Pituitary Drugs Flashcards
Somatropin
Recombinant GH
191 aa peptide that confers same action as physiologic
Use: GH def - Turners, Prader-Willi, renal insuff, in adults
Illicit in sports, controversial in idiopathic short kids
Somatropin SE
insulin resistance,
glucose intolerance, slight
risk of pseudotumor cerebri, Misuse in athletes:
acromegaly, arthropathy, visceromegaly
Octreotide
Somatostatin Analog
Half life = 90 min
IM every month
Lanreotide
Somatostatin Analog
SC every month
Somatostatin Analog
Inhibit GH release via Gi & GI (decrease motility)
Use: acromegaly and gigantism, bleeding from esophageal varices
Somatostatin Analog SE
Transient hyperglycemia Cramps, loose stools
Cardiac effects
Cabergoline
DA Agonist
Bromocriptine
DA Agonist
DA Agonist
Binds D2 receptors inhibits PRL secretion and reduces prolactinoma size omewhat inhibits GH secretion Hyperprolactinema and 2nd line GH excess Oral
Bromocriptine: SE
N/V, HA, postural hypotension
Pegvisomant
GH Antag
GH Excess 2nd line
Desmopressin
ADH Analog V1 - Gq (VC) & V2 - Gs antidiuretic
Nasal or Oral
Use: Central DI
Drugs that induce DI
Lithium & demeclocycline
Chlorpropamide
1st gen sulfonylurea potentiates ADH action
Use: Central DI if DDAVP intolerant
Mecasermin
Recombinant IGF-1
Used for GH Def if GH insensitive
Nephrogenic DI Drugs
Thiazides - reduces polyuria
NSAIDs - (indomethacin) inhibit PG synth (PGS reduce ADH act)
Usually combo
Demeclocycline
Inhibits ADH on distal tubule.
Use: SIADH
Tolvaptan
V2 Antag
Oral, $$$
Conivaptan
V2 Antag
IV, CYP3A4
V2 Antag & SE
Use: SIADH
SE: Rapid correction of hyponatremia can lead to cerebellar pontine myelinolysis
SIADH
Incomplete suppression of ADH under hypoosmolar conditions
Drugs Induced: SSRIs, halperidol, TCADs
