Pituitary-related drugs - Ch. 62

Question 1

What are the uses of pituitary-related drugs?

Answer 1

Replacement therapy in hormone deficiency
Therapy to produce a specific response when a hormone excess is present

Question 2

What are some anterior pituitary agents?

Answer 2

Somatropin (GH)
Octreotide

Question 3

What are some posterior pituitary agents?

Answer 3

Vasopressin/desmopressin

Question 4

How does GH (growth hormone) deficiency present?

Answer 4

paediatric short stature
adult muscle mass loss

Question 5

What is somatropin (GH)?

Answer 5

Recombinant GH
-peptide

Question 6

What does somatropin do in pediatric patients?

Answer 6

Stimulate skeletal growth

Question 7

What does somatropin do in adult patients?

Answer 7

Increase lean muscle mass
Decrease adipose mass

Question 8

How is somatropin administered?

Answer 8

SC

Question 9

What happens if someone has GH excess during childhood?

Answer 9

Gigantism
-7-9 feet tall
-Body proportions are normal

Question 10

What can cause gigantism?

Answer 10

Pituitary tumour
-surgical removal

Question 11

What is associated with gigantism?

Answer 11

Headache
Profuse sweating
soft tissue swelling
cardiomegaly
hypertension
arthralgias
diabetes

Question 12

What happens if someone has GH excess during adulthood?

Answer 12

Acromegaly

Question 13

What happens to someone with acromegaly?

Answer 13

Course facial feautres
Large hands and feet
Head ache
profuse sweating
soft tissue sweating
cardiomegaly
hypertension
arthalgias
diabetes

Question 14

What are the treatment options for acromegaly?

Answer 14

Surgery
radiation
drugs - when surgery/radiation is not wholly successful

Question 15

What drugs are used to treat GH excess?

Answer 15

Octreotide
lancretide
pasireotide

Question 16

What do Octreotide, lanreotide, pasireotide mimic?

Answer 16

Somatostatin

Question 17

What do Octreotide, lanreotide, pasireotide do?

Answer 17

Inhibits GH release

Question 18

How is Octreotide, lanreotide, pasireotide administered?

Answer 18

SC or IM
-daily or dept

Question 19

What is an example of a GH receptor antagonist?

Answer 19

pegvisomant

Question 20

What is diabetes insipidus caused by?

Answer 20

Most caused by deficiency of vasopressin (antidiuretic hormone) that leads to a production of large volumes of dilute urine

Question 21

What does vasopressin do?

Answer 21

Increases water reabsorption from kidney collecting ducts

Question 22

What happens when vasopressin is reduced?

Answer 22

Less water reabsorbed into the body so it is excreted in urine
up to 25L/day

Question 23

What is central diabetes insipidus?

Answer 23

Common causes: Brain surgery and head trauma
-Severity depends on how much vasopressin is released
Mostly transient, some persistent

Question 24

What is used in the treatment of diabetes insipidus?

Answer 24

Posterior pituitary drugs:
Vasopressin
Desmopressin

Question 25

What do posterior pituitary drugs reduce in pts with diabetes insipidus?

Answer 25

Reduce urinary output
Reduce severe thirst

Question 26

What is PO desmopressin used for?

Answer 26

Nocturnal enuresis
(bedwetting)

Question 27

What is the preferred drug for long-term central DI?

Answer 27

PO or intranasal Desmopressin
-Has longer duration of action and better adverse effect profile
-No vasoconstrictor activity

Question 28

What can vasopressin/desmopressin potentially lead to?

Answer 28

Water intoxication

Question 29

Symptoms of water intoxication?

Answer 29

Drowsiness
headache
light-headedness
Shortness of breath
Hyponatremia

Question 30

What else is desmopressin useful for?

Answer 30

Clotting disorders
-Hemophilia A
-von Willebrand’s disease (increased clotting factor VIII)

Question 31

Describe the vasoconstrictor effect of Vasopressin?

Answer 31

Enhances CPR during cardiac arrest
Useful for treatment of various types of bleeding, especially GI bleeding