Pituitary And Thyriod Flashcards
GHRH have a specific features :
1-rapidly elevates serum GH .
2-high specificity .
name drug that acts like somatostatin
Octreotide
somatostatin effect of a different part of the body? (TSH, GH,GUT ,cell proliferation)
1-Inhibits the release of Somatotropin (GH) & TSH from the pituitary
2-Inhibits the release of glucagon and insulin from the pancreas.
3-Inhibits the secretion of gut peptides such as vasoactive intestinal
polypeptide (VIP) and gastrin
4-It inhibits the growth and proliferation of many cell types.
Octreotide is an SST analog administered by________
SC, IM, or IV injection.
Octreotide is used to treat several conditions like what?
1-Acromegaly 2-Glucagonoma 3-Gastrinoma 4-Severe diarrhea 5-TSH-secreting adenomas 6-Variceal and upper GI bleeding
What is the condition that can cause an increase of VIP secretion ?
VIP-secreting tumors (VIPomas)
how octreotide treats Variceal and upper GI bleeding?
by splanchnic vasoconstrictive effect
Gonadotropin-releasing Hormone (GnRH) and Analogs Regulate the release of________&__________
FSH and LH
GnRH Receptor Agonists names :
Leuprolide • Gonadorelin • Triptorelin • Nafarelin • Goserelin • Histrelin remember relin :)
Pulsatile administration to which drugs _________
GnRH Analogs
Pulsatile administration of GnRH Analogs EVERY ________hours by computerized pump increase the synthesis of ____&______
(every 1–4 h), LH,FSH
• FSH is responsible for________
follicle development in first 14 day
LH is responsible for________
ovulation
Treatment of certain types of infertility BY ________
GnRH Analogs (pulsatile administration )
2 WAYS FOR GIVE ( administart )GnRH analogs _________
Pulsatile administration&Chronic administration
uses of chronic administration of GnRH Agonist (mention 3) :
1-reduced production of gonadal steroids; Androgens &
Estrogens (chemical castration).
2-treat Precocciuos puberty
3-Hormone-dependent cancers and hyperplasias such as prostate
cancer, breast cancer, endometriosis, and fibroids.
chemical castration methods to1- ________ by which drug 2-________
1-reduced production of gonadal steroids; Androgens &
Estrogens
2-(GnRH) chronic administration
endometriosis in GnRH agonist drugs (mechanism)
Tissue similar to endometrium grows outside the uterus (ovaries, fallopian tubes, pelvis) so growth of this layer needs HIGH levels of LH & FSH SO when it is increase cause proliferation and thickening so we need to stope that by decrease level of FSH & LH
fibroids
Abnormal tissues
growth in uterus BY sexual hormones
Chronic administration Available as
implantable formulation
Adverse effects in Women (GnRH):
_ Hot flushes and sweating
– Diminished libido and depression
– Ovarian cysts
Contraindicated OF GnRH Agonist in women
Contraindicated in pregnancy and breast-feeding
Adverse effects in Men(GnRH agonist) :
– Hot flushes and edema
– Bone pain due to initial rise in testosterone levels
– Diminished libido
– Gynecomastia:(an increase in the amount of breast gland tissue in boys or men)
GnRH Antagonists (names)
Ganirelix
Abarelix
Cetrorelix
remember relix
GnRH antagonists__________bind to GnRH receptors in
the pituitary gland ,blocking the release of _________from the pituitary.
competitively and reversibly ,LH and FSH
GnRH Receptor Antagonists effect in women an men
In men, the reduction in LH subsequently leads to rapid suppression
of testosterone release from the testes
In women, it leads to suppression of estrogen release from the ovaries.
LH surge found in ________ drug unlike _______ drug so it have an an immediate onset of action without initial surge
GnRH agonist , GnRH antagonists
Clinical Uses of GnRH Receptor Antagonists
• Prostate cancer
• Hormone-sensitive breast cancer and some benign disorders such
as endometriosis and uterine fibroids
• Some cases of infertility: Prevents premature LH surge
Some cases of infertility: Prevents premature LH surge treat by ________ drugs
GnRH ANtagonist drugs
Drugs that reduce _____________cause an
increase in prolactin secretion:
CNS dopaminergic activity ( antidopaminergics)
antidopaminergics drugs example
− Antipsychotics
− Antidepressants
− Anti-anxiety
Drugs that promote prolactin secretion can be used to treat _________
lactation failure.
a side effect found in antidopaminergics drugs (important in lactation )
hyperprolactinemia
Inhibition of prolactin secretion can be produced by a number of ________
dopamine agonists
Bromocriptine is a drug example for what ?
and explain the target for this drug
a drug that inhibits prolactin secretion (dopamine agonists)
target:
acts as an agonist of dopamine D2-receptors and an
the antagonist of D1-receptors.
cabergoline a potent _______agonist greater______selectivity.
D2
It is more effective in reducing hyperprolactinemia than bromocriptine
Cabergoline
Has a long half-life that permits twice-weekly dosing
Cabergoline
examples of drugs that decrease level of prolactin secretion
dopamine agonists :
Cabergoline
bromocriptine
Therapeutic uses of PIF:
1-in amenorrhea, galactorrhea, and
prolactin-secreting tumors
2-The correction of female infertility secondary to hyperprolactinemia
3-Treatment of Parkinson disease.
amenorrhea, galactorrhea can be treated by ______
PIF (dopamine agonists)
Growth hormone agonists:
(GH, somatotropin), methionyl-growth
hormone (somatrem)
GH Administered ________ &Half-life:________.
SC or IM , 25 min
GH sufficient to induce ________by the________,is responsible for the ______.
IGF-1 release , liver,GH-like actions
GH sufficient to induce ________by the________,is responsible for the ______.
IGF-1 release , liver,GH-like actions
Therapeutic uses of GH:
Replacement therapy in children with GH deficiency before epiphyseal closure Prader-Willi syndrome Turner syndrome treatment of cachexia and AIDS wasting
Side effects of GH AND contraindications :
• Edema • Arthralgias and myalgias • Flue-like symptoms • Increase the risk of Diabetes contraindication :• Should not be given to children with closed epiphysis
Pegvisomant
the treatment of acromegaly
Pegvisomant is administered ______
SC
Pegvisomant is more selective than _________ so it use to treat acromegaly
octreotide
______________of pituitary origin are not used pharmacologically.
FSH and LH
Gonadotropins drugs names (HORMONS )
Menotropins (human menopausal gonadotropins, hMG)
Urofollitropin
Follitropin
hCG
drug Contain a mixture of LH and FSH
Menotropins
Produced by the placenta and can be isolated and purified from the
urine of pregnant women
hCG
All of these hormones(hMG ,hCG…….) must be administered _________
parenterally (SC or IM),
hCG USES :
-gonadal steroidogenesis in cases of LH insufficiency -induce external sexual maturation and spermatogenesis -promote the descent of the testes in cryptorchidism -Menotropins (hMG) is used in concert with hCG to stimulate ovulation in women with functioning ovaries
Menotropins and hCG cause Adverse effects
ovarian enlargement in about 20% of treated women
ADH causes __________at higher doses
vasoconstriction
ADH stimulates the hepatic synthesis of __________ and
__________.
coagulation factor VIII &von Willebrand factor
Aqueous vasopressin (Pitressin) > ADH drugs
short-acting preparation that acts on
both V1 and V2 receptors, is administered parenterally and lasts 2–6 hours
Desmopressin acetate (DDAVP, Stimate)
is a longer lasting (10–20 h)
preparation administered intranasally, parenterally, or orally
Desmopressin treat _________
severe central diabetes
insipidus
nocturnal enuresis by reducing nighttime urine
production
Vasopressin
substitute for epinephrine in cardiac arrest with asystole (shock)
SIADH cause
hyponatremia
vaptans
specific and direct therapy of SIADH
Thyroid drugs
levothyroxine (L-T4), liothyronine (T3)
Clinical use OF Thyroid drugs
- Hypothyroidism: cretinism & myxedema;
2. simple goiter
Overdose leads to thyrotoxicosis and angina or MI (usually in ageds) in ________ drugs
thyriod drugs
Thyroid drugs overdose leads to _________
leads to thyrotoxicosis and angina or MI (usually in ageds)
Anti-thyroid drugs
Thioamides
Iodides (NaI, KI)
Radioactive iodine (131I)
β-adrenoceptor blockers
Thioamides Pharmacological action:
They inhibit thyroid hormone synthesis
also inhibit T4 conversion into T3
Thioamaides have ________ on thyroglobulin already stored in the gland, as
a result the clinical effects appears________until thyroglobulin stores are
depleted.
no effects,slowly
Methemazole is preferred over__________because it has a longer t1/2 (given once
daily)
PTU
________ is recommended during the first trimester of pregnancy, due to a greater
risk of teratogenecity associated with __________.
PTU, methimazole.
Clinical use of Thioamides
- Mild hyperthyroidism and for those surgery & 131I are not permitted;
- Operation preparation
- Thyroid crisis (comprehensive therapy).
Adverse effects of Thioamides
- Long-term use leads to thyroid hyperplasia
- Pruritic maculopapular rash is the most common adverse reaction
- Agranulocytosis
• Agranulocytosis is adverse effect of __________
thioamides
Iodides (NaI, KI) Pharmacological action
(Wolff-Chaikoff effect): Inhibition of T3 & T4
release and synthesis.
Decrease of size & vascularity of the hyperplastic gland
the drug is ______________
Iodides (NaI, KI)
Iodides (NaI, KI) clinical use
- Treatment of Thyroid Storm
* Prior to surgery (Decrease of size & vascularity of the gland)
Adverse reactions
• Acneiform rash
• Swollen salivary glands and mucous membrane ulcerations for ___________ drugs
Iodides (NaI, KI)
Adverse reactions of Iodides (NaI, KI)
- Acneiform rash
* Swollen salivary glands and mucous membrane ulcerations
131I is the only isotope for treatment of____________
thyrotoxicosis.
Woman in pregnancy or lactation is forbidden!
Radioactive iodine (131I) contraindications
Its therapeutic effect depends on emission of __________with an effective
half-life of _ days & a penetration range of 0.4-2 mm.
β rays ,5
β-adrenoceptor blockers
Propranolol is the most widely studied and used.
The absence of which pituitary hormone causes polyuria and polydipsia in diabetic patients?
a. Oxytocin.
b. Vasopressin.
c. Thyrotropin.
d. Growth hormone.
b-vasopressin
Which pituitary hormone can be used intravenously to stimulate uterine contractions?
a. Prolactin.
b. Oxytocin.
c. Vasopressin.
d. Growth hormone
b-oxytocin
Thyrotropin (thyroid-stimulating hormone) is secreted from the
a. thyroid.
b. parathyroid.
c. anterior lobe of the pituitary gland.
d. posterior lobe of the pituitary gland.
c. anterior lobe of the pituitary gland.
Which is linked to hypothyroidism?
a. Nervousness and tremors.
b. Skeletal muscle weakness and wasting.
c. Increased risk of coronary artery disease.
d. Increase in appetite with decrease in body weight
c. Increased risk of coronary artery disease.
The antithyroid drug is : a‐ Octreotide b‐ Propylthiouracil c‐ Prednisolone d‐ Repaglinide e‐ Cinacalcet
b‐ Propylthiouracil
Leuprolide is derivative of : a‐ FSH b‐ LH c‐ TSH d‐ GnRH e‐ Prolactin
d
I131 is used for : a‐ Non toxix goiter b‐ Hashimoto’s disease c‐ Thyrotoxicosis d‐ Hypothyroidism e‐ Iodide deficiency
c‐ Thyrotoxicosis
Vasopressin possesses the following:
a) Antidiuretic property
b) Vasodilatation property
c) Release of a thyroid hormone into the plasma
d) Diuretic property
a) Antidiuretic property
Oxytocin produces the following effects:
a) It causes contraction of the uterus
b) It assists the progress of spermatozoa into the uterine cavity
c) It brings about milk ejection from the lactating mammary gland
d) All of the above
d
Vasopressin causes a pressor effect by:
a) Releasing noradrenaline from the nerve terminals
b) Releasing and activating renin-angiotensin system
c) A direct action on smooth muscles of the blood vessels
d) All of the above mechanisms
c) A direct action on smooth muscles of the blood vessels
Which of the following hormones is produced by the thyroid gland?
a) Thyroxine
b) Thyroid-stimulating hormone
c) Thyrotropin-releasing hormone
d) Thyroglobulin.
a) Thyroxine
. Thyroid hormones produce various pharmacological effects. Indicate the wrong statement(s).
a) Decline of the basal metabolic rate in the body
b) Increase in the rate and force of contraction of the heart
c) Increase in the blood cholestrol level
d) Increase in the heat production
a
Indications of thyroid hormones are following, EXCEPT:
a) Cretinism
b) Myxoedema
c) Hashimoto’s disease
d) For treatment of simple obesity
d
The common side effect of thyroid hormones is following:
a) Increases in basal metabolic rate
b) Angina pectoris
c) Tremors
d) Exopthalmos
d
Daily administration of large doses (several milligrammes) of iodides to a thyrotoxic patient causes:
a) Involution of the thyroid which reaches a maximum in two weeks
b) Increased vascularity of the thyroid gland
c) Decreased storage of the colloid in the thyroid gland
d) Thyroid gland growing firm and less vascular
d
