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Block 2 Pharmacology > pituitary > Flashcards

pituitary Flashcards

1
Q

Posterior pituitary Hormones are synthesized in neurons that originate in _____.

A

hypothalamus

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2
Q

Anterior pituitary Hormones are synthesized in epithelial cells, but are under neural control via ______.

A

portal circulation

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3
Q

Pituitary Hormones and Drugs- Most require parenteral administration because of ?

A

proteolytic breakdown in the gut

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4
Q

routes of Pituitary Hormones and Drugs

A

IM, IV, SubQ, IN, PO

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5
Q

____ Controls the rate of water excretion in urine.

A
  • Antidiuretic hormone (ADH) (vasopressin)
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6
Q

increased ADH increases permeability and ____ water loss in urine.

A

decreases

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7
Q

decreased ADH cause kidneys to be impermeable to water, so there is ___ reabsorption

A

decreased

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8
Q

hormone that Elicits uterine contractions during labor

A

oxytocin

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9
Q

hormone that allows for Milk expression in lactation

A

oxytocin

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10
Q

in diabetes insipidus, what hormone is of major use?

A

vasopressin

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11
Q

In kidney, vasopressin binds to V2 receptor to increase ______ in the collecting tubules

A

water permeability and reabsorption

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12
Q

In liver, vascular smooth muscle, other tissue, vasopressin binds to V1 receptors for a variety of actions such as ______.

A

vasoconstriction

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13
Q

uses for Vasopressin (3)

A

o Diabetes insipidus
o Esophageal varices
o Cardiac arrest/shock

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14
Q

Vasopressin ADRs

A

o Water intoxication, hyponatremia

o HA, bronchoconstriction, tremor

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15
Q

use vasopressin with caution in what diseases?

A

o Coronary artery disease (CAD), epilepsy, asthma, vascular disease, elderly

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16
Q

desmopressin was modified to _________.

A
  • Molecule modified to have minimal activity at the V1 receptor
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17
Q

what is the Preferred agent for diabetes insipidus and nocturnal enuresis

A

desmopressin

Also used to treat hemophilia A and vWF deficiency

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18
Q

in vWF deficiency, desmopressin does what?

A

o Increases plasma levels of vWF, factor VIII, and t-PA

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19
Q

desmopressin routes

A
  • IM, IV, SubQ, IN, and PO forms
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20
Q

Oxytocin (Pitocin) uses

A

medical (not elective) induction of labor, adjunct in abortion, postpartum bleeding

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21
Q

Oxytocin (Pitocin) contraindications

A

fetal distress, abnormal fetal presentation, premature births

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22
Q

what are the anterior pituitary hormones?

A
  • GHRH: growth hormone-releasing hormone
  • TRH: thyrotropin-releasing hormone
  • CRH: corticotropin-releasing hormone
  • GnRH (LHRH): gonadotropin-releasing hormone (luteinizing hormone-releasing hormone)
  • PIH: prolactin-inhibiting hormone (dopamine) and PRH: prolactin-releasing hormone
  • ACTH: adrenocorticotropic hormone
  • TSH: thyroid-stimulating hormone
  • FSH: follicle-stimulating hormone
  • LH: luteinizing hormone
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23
Q

Thyrotropin-releasing hormone (TRH) action on anterior pituitary

A

Stimulates secretion of TSH by thyrotropes

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24
Q

Gonadotropin-releasing hormone (GnRH) Action on Anterior Pituitary

A

Stimulates secretion of FSH and LH by gonadotropes

25
Q

Corticotropin-releasing hormone (CRH) Action on Anterior Pituitary

A

Stimulates secretion of ACTH by corticotropes

26
Q

Growth hormone-releasing hormone (GHRH) Action on Anterior Pituitary

A

Stimulates secretion of growth hormone by somatotropes

27
Q

Growth hormone inhibitory hormone (somatostatin) Action on Anterior Pituitary

A

Inhibits secretion of growth hormone by somatotropes

28
Q

Prolactin-inhibiting hormone (PIH) Action on Anterior Pituitary

A

Inhibits secretion of prolactin by lactotropes

29
Q

ACTH (corticotropin) Diagnostic uses

A 
Differentiate between Cushing syndrome and ectopic ACTH-producing cells
Differentiate primary (Addison disease) from secondary adrenal insufficiency
30
Q

ACTH (corticotropin) therapeutic uses

A

multiple sclerosis, infantile spasms, some other inflammatory conditions

31
Q

ACTH (corticotropin) Synthetic agent

A

Cosyntropin: is preferred agent for diagnosis of adrenal insufficiency

32
Q

what is preferred agent for diagnosis of adrenal insufficiency?

A

Cosyntropin

33
Q

ACTH (corticotropin)/Cosyntropin ADRs

A

ADRs are like glucocorticoids (osteoporosis, hypertension, edema, hypokalemia, CNS stimulation, infection, etc.)

34
Q

Name of the synthetic form used to treat Growth Hormone deficiencies

A

Somatropin

35
Q

Somatropin ADRs

A

edema (HTN, intracranial HTN, etc.), neoplasms, bone malformations

36
Q

Trend in recent years as the “anti-aging” drug but is not indicated for use to increase or maintain ______.

A

lean muscle mass

37
Q

Somatropin has been abused by ______.

A

athletes

38
Q

what do you use for IGF-1 deficiency

A

IGF-1 analogue: mecasermin (Increlex)

39
Q

what do you use for HIV-associated lipodystrophy

A

GH secretagogue: tesamorelin (Egrifta)

40
Q

GH Receptor Antagonist drug name

A

Pegvisomant (Somavert)

41
Q

MOA of Pegvisomant (Somavert)

A

Binds to receptor and prevents endogenous binding

42
Q

what is Pegvisomant (Somavert) used to treat?

A

treatment-resistant acromegaly

43
Q

Somatostatin (GH inhibitor) Analogs drug names (3)

A 
o	Octreotide ( Sandostatin)
o	Lanreotide (Somatuline Depot)
o	Pasireotide (Signifor)
44
Q

what Somatostatin (GH inhibitor) Analogs is used to treat Cushing’s?

A

Pasireotide (Signifor)

45
Q

what Somatostatin (GH inhibitor) Analogs is used to treat refractory acromegaly

A

Lanreotide (Somatuline Depot)

46
Q

what Somatostatin (GH inhibitor) Analogs is used to treat acromegaly, cancer( and also Off-label: diarrhea, esophageal varices)

A

Octreotide ( Sandostatin)

47
Q

Gonadotropin-releasing Hormone (GnRH) Agonists

drug names

A
  • Goserelin (Zoladex)
  • Histrelin (Vantas)
  • Leuprolide (Lupron)
  • Nafarelin (Synarel)
  • Triptorelin (Trelstar)
48
Q

when using Gonadotropin-releasing Hormone (GnRH) Agonists continuously, we stimulate the receptors and causes release of _______ to be inhibited with chronic administration

A

FSH and LH

49
Q

what is Gonadotropin-releasing Hormone (GnRH) used to treat?

A

prostate cancer, endometriosis, precocious puberty

50
Q

what is Gonadotropin-releasing Hormone (GnRH) Contraindication?

A

pregnancy

51
Q

Gonadotropin-releasing Hormone (GnRH) ADRs in women

A

hot flushes, sweating, decreased libido, depression and ovarian cysts

52
Q

Gonadotropin-releasing Hormone (GnRH) ADRs in men

A

increased early in course of therapy testosterone causes bone pain; hot flushes, **gynecomastia, edema, diminished libido

53
Q

GnRH Antagonists drug names

A
  • Degarelix (Firmagon)

- Cetrorelix (Cetrotide)

54
Q

what GnRH Antagonists is Used for advanced prostate cancer

A
  • Degarelix (Firmagon)
55
Q

what GnRH Antagonists is Used o to control ovulation by delaying LH surge until ovarian follicle is of adequate size

A
  • Cetrorelix (Cetrotide)
56
Q

GnRH Antagonists (Degarelix (Firmagon), Cetrorelix (Cetrotide)) are what pregnancy category?

A

x

57
Q

Variety of FSH/LH agonists used for _____ treatment in women and men

A

infertility

58
Q

prolactin Functions:

A

o Stimulate and maintain lactation

o Decrease sex drive and reproductive function

59
Q

Hyperprolactinemia (often associated with tumors) is treated with D2 agonists like ______.

A

bromocriptine and cabergoline

Block 2 Pharmacology (13 decks)

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