivaptan: Raise serum Na in HOSPITALIZED pts. ** NO HEART FAILURE
Tolvaptan: Hypervolemic and Euvolemic Hyponatremia *** Including Pts w/ HEART FAILURE and SIADH
Oxytocin is what class/type of drug, what do they do?
Oxytocin
Stimulate lactaion
Induce labor
Postpartum bleeding
Both GnRH/LHRH analogs and GnRH antagonist can be used to treat LH surges in women undergoing controlled ovarian hyperstim procedure and advanced prostate cancer. Why might GnRH antagonists be a better idea?
Agonists lower hormone levels by “flooding” the target receptors influencing negative feedback. This results in:
Initial stimulation of LH and Testosterone
Clinical “flare” due to initial surge
Temporary PSA rise.
**Antagonists are complete and immediate
Preferred treatment for Acromegaly if due to tumor is what? When would we use pharm tx?
Surgical resection
If
- Control BEFORE surgery
- surgery not possible
- Surgical failure/relapse
If someone is taking Bromocriptine and they complain of bad nausea, what drug can you switch them to?
Carbergoline
Treating what condition requires weighing the risk of inducing Central Pontine Myelinolysis (CPM)? What drugs carry this black box warning?
Syndrome of Inappropriate Antidiuretic Hormone Secretion (SIADH)
Vassopressin - 2 receptor Antagonists - Conivaptan and Tolvaptan
When raising serum sodium in SIADH patients, what numbers guide how we raise it? How fast, how slow?
Raise serum sodium by 0.5-1 mEq/hr
NO MORE THAN 10-12 mEq in first 24hrs.
Max - 125-130 mEq/L
What are our four treatment options for SIADH in the EMERGENCY setting?
3% hypertonic saline (513)
Loop diuretics w/ saline
Vasopressin-2 receptor antagonist
Water restriction
What are our two treatment options for SIADH in the chronic asymptomatic setting?
Vasopressin-2 receptor antagonist (if unavailable, use diuretic)
Fluid restriction.
Metoclopramide is what type of drug. What is its important off label use? Why are we concerned about it?
Dopamine antagonist
Stimulate lactation
CNS effects in infants
What will a Hyperprolactinemia patient present with? What drugs can we use to treat this?
Men - Erectile Dysfunction, decreased libido, Gyno, reduced muscle
Women - Amenorrhea, Anovulation, Infertility, Hirsutism, and acne
Both: ** Headache and Visual disturbances
Drugs: Dopamine agonists - Bromocriptine and Cabergoline
