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Pharm3: Mod1: Endocrine > Mod 1 lecture 1: hypothalamic-pituitary-gonadal axis > Flashcards

Mod 1 lecture 1: hypothalamic-pituitary-gonadal axis Flashcards

1
Q

what hormones does the hypothalamus release

A

GHRH
CRH
TRH
GnRH
(PRH;?TRH)

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2
Q

what are inhibiting hormones secreted by hypothalmus

A

somatostains (GHIH and TSH)
Dopamine (PIH)

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3
Q

what does GH stimulate

A

liver and increases somatomedins

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4
Q

what is another name for growth hormone

A

somatotropin

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5
Q

what tissues does GH target

A

bone, adipose, liver, muscle and growth plates

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6
Q

what are the growth hormone release modulators

A

somatotropin (genotropin, humatrope)
octreotide (sandostatin)
Pegvisomant(somavert)

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7
Q

what is somatropin

A

synthetic somatotropin (human GH)

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8
Q

what are the indications for somatropin

A

GH deficiency
Growth failure (turner syndrome, Noonan syndrome, prader-willi syndrome)
HIV patients with cachexia

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9
Q

what are the AE of somatropin

A

pain at injection side
edema
arthralgia and myalgia
nausea
glucose tolerance: insulin insensitivity

*warning:
do not use in pediatric patients with closed epiphyses
increased ICP

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10
Q

What is somatostatin

A

inhibitory hormone of GH
Hypothalamus:
-acts on anterior pituitary gland
-binds to pituitary GHRH receptors
-suppresses GH and TSH release
GI tract: supresses secretions and motility

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11
Q

What is Octreotide

A

long-acting synthetic somatostatin analog - GH release suppression
DOA: 12hrs to 6 weeks
GH release modulator

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12
Q

what are the inidcations of Octreotide

A

acromegaly
Severe diarrhea caused by carcinoid tumor
bleeding esophageal varices

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13
Q

what are the AE of octreotide

A

CVS: bradycardia and conduction distrubances
GI: diarrhea, abdominal pain, flatulance, nausea and streatorrhea

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14
Q

What is Pegvisomant

A

GH receptor antagonist - modified HGH with receptor blocking-properties

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15
Q

what are the indications for Pegviosomant

A

acromegaly that is refractory to other pharmacological surgical or radiological intervention

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16
Q

What are the AE of Pegviosomant

A

GI: diarrhea and nausea
CNS: pain
Hepatic: abnormal hepatic function tests

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17
Q

What is ACTH

A

corticotropin - naturally occuring hormones

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18
Q

What is ACTH

A

corticotropin - naturally occuring hormones
anteriro pituitary homrone
stimulates steroid biosynthesis

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19
Q

what is cortosyn

A

cosyntropin - sythesized ACTH hormon

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20
Q

What is CRH

A

corticotropin - releasing homrone
hypothalamic hormone
regulates synthesis and release of ACTH

21
Q

What is Cosyntropin

A

synthtic ACTH
full biological potency
stimulates adrenal cortex to secrete adrenal steroids (cortisol), androgenic substances, and a small amount of aldosterolne

22
Q

what are the indications for Cosyntropin

A

diagnostic tool for ACTH stimulation test
screening for adrenocorticosteroid deficiency - primary adults insufficiency (hypoadrenaliism - addisons disease)

23
Q

What are the AE of Cosyntropin

A

excess glucocoriticoid toxicities:
HTN, peripheral edema, hypokalemia, osteoporosis

24
Q

What is GnRH

A

gonadotropin-releaseing hormone
secreted from the hypothalamus
binds to receptors in anterior pituitary gland
release in gonadotropins (FSH and LH)

25
Q

what is essential for gonadotropin rlease

A

pulsatile secretion

26
Q

what results in the down regulation of GnRH receptors and suppression of gonadotropin release

A

continuous secretion

27
Q

what are the indicatiosn for suppression of gonadotropin production

A

prostate cancer
endometriosis and uterine myomas (fibroids)
precocious puberty
infertility treatment: controlled ovarian stimulation, suppression of LH surge and ovulation
suppressing sex hormones in transgender people

28
Q

what are the adverse effects of FSH-LH release modulators in females

A

generalized menopausal symptoms
ovarian cysts

29
Q

what are the AE of FSH-LH release modulators in males

A

transient increase in testosterone
hot flashes, sweats, edema, gynecomastia, decreased libido, decreased HCT, and bone density

30
Q

What is Leuprolide (lupron) used for

A

used to treat prostate cancer, breast cancer, endometriosis, uterine fibroids and early puberty
can delay the onset of puberty in transgender youth prior to initiation of HRT
can be used to delay or prevent early ovulation in order to allow for the development of mature eggs for retrieval in IVF cycles

31
Q

What is goserelin (zoladex)

A

used to suppress production of sex hormones (testosterone and estrogen), particularly in the treatment of breast and prostate cancer

32
Q

what is nafarelin (synarel)

A

used in the treatment of endometriosis and early puberty

33
Q

what is histrelin (vantas)

A

used to treat advanced prostate cancer in adults,. will reduce level of testosterone

34
Q

what is Prolactin

A

hormone secreted from the anterior pituitary
stimulates and maintains lactation
decreases libido

35
Q

what regulates prolactin

A

tonic inhibition by dopamine - dopamine antagonists (antipsychoatics) increase prolactin secretion
TRH also stimulates the release of prolactin

36
Q

what is Bromocriptine

A

dopamine receptor agonist that treats hyperprolactinemia, parkinsons disease

37
Q

what is cabergoline

A

first-line agent in the management of prolactinomas due to its higher affinity for D2 receptor sites, less severe side effect and more convenient dosing schedule than bromocriptine

38
Q

what are the indications for bromocriptine and cabergoline

A

D2 receptor agonists - suppress prolactin release
Lactotroph adenomas (prolactinomas) - hyper prolactemia

39
Q

what are the affects that Bromocriptine has on T2DM

A

acts on circadian neuronal activities in the hypothalamus to reset an abnormally elevated hypothalatic drive for increase plasma glucose, free fatty acids, and triglycerides in insulin-resistant patients
minimally effecting at decreasing A1C (0.5%)

40
Q

what are the AE of bromocriptine and cabergoline

A

CNS: HA, Dizziness, psychosis
GI: nausea

41
Q

what hormones are secreted by posterior pituitary gland

A

oxytocin
vasopressin
desmopressin

42
Q

what tissues are targeted by oxytocin

A

uterus and breast - contraction and milk expression

43
Q

what tissues are targeted by vasopressin (aka ADH)

A

Nephron (CT and CD) - V2 receptors - water reabsoprtion and hyponatremia
vascular smooth muscle - v1 receptors - vasoconstriction

44
Q

what is the use of oxytocin

A

stimulate uterine contraction
labor induction
postpartum hemorrhage

45
Q

what are the AE of oxytocin

A

hypotension and arrhythmias
fluid retention (ADH effects)
placental abruption or uterine rupture
fetal distress and death

46
Q

what is vasopressin

A

synthetic vasopressin (ADH analog)
stimulates arginine vasopressin receptors (AVP)
desmopressing has selective V2 activity

47
Q

what are the indications for vasopressin

A

central diabetes insipidus (absence of ADH)
nocturnal enuresis

48
Q

what are the AE of Vasopressin

A

water intoxication and hyponatremia
HA, bronchconstriction and tremor
*warning:
caution when using vasopressin in patients with CAD, epilepsy and asthma
Nasal spray has been linked to increased seizures in children

Pharm3: Mod1: Endocrine (5 decks)

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