Hypothalmic/Pituitary

Question 1

Somatropin

Answer 1

GH recombinant Human Hormone

Method:Given IM or Sub Q

Mech: JakStat and has action in nucleus Effects: Increased linear growth in SS kids, increase muscle/bone formation, decrease fat, Turner and Prader WIlli patients, AIDS pts, Burn Pts Adverse:Abuse for anabolic steroids,

Laron Dwarfism=receptor defect and are unresponsive to GH treatment—> HAVE TO GIVE THEM IGF

Question 2

Sermorelin

Answer 2

• Shortened GHRH analog
• Activates GHRH-R on Pituitary Cells–>stimulates endogenous release of GH–>IGF-1
• Used in GH deficiency BUT ineffective in pts with pituitary defect
• Preferred to Recombinant GH(Somatropin)

Question 3

Endogenous Somatostatin

Answer 3

• ** Inhibits GH Release**
  
  • Side Effects=Inhibition of TSH and PROLACTIN, Insulin and Glucagon, VIP in gut
• ​NOT USEFUL AS A DRUG
  
  • ​Half Life too short

Question 4

Octreotide

Answer 4

• Shortended and Stabilized version of SST
  
  • Longer Half Life
• Method: 2-3 Injections daily or Monthly Depot
• Mech: GPCR activation of SST receptors
• Use: Treats Acromegaly, Inhibits hormone secreting tumors, and GI Secretion disorders
• Adverse: Decreased GI Motility/Secretions–> Loose Stools, malabsorption

EXPENSIVE

Question 5

Cabergoline

Answer 5

• Dopamine Agonist given to inhibit Prolactin
• NOT a peptide
• 1-2x per week dosing
• Use: Parkinsons treatment, Hyperprolactinemia, Inhibits GH release in Acromegaly pts ONLY(Stimulates GH in normals)
• Adverse: **Nausea, Dizziness Hypotension, **​Tolerance develops

Question 6

Vasopressin Mech

Answer 6

V1=Vascular Smooth Muscle, vasoconstriction

V2=Kidney, incrased water reabsorb

V3=endothelial cells, increase clotting ^VWB Factor

Question 7

Diabetes Insipidus

Answer 7

Deficiency in Vasopressin

Lack of V2 action on the Kidney

Question 8

SIADH

Answer 8

Vasopressin Over Production

Excess V2 action in the Kidney

Question 9

Arginine Vasopressin

Answer 9

• Synthetic Peptide Identical to human hormone
• Short acting
• IV IM SUB Q or Nasal
• V1 and V2 EFFECTS
• Use: When need short action or when just want V1(Vasoconstriction effects), Constriction of bleeding artery
• Adverse: Increase BP, GI and Uterine Contractions(cross reactivity w/ oxytocin R)

Question 10

Desmopressin

Answer 10

• Modified Synthetic peptide analog of vasopressin
• much longer acting(10-20 hrs), V2>>>>V1
• Nasal Des=first choice drug for Diabetes Insipid
• Use: DI, Hemophilia to increase VWB Factor,
• Adverse: MINIMAL SIDE EFFECTS