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Endocrine 2 > Kruse: hypothalamic and pituitary hormones > Flashcards

Kruse: hypothalamic and pituitary hormones Flashcards

1
Q

Growth hormone

A

Somatropin

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2
Q

IGF-1 agonist

A

Mescasermin

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3
Q

Somatostatin analogs

A
  • Octreotide

- Lanreotide

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4
Q

GH antagonist

A

Pegvisomant

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5
Q

Dopamine agonists

A
  • Bromocriptine

- Cabergoline

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6
Q

Vasopressin receptor agonists

A
  • Vasopressin

- Desmopressin

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7
Q

Vasopressin receptor antagonist

A
  • Conivaptan

- Tolvaptan

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8
Q

Anterior pituitary hormones are negatively regulated by what hypothalamic peptides and catecholamines?

A
  • Somatostatin

- dopamine

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9
Q

These are single chain protein hormones that activate kinase linked receptors of the JAK/STAT superfamily

A

GH and prolactin

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10
Q

These are dimeric proteins that activate G protein couples receptors

A
  • TSH
  • FSH
  • LH
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11
Q

This is a single peptide cleaved from a larger precursor contains the peptide B-endorphin that also binds GPCRs

A

ACTH

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12
Q

Growth hormone production is stimulated by GHRH and inhibited by what?

A

peptide somatostatin (SST)

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13
Q

Prolactin is inhibited by dopamine via what receptor?

A

D2

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14
Q

Disruption of the pituitary stalk and the hypothalamohypophysial portal vessels will do what to prolactin?
What happens to rest of the anterior pituitary hormones?

A

increase

decrease

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15
Q

Syndromes where you can use GH

A
  • Prader Willi
  • Turner
  • Noonan
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16
Q

other uses for GH

A
  • Wasting in patients with AIDS

- Patients with short bowel syndrome who are dependent on total parenteral nutrition

17
Q

GH toxicity and contraindication

A
  • Rare in children: intracranial HTN (vision changes, headache, nausea, vomiting), scoliosis, otitis media in patients with Turner syndrome, hypothyroidism, pancreatitis, gynecomastia
  • Adults: peripheral edema, myalgias, arthralgias, carpal tunnel syndrome
  • Contraindicated in patients with a known malignancy
18
Q

A small number of children with growth failure have severe IGF-1 deficiency that is not responsive to exogenous GH due to what?

A

mutations in GH receptor and development of neutralizing antibodies to GH

19
Q

What is mecasermin a complex of

A

rhIGF-1 and rhIGFBP-3 (this is needed to increase half life of rhIGF-1)

20
Q

Mecasermin is administered how

A

SQ

21
Q

most common adverse effect of Mecasermin

A

-hypoglycemia: eating 20 minutes before administration prevents this

22
Q

What is the most widely used SST analog

A

Octreotide

23
Q

Octreotide reduces what symptoms associated with hormone secreting tumors?

A
  • Acromegaly
  • Carcinoid syndrome
  • Gastrinoma
  • Glucagonoma
  • Nesidioblastosis
  • diabetic diarrhea
  • watery diarrhea
  • hypokalemia
  • achlorhydria (WDHA) syndrome
24
Q

Lanreotide is approved for treatment of what?

A

acromegaly

25
Q

Adverse effects of SST analogs

A
  • GI
  • Gallbladder sludge and gallstones
  • Cardiac effects (sinus bradycardia, conduction disturbances)
  • vitamin B12 deficiency
26
Q

What is Pegvisomant used to treat

A

Acromegaly

27
Q

Toxicity and contraindications for Dopamine agonists?

A
  • nausea, headache, light headedness, orthostatic hypotension, fatigue are most common
  • Psychiatric manifestation
  • Pulmonary infiltrated may occur with chronic high dose
  • Patients with MACROadenoma and pregnant . .continue
  • if MICRO then discontinue
  • Dopamine agonists are not recommended to suppress postpartum lactation due to increased incidence of stroke or coronary thrombosis
28
Q

Receptors for vasopressin

A
  • V1: vascular smooth muscle cells –> vasoconstriction
  • V2: renal tubule cells –> reduce diuresis through increased water permeability and water resorption n collecting tubules
  • Extrarenal V2 . . release of coagulation factor VIII and vWF
29
Q

What is preferred for central diabetes insipidus, Desmopressin or vasopress

A

Desmopressin . . due to selectivity for V2

30
Q

When is desmopressin used

A

treatment of coagulopathy in hemophilia A and Von Willebrand disease

31
Q

Toxicity and contraindications for Vasopressin and desmopressin

A
  • headache, nausea, abdominal cramps, agitation, and allergic reactions occur rarely
  • Overdose: hyponatremia and seizures
  • Vasopressin should be used with caution in patients with coronary artery disease due to vasoconstriction
32
Q

Which vasopressin Antagonist is selective for V2?

Which binds to both?

A
  • Tolvaptan

- Conivaptan

33
Q

Metabolism of vasopressin antagonists?

A

CYP3A4

Endocrine 2 (10 decks)

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