Pituitary, Hypothalamic, Calcium Meds Flashcards
desmopressin (DDAVP)
Synthetic Vasopressin Derivative
- used in the tx of diabetes insipidus of pituitary origin
- oral, iv, SC or intranasal
vasopressin (Pitressin)
- hormone produced in posterior pituitary
- can act on V1 (CV effects) and V2 (renal tubule) receptors
- used in tx of diabetes insipidus
- oral, iv, SC, or intranasal
oxytocin (Pitocin)
- hormone produced in post. pituitary
- modulates transmembrane ion currents in the smooth muscle of the myometrium to produce sustained uterine contractions
- used to induce labor (IV or IM)
vitamin D
- synthesized via complex series of actions involving the liver, kidney, and skin, some of which are influenced by PTH
- main effect= inc. absorption of Ca from gut (also dec. excretion of Ca in urine and inc. Ca reabsorption from bone)
- net effect= inc. serum Ca
- oral or IM administration
vitamin D2 (ergocalciferol)
- plant derived and used to make vitamin D
- same affects as natural vit D
vitamin D3 (calcitriol)
- animal derived and used to make vitamin D
- same effects as natural vit D
PTH/teriparatide (Forteo)
exogenous PTH
- when given at low doses on daily bases, acts on osteoblasts to STIMULATE bone formation
- injectible
- has opposite effects then what PTH does physiologically
- only treatment that stimulates formation of new bone
- expensive
calcitonin (Calcimar)
- made in C cells of the thyroid and inhibits bone reabsorption and causes dec. serum Ca
- available as Salmon calcitonin (longer 1/2 life) and synthetic human calcitonin
- used SC, IM, or intranasal
SRIH
- somatostatin
- inhibits secretion of GH from pituitary
prolactin
- structurally homologous to GH and prolactin receptor structurally homologous to GH receptor
- stimulates lactation and inhibits reproductive functions
- not used as a drug
- release normally inhibited by dopamine
somatostatin
-inhibits GH release from the pituitary
hyperprolactinemia
- abnormal hypersecretion of prolactin
- common cause of amenorrhea, galactorrhea, and female infertility that is treated with dopa agonists
alendronate
biophosphonate
- taken up by osteoclasts and slows the dissolution of hydroxyapatite (main component of bone).
- inhibit geranylgeranyl diphosphate synthase (inhibit bone resorption).
- PO only
- Do not lay down right after taking (esophagitis); can cause osteonecrosis of the jaw.
etidronate
biophosphonate
- taken up by osteoclasts and slows the dissolution of hydroxyapatite (main component of bone).
- inhibit geranylgeranyl diphosphate synthase (inhibit bone resorption).
- Do not lay down right after taking (esophagitis); can cause osteonecrosis of the jaw.
ibandronate
biophosphonate
- taken up by osteoclasts and slows the dissolution of hydroxyapatite (main component of bone).
- inhibit geranylgeranyl diphosphate synthase (inhibit bone resorption).
- PO, IV
- Do not lay down right after taking (esophagitis); can cause osteonecrosis of the jaw.
pamidronate
biophosphonate
- taken up by osteoclasts and slows the dissolution of hydroxyapatite (main component of bone).
- inhibit geranylgeranyl diphosphate synthase (inhibit bone resorption).
- Do not lay down right after taking (esophagitis); can cause osteonecrosis of the jaw.
tiludronate
biophosphonate
- taken up by osteoclasts and slows the dissolution of hydroxyapatite (main component of bone).
- inhibit geranylgeranyl diphosphate synthase (inhibit bone resorption).
- Do not lay down right after taking (esophagitis); can cause osteonecrosis of the jaw.
zoledronate
biophosphonate
- taken up by osteoclasts and slows the dissolution of hydroxyapatite (main component of bone).
- inhibit geranylgeranyl diphosphate synthase (inhibit bone resorption).
- PO, IV
- Do not lay down right after taking (esophagitis); can cause osteonecrosis of the jaw.
denosumab
Antibody that binds RANKL and prevents it from binding to RANK receptors on osteoclasts (decreases bone resorption)
growth hormone
GH
-use: GH deficieny, wasting in AIDs
-human recombinant given SQ daily or IM monthly
side effects- peripheral edema, impaired glucose tolerance, carpal tunnel, hypothyroidism
injection site reactions and headaches
sermorelin acetate
GH analog
-injectible
side effects- peripheral edema, impaired glucose tolerance, hypothyroidism
injection site reactions and headache
IGF-1
mediate effects of GH
-human, recombinant
Used only in syndromes of GH resistance
-injection
pegvisomant
GH antagonist
- SQ injection
- binds to GH receptor but it doesn’t allow dimerization
- 9 amino acid mutation of wild-type GH, 5 of these have covalently attached polethylene glycol moieties
octreotide
somatostatin agonist
- inhibit the release of GH
- selective for type 2 and 5 receptors
- side effects: GI- nausea, flatulence, abdominal pain, Gallstones are common
lanreotide
somatostatin agonist
- inhibit the release of GH
- selective for type 2 and 5 receptors
- side effects: GI- nausea, flatulence, abdominal pain, Gallstones are common
bromocriptine
D2 agonist
- inhibits the release of prolactin
- treatment of amenorrhea, galactorrhea, and infertility
- side effects: nausea, headaches, orthostatic hypotension
cabergoline
D2 agonist
- inhibits the release of prolactin
- treatment of amenorrhea, galactorrhea and infertility
- side effects: nausea, headache, orthostatic hypotension
