Pituitary and Hypothalamic Hormones, Calcium Metabolism

Question 1

Growth hormone

Answer 1

• GH related
• Human, recombinant (SQ once a day) or depot form (IM once a month)
• In adults – peripheral edema, carpal tunnel syndrome, impaired glucose tolerance, hypothyroidism
• Stimulate growth in children, correct metabolic problems in adults

Question 2

Sermorelin acetate

Answer 2

• GH related
• Synthetic GHRH analog - injectable
• Injection site reactions, headaches
• Stimulate growth in children, correct metabolic problems in adults

Question 3

IGF-1

Answer 3

• GH related
• Human, recombinant - injectable
• Injection site reactions, headaches
• Only for syndromes of GH resistance

Question 4

Pegvisomant

Answer 4

• GH antagonist – SQ injection
• Bind to GH receptor but doesn’t allow for dimerization
• Acromegaly, gigantism

Question 5

Octreotide

Lanreotide

Answer 5

• Somatostatin agonist – SQ or IM injection
• Selective for type 2 and 5 somatostatin receptors – inhibit GI release
• Nausea, flatulence, abdominal pain, gallstones
• Acromegaly, gigantism

Question 6

Bromocriptine

Cabergoline

Answer 6

• D2 agonist
• Inhibits prolactin release by working on dopamine receptor
• Nausea, headaches, orthostatic hypotension
• Amenorrhea, galactorrhea, associated infertility

Question 7

Oxytocin

Answer 7

• Posterior pituitary
• Modulates transmembrane ion currents in smooth muscle of myometrium to produce sustained uterine contractions
• Induce labor – IV or IM injections

Question 8

Vasopressin

Desmopressin

Answer 8

• Posterior pituitary
• V1 in smooth muscle (vasoconstriction), V2 in renal tubule (increase resorption of water)
• Replacement therapy in diabetes insipidus

Question 9

Vitamin D
D2 (ergocalciferol)
D3 (calcitrol

Answer 9

• Vitamin D/analogs – oral or IM
• Increased absorption of calcium, better prostate or breast health
• Hypocalcemia

Question 10

PTH/teriparatide

Answer 10

• Miscellaneous – injectable
• Increased absorption of calcium, better prostate or breast health
• Hypocalcemia

Question 11

PTH/teriparatide

Answer 11

• Miscellaneous – injectable
• Given at low doses to stimulate bone formation from osteoblasts
• Osteoporosis

Question 12

Alendronate
Tiludronate
Risedronate

Etidronate
Pamidronate (parenteral only)

Answer 12

• Bisphosphaonates – oral or parenteral
• Taken up by osteoclasts – inhibitors of geranylgeranyl diphosphate synthase (isoprenoid biosynthesis) – inhibition of bone resorption
• Poorly absorbed when taken orally, may induce esophagitis, osteonecrosis of jaw
• Hypercalcemia, osteoporosis

Question 13

Denosumab

Answer 13

• RANKL antibody - injectable
• Antibody that inhbits bone resorption by binding to RANKL, so preventing its binding to RANK (receptor present in osteoclasts that stimulates their bone resorptive activity)
• Osteoporosis