Tx of Hypothalamus, Pituitary and Adrenal Disorders Flashcards
Treatment for Laron Syndrome (Dwarfism). It is a recombinant form of IGF-1
Mecasermin
- AE: hypoglycemia
- IGF-1 is effector molecule of GH
Tx for Prader-Willi syndrome
GH replacement…decreases body fat, increases lean body mass
Tx of Acromegaly
primary Tx is Transphenoidal surgery
Med Tx:
- Octreotide, Lanreotide
* Somatostatin mimic
Pegvisomant
GH receptor antagonist…used in Tx of Acromegaly
- does NOT reduce size of tumor
- GH levels may increase
Drugs used as a means of lowering prolactin secretion
dopamine D2 receptor agonists
- bromocriptine
- cabergoline
Bromocriptine
dopamine D2 receptor agonist…used to Tx small prolactinoma
*AE: nausea, vomit, headache, postural hypotension
Cabergoline
more selective dopamine D2 receptor agonist than bromocriptine
Tx of central diabetes insipidus
desmopressin (ADH analog)…specific to V2 receptor
Tx of nephrogenic insipidus
no specific treatment, gene therapy?
*paradoxically Tx’d w/ thiazide diuretic to increase GFR
Conivaptan
Tx for SIADH (syndrome of inappropriate ADH–i.e. too much ADH)
*high affinity for V1 in vasculature and V2 in kidney
Tolvaptan
Tx for SIADH (syndrome of inappropriate ADH–i.e. too much ADH)
30 fold higher affinity for V2 than for V1
Thioamides, block iodination process (inhibits TSH synthesis) (2)
- Propylthiouracil
- Methimazole
* derm rxns
* bone marrow depression
* methimazole has a longer half-life (6hrs)
non-selective inhibitor of adrenal gonadal steroids. It blocks multiple enzymes in cortisol pathway (cyp 17-20 and 3B hydroxysteroid).
Ketoconazole
*AE: hepatotoxicity (>200mg dose), headaches, sedation, nausea
non-selective cytotoxic agent on adrenal cortex. Used in patients w adrenal carcinoma
Mitotane
*AE: nausea, diarrhea, vomiting, depression
originally used for elective abortions. This drug is a glucocorticoid receptor antagonist. Can be rapidly effective for diabetes-related Cushing’s Dx.
Mifepristone
*AE: substantial hypokalemia and QT prolongation
