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Pharmacology > Pituitary hormones > Flashcards

Pituitary hormones Flashcards

1
Q

What are the physiological actions of growth hormone?

A

Growth, nitrogen retention, promote lipids as an energy source instead of carbohydrates

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2
Q

What is the action of somatostatin?

A

Inhibits growth hormone (GHIH), glucagon and insulin

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3
Q

What is somatostatin used for?

A

Treatment of acute haemorrhage from esophageal varices

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4
Q

What is the somatostatin analogue?

A

Octreotide

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5
Q

T or F - Octreotide is less effective in inhibiting GH and insulin than somatostatin?

A

False. It is 45x more effective at inhibiting GH and 2x more effective at inhibiting insulin

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6
Q

What are the uses for octreotide?

A
  • Acromegaly (and Gigantism)
  • Upper GI haemorrhage
  • Insulin secreting tumours
  • Oesophageal varices
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7
Q

What are the A/E of octreotide?

A
  • Nausea, vomiting, flatulence
  • Local reactions
  • Hyperglycaemia – chronic
    administration
  • Pancreatitis, hepatitis
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8
Q

What is the role of GHRH?

A

Stimulate the release of GH

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9
Q

What is the name of GHRH peptide?

A

sermorelin

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10
Q

What is the therapeutic use of sermorelin?

A

stimulates GH in GH-deficient
children

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11
Q

Up until what point can sermorelin be used?

A

Until aprox 8 yrs old. Used until epiphyseal plates are closed

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12
Q

What are the A/E of GHRH and sermorelin?

A
  • Acute and transient
  • Headache, flushing, injection
    site reactions
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13
Q

What is the synthetic human growth hormone?

A

Somatropin

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14
Q

What is the action of somatropin?

A

Promotes the growth of long bones, ↑ protein synthesis, stimulate synthesis of IGF-I and IGF-II
↑ sulfate uptake into cartilage

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15
Q

What are the adverse effects of somatropin?

A
  • arthralgias,
  • fluid retention
  • lipodystrophy
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16
Q

What is a risk in pt receiving Tx with somatropin?

A

Hypocalcemia

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17
Q

What is the function of TRH?

A

Stimulate TSH secretion

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18
Q

What effect does TRH have in a pituitary tumor?

A

With pituitary tumour, TRH
release stimulates the
release of GH
(acromegaly) and ACTH
(cushings disease)

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19
Q

What is the function of TSH?

A

Stimulate thyroid to
produceT4, T3 and
thyroglobulin

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20
Q

What is the recombinant form of TSH and what it is used for?

A

Thyrotopin alfa (rhTSH)
* (Diagnostic tool)
* - used with or without radioactive
iodine imaging to test the presence
of Tg in patients with thyroid cancer

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21
Q

How is thyrotropin alfa administered?

A

IM only

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22
Q

What are the A/E of thyrotropin alfa?

A

nausea, headache,
hyperthyroidism

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23
Q

What is the action of corticotropen releasing hormone?

A

Stimulates release of ACTH and β-endorphins

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24
Q

What is the diagnostic use of CRH?

A

Distinguish Cushings disease from ectopic
ACTH secretion

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25
Q

What are the A/E of CRH?

A

transient facial flushing

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26
Q

What is the action of ACTH?

A

Stimulates synthesis and release of
cortisol, adrenal androgens,
glucocorticoids

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27
Q

What is the ACTH analogue?

A

Tetracosactide

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28
Q

What is the use of Tetracosactide?

A

Diagnostic agent (assess adrenocortical
responsiveness)

29
Q

What are the A/E of tetracosactide?

A

Hyperandrogenism in females, hyperpigmentation,
allergic reactions, Na+/H20 retention, ↑ BP,
hyperglycaemia and osteoporosis

30
Q

What is the function of GnRH?

A

Controls the release of FSH and LH

31
Q

What are the GnRH analogues?

A

Leuprorelin
Goserelin
Buserelin
Triptorelin

32
Q

What effect is achieved when GnRH analogues are administered in a pulsatile manner?

A

Used to treat infertility

33
Q

What effect is achieved when GnRH analogues are administered in a sustained, non-pulsatile manner?

A

Used to suppress LH and FSH in a tumor

34
Q

What drug is the synthetic form of hCG?

A

Choriogonadotropin alfa

35
Q

What is the use of Choriogonadotropin alfa?

A

Tx of infertility in females. Causes the ovulation

36
Q

What is Choriogonadotropin alfa given in combination with?

A

FSH

37
Q

What are the A/E of Choriogonadotropin alfa?

A

Headache, fatigue,
Nausea, vomiting,
Abdominal pain,
Ovarian hyperstimulation

38
Q

What is the FSH analogue?

A

follitropin-α

39
Q

What is the function of follitropin-α?

A

In females: stimulates gametogenisis and follicular development.
Conversion of estrogens to androgens in granulosa cells
In males: stimulates gametogenesis and
spermatogenesis

40
Q

What are the A/E of follitropin-α?

A

Enlarged ovary,
hyperstimulatory syndrome,
gynaecomastia,
ectopic pregnancy

41
Q

What is the analogue of LH?

A

Lutropin alfa

42
Q

What is Lutropin alfa used in combination with?

A

FSH

43
Q

What is the function of Lutropin alfa?

A
  • Regulation of gonadal steroid production
  • Stimulate testosterone production and follicular development
  • Induces ovulation
  • Stimulate corpus luteum to produce progesterone and androgens
44
Q

What are the A/E of Lutropin alfa?

A

Headache, depression, oedema, skin rash,
gynaecomastia, multiple pregnancy

45
Q

What drug is a LHRH antagonist?

A

Cetrorelix

46
Q

What is the function of cetrorelix?

A

Inhibits secretion of LH
and FSH

47
Q

When is cetrorelix indicated?

A

Prevention of premature
ovulation in patients
undergoing fertility
treatment

48
Q

What are the A/E of cetrorelix?

A

Nausea, headache, pain at
injection site

49
Q

What are the C/I for cetrorelix?

A

Renal, Hepatic
Impairment

50
Q

What is the Tx for Hyperprolactinemia?

A

prolactin secretion inhibited
by dopamine agonists →
shrink prolactin secreting
tumours

51
Q

What drugs are used in hyperprolactinemia?

A

Cabergoline, bromocriptine,
quinagolide

52
Q

What are the uses of dopamine agonists?

A

Amenorrhea, galactorrhoea, infertility assoc with
hyperprolactinaemia

53
Q

What are the A/E of dopamine agonists?

A

N, H, lightheadedness, postural hypotension,
fatigue
Cabergoline < nausea than bromocriptine

54
Q

What are the DI of dopamine agonists?

A

Antipsychotics and TCAD - ↑ prolactin levels

55
Q

What is the function of oxytocin?

A
  • Milk ejection
  • Induce uterine
    contraction / maintain
    labour with uterine
    dysfunction
  • Prevent / control
    bleeding after birth /
    abortion
56
Q

How is oxytocin administered?

A
  • IM → uterine
    response 3-5 min
  • Slow IV → immediate
    response
  • Nasal spray →
    induce postpartum
    lactation
57
Q

What are the CI for oxytocin?

A

Ø Fetal distress,
predisposition to uterine
rupture
Ø Vaginal delivery
contraintraindicated
Ø Intranasal administration
during pregnancy

58
Q

What are the A/E of oxytocin?

A

Nausea, vomiting,
uterine rupture, water
intoxication (high dose of
oxytocin), fetal death

59
Q

What are the DI of oxytocin?

A

Prostaglandins
potentiate the
effects

60
Q

What is the function of vasopressin (ADH)?

A

Has antidiuretic and vasopressor activities
Short-term management of bleeding
oesophageal varices

61
Q

What drug has potent vasoconstrictive activity and lacks antidiuretic activity?

A

Ornipressin

62
Q

What is the MOA of vasopressin?

A

V1 → vascular smooth muscle → vasoconstriction
♦ V2 → renal tubule cells → antidiuresis by
↑ H20 permeability and collecting tubule
H20 resorption
Ornipressin binds only to V1

63
Q

What are the signs of desmopressin/ADH toxicity?

A
  • Headache, nausea, abdominal cramps,
    agitation, allergic reactions
  • Avoid in , < 5 years, > 65 years
  • Limit fluid intake to a minimum
    Excess intake → hyponatremia
  • Discontinue if vomiting and diarrhoea
  • Avoid drugs that release vasopressin
  • E.g. tricyclic antidepressants
64
Q

What drug is a synthetic vasopressin analogue?

A

Desmopressin

65
Q

T or F - Desmopression is longer acting than vasopressin?

A

True

66
Q

What is the indication for desmopressin?

A

Used in the treatment of diabetes insipidus,
nocturnal enuresis, mild haemophilia A and von
Willebrands disease

67
Q

What is the MOA for desmopressin?

A

V 2 activity only → negligible vasoconstriction

68
Q

How is desmopressin administered?

A

IN / IV / subcut / oral
♦ IN → less effective if congestion present
♦ Bedtime desmopressin IN → ↓ nocturnal enuresis
♦ Has Factor VIII releasing activity → ↑ levels in von Willebrands and mild haemophilia A

69
Q
A

Pharmacology (11 decks)

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