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Systemic Pharma- Respiratory + Endocrine > Pituitary Gland > Flashcards

Pituitary Gland Flashcards

1
Q

GH secretion is regulated by?

A
  • Hypothalamic GH releasing factor (GHRF)
  • Somatostatin
  • Insulin-like growth factor (IGF)-1
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2
Q

physiological effects of GH

A

1) Anabolic effects
* Bone growth
* Bone mineral density increase after the epiphyses have closed
* Increased muscle mass
* Protein synthesis

2) Metabolic Effects
* Increased lipolysis
* Gluconeogenesis stimulation

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3
Q

Drug of choice to treat GH deficiency

A

Somatropin
(Recombinant GH)

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4
Q

Adm of Somatropin

A

SC

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5
Q

CU of Somatropin

A

1) Pituitary dwarfism
2) Turner’s syndrome
3) AIDS-associated wasting
4) Used illicitly by athletes

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6
Q

Pituitary Dwarfism is caused by lack of?

A

GH, GHRF and IGF-1 generation/action

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7
Q

AE of Somatoropin

A
  • Few side effects in children

Adults:
* Peripheral edema
* Carpel tunnel syndrome
* Arthalgias (joint stiffness)
* Myalgia
* Insulin resistance

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8
Q

Recombinant IGF-1

A

Mecasermin

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9
Q

CU of Mecasermin

A

Treatment of growth failure in children
caused by
- Lack adequate amounts of IGF
- GH deficiency alternative to recombinant GH
* note: GH is more effective

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10
Q

Adm of Mecasermin

A

SC injection

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11
Q

Excessive production of GH
* Children -> ——–
* Adults –> ——-

A
  • Children –> Gigantism
  • Adults –> Acromegaly
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12
Q

Tx of excessive GH production

A

Pegvisomant
Bromocriptine

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13
Q

MoA of Pegvisomant

A

Recombinant modified version of GH –> Highly selective antagonist of GH actions

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14
Q

CU of Pegvisomant

A

2nd line tx in Excessive GH production
(when somatostain have failed)

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15
Q

CU of Bromocriptin

A

3rd line tx of execcive GH production

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16
Q

MoA of Bromocriptine

A

Dopamine agonist –> decreases production of GH from pituitary gland (AP)

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17
Q

1st line tx of Excessive GH production

A

Somatostatin

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18
Q

MoA of Somatostatin in the Anterior pituitary

A

Inhibits release of GH and TSH

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19
Q

MoA of Somatostatin in the pancreas

A

Inhibits insulin and glucagon release

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20
Q

MoA of Somatostain in the GI tract

A

Reduces gastric acid and pancreatic
secretions

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21
Q

Somatostain analogues

A

Octreotide
Lanreotide

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22
Q

Favoured tx of Acromegaly?

A

Somatostain analogue
(Octreotide, lanreotide)

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23
Q

CU of Octreotide

A

1) Oesophageal Varices
2) Acromegaly due Excessive GH
3) Carcinoid and other hormone-secreting tumours

24
Q

AE of Somatostain Analogues

A

1) Injection site pain (SC injection),
2) GI disturbances,
3) gallstones,
4) postprandial hyperglycemia (due to insulin inhibition in the pancrease)
5) hypothyroidism (due to inhibition of TSH)

25
Q

Fxn of Prolactin

A

Lactation

26
Q

What is used in the prevention of lactation?

A

Bromocriptine (Dopamine agonist)

27
Q

What is used to stimulate lactation

A

Dopamine antagonsits

28
Q

MoA of Dopamine Antagonists in terms of lactation

A

Stimulate prolactine release –> increase lactatin

29
Q

MoA of Dopamine Agonists in terms of lactation

A

Supress prolactine release –> inhibit lactation

30
Q

CU of Bromocriptine

A

1) Prevent lactation
2) Galactorrhoea
3) Prolactinoma
4) Tx of Parkinsonism and acromegaly

31
Q

AE of Bromocriptine

A

1) Nausea/vomiting
2) Headache
3) Postural hypotension
4) Less frequent : Psychosis/hallucinations, Insomnia

32
Q

Dopamine anatgonists

A

Metoclopramide; domperidone

33
Q

Anti-psychotics may
cause —————- as a
side effect

A

Galactorrhea

34
Q

Physiological action Vasopressin receptor 1A (V1A)

A

Phospholipase C/IP3 system activation –> Contraction of smooth muscle

35
Q

Physiological effect og Vasopressin receptor 1B [V1B (v3)]

A

Phospholipase C/IP3 system activation -> Release of adrenocorticotropic hormone (ACTH) from anterior pituitary

36
Q

Physiological action of V2 receptor

A
  • Stimulation of adenylyl cyclase
  • Action in collecting ducts of the nephron
    –> Increases permeability to water (aquaporin insertion)
  • Release of blood coagulation factors
37
Q

V2 receptor acts on?

A

Collecting ducts of the nephron –> increases permeabilty to water ( aqaporin insertion)

38
Q

Vasopressin analogues

A

1) Terlipressin (V1 selective)
2) Desmopressin (V2 selective)

- pressin

39
Q

CU of Terlipressin

A

tx of bleeding in Oesophageal varices

40
Q

CU of Desmopressin

A

1) Central diabetes insipidus (not nephrotic DI)
2) Persistent nocturnal enuresis
3) Prophylaxis against bleeding in haemophilia

41
Q

AE of Vasopressin Analogues V1- mediated AE

A

1) Facial pallor
2) Increased intestinal activity (nausea/cramps)
3) Spasm of coronary arteries (angina)
4) Reduced CO

- Terlipressin

42
Q

AE of vasopressin analouge, V2-mediated AE

A

Water intoxication
(hyperhydration)

* Desmopressin

43
Q

Vasopressin Antagonists

A

1) Tolvaptan (oral) - selective V2 anatogonist
2) Conivaptan (IV) - non-selective V1A/V2 antagonist

-aptan

44
Q

Adm of Tolvaptan

A

Oral

45
Q

Adm of Conivaptan

A

IV

HINT: Conivaptan

46
Q

MoA of Conivaptan

A

Non-selective V1A/V2 anatgonist

47
Q

MoA of Tolvaptan

A

Selective V2 antagonist

48
Q

CU of Tolvaptan

A

1) Treatment of syndrome of inappropriate ADH
secretion (‘SIADH’)
2) Hypervolemic or euvolemic hyponatremia

49
Q

CU of Conivaptan

A

Hypervolemic or euvolemic hyponatremia in hospitalized patients

* Emergency tx (IV)

50
Q

AE of Tolvaptan

A

1) GI-related adverse effects,
2) hyperglycemia,
3) pyrexia (fever)

51
Q

AE of Conivaptan

A

1) Drug-drug interactions preclude chronic use
2) Infusion-site reactions

52
Q

A Tetracycline drug

A

Demecolocycline

53
Q

CU of Demeclocycline

A

SIADH

54
Q

AE of Demeclocycline

A
  • Nephrogenic DI
  • Photosensitivity
  • Abnormalities of bone and teeth
55
Q

MoA of Demeclocycline

A

V2 antangonist

56
Q

Drugs used to test for ACTH production i Cushing’s syndrome

A

Metyrapone
(anti-adrenal CS -> inhibits the synthesis of endogenous adrenal glucocorticoids)

57
Q

**

tx of Cushing’s syndrome

A

ketoconazole
(anti-glucocorticoid)

Systemic Pharma- Respiratory + Endocrine (6 decks)

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