Pituitary and Hypothalamus Drugs

Question 1

What is mecasermin and what does it treat?

Answer 1

Recombinant IGF-1 agonist of IGF-1 receptors used to treat GH receptor mutation or abnormal GH functioning not responsive to GH treatment. Also used to treat IGF-1 deficiency.

Question 2

What is pegvisomant, what does it treat, and what is its ADRs?

Answer 2

Blocks GH receptors and is used to treat excess GH i.e. as seen in Acromegaly. Toxicity increases liver enzymes.

Question 3

What is atosiban, what does it treat, and what is its ADRs?

Answer 3

Blocks oxytocin receptors to decrease uterine contractions i.e. as tocolysis for premature labor (not FDA approved bc no benefit compared to already available drugs). ADR is concern about increased rate in infant deaths.

Question 4

Lithium side effect in kidney?

Answer 4

nephrogenic diabetes insipidus

Question 5

Lithium side effect in thyroid ?

Answer 5

hypothyroidism

Question 6

What drugs cause SIADH?

Answer 6

include but not limited to chlorpropamide, carbamazepine, cyclophosphamide, SSRIs, ACE Inhibitors and vincristine

Question 7

What visual field defect is caused if optic chiasm is damaged by pituitary adenoma and what drug can you use to treat?

Answer 7

bi-temporal hemianopia (chiasmal, tunnel vission, periphery blind)

Question 8

Which kind of pituitary adenoma need surgery?

Answer 8

As a general rule, smaller pituitary tumors (microadenomas) are easier to treat with surgery. The larger (macroadenomas) and more invasive the tumor, the less likely the tumor can be cured by surgery. Side effects also tend to be more likely after surgery to remove large, invasive tumors.

Question 9

Why is desmopressin (vasopressin receptor agonist) used to treat bleeding disorders?

Answer 9

Bc acts on extrarenal V2 (Gs) receptors to increase factor VIII and von Willebrand factor

Question 10

What drug can treat primary enuresis (wetting bed since baby)?

Answer 10

Desmopressin

Question 11

What is a pituitary adenoma called that is <10mm in diameter?

Answer 11

microadenoma

Question 12

Which pituitary adenoma is MC in females and causes amenorrhea and galactorrhea?

Answer 12

microadenoma

Question 13

What is used to treat microadenomas of the pituitary?

Answer 13

bromocriptine, cabergoline.

Question 14

Which pituitary adenoma is MC in females and causes amenorrhea and galactorrhea?

Answer 14

microadenoma

Question 15

What is used to treat microadenomas of the pituitary?

Answer 15

bromocriptine, cabergoline

Question 16

What is the pituitary adenoma MC in males and causes a visual field defect?

Answer 16

macroadenoma

Question 17

What is used to treat macroadenomas of the pituitary?

Answer 17

surgery (trans-sphenoidal approach) and radiation

Question 18

Which antibiotic can treat SIADH and what is its MOA?

Answer 18

demeclocycline (tetracycline); protein-synthesis inhibitor antibiotic, inhibition of adenylyl cyclase after hormone binds to V2 receptors

Question 19

What are the primary drugs used in the treatment of nocturnal enuresis?

Answer 19

Desmopressin (DDAVP) and imipramine (Tofranil)