pharm: GH + ADH Flashcards
Thyroid Function
Acts like a car accelerator, increasing metabolism.
Hormone Regulation
Negative feedback mechanism prevents excessive hormone production.
Growth Hormone (GH) - Somatropin
Produced by the anterior pituitary, targets bone & skeletal muscle, promotes growth & protein synthesis, reduces glucose utilization (raises plasma glucose).
GH Deficiency - Effects
Childhood: Short stature. Adulthood: Reduced muscle mass.
GH Excess - Effects
Childhood: Gigantism (growth plates open, excessive height). Adulthood: Acromegaly (growth plates closed, abnormal tissue growth).
Conditions Treated with GH Therapy
Non-GH short stature, Turner’s syndrome, Prader-Willi syndrome, chronic renal insufficiency, cachexia, short-bowel syndrome, AIDS wasting syndrome.
Treatment for Excess GH
Gigantism: Pituitary gland removal. Acromegaly: Management strategies (e.g., surgery, medications).
Adverse Effects of Somatropin
Hyperglycemia (monitor in diabetics), neutralizing antibodies (can inactivate the drug).
Contraindications & Precautions
Pregnancy/lactation (risk vs. benefit), obesity/severe respiratory impairment (esp. in Prader-Willi), diabetes, hypothyroidism (can worsen function), glucocorticoid use (suppresses growth).
Administration Guidelines
IM or Sub-Q, reconstitute med gently (do not shake), check for particles/discoloration, give after 5 PM, rotate injection sites (abdomen & thighs).
Monitoring Requirements
Baseline height & weight, growth patterns, glucose levels (esp. in diabetics), thyroid function, protein levels (for muscle growth).
Growth Hormone Antagonists (Octreotide, Lanreotide, Pegvisomant)
Suppress GH release, used when surgery/radiation is not possible.
Adverse Effects (General)
GI issues (nausea, diarrhea), injection site reactions, metabolic disturbances (hypo/hyperglycemia, liver injury).
AEs of Octreotide
AEs: GI (gallstones, nausea, cramps, diarrhea, flatulence, ileus), hypo-/hyperglycemia. Administration: IM, SQ, IV. Give without food or at bedtime (reduces nausea). Interactions: Antidysrhythmics, insulin.
AEs of Lanreotide
AEs: GI (gallstones, diarrhea), injection site reactions. Administration: SQ. Interactions: Bradycardia risk.
AEs of Pegvisomant
AEs: GI (nausea, diarrhea), liver injury, chest pain, flu-like symptoms. Administration: SQ. Interactions: Opioids.
Cautions for GH Antagonists
Diabetes, hypothyroidism, renal disease, gallbladder disease, older adults.
Injection Considerations
Inject slowly to reduce pain.
Antidiuretic Hormone (ADH) - Vasopressin & Desmopressin (DDAVP)
Maintains fluid balance by promoting water reabsorption in the kidneys via vasoconstriction.
Uses of ADH
Diabetes insipidus (DI), nocturnal enuresis (bedwetting), hemophilia (stimulates clotting factors), CPR (high doses for vasoconstriction).
Adverse Effects of ADH
Water intoxication (sleepiness, headache → convulsions → coma), MI, angina, diaphoresis.
Vasopressin Administration
SQ, IM, IV (generally fewer AEs).
Desmopressin (DDAVP) Administration
Oral, intranasal (for hemophilia nosebleeds), SQ, IV.
Pregnancy/Lactation Considerations
Reduce fluid intake to prevent water retention.
Cautions for ADH Use
CAD, decreased peripheral circulation, chronic nephritis/renal impairment (risk of excessive vasoconstriction).
ADH Interactions
Increased effect: Carbamazepine, TCAs. Decreased effect: EtOH, heparin, lithium, phenytoin.
Monitoring for ADH Therapy
BP, HR, daily weight, I&O, lung sounds (crackles = fluid overload), edema.
Labs to Monitor
Potassium, sodium, BUN, creatinine, specific gravity, osmolality.
Signs of Water Intoxication
Headache, drowsiness, confusion (report immediately).
