Unit 10: HPA Endocrine Meds

Question 1

On what does TSH act?

Answer 1

thyroid

Question 2

On what do LH and FSH act?

Answer 2

ovaries

Question 3

On what does ACTH act?

Answer 3

adrenals

Question 4

On what does GH act?

Answer 4

bone and soft tissues

Question 5

What is GHRH?

Answer 5

growth hormone releasing hormone

Question 6

What is TRH?

Answer 6

thyroid releasing hormone

Question 7

What is CRH?

Answer 7

corticotropin-releasing hormone

Question 8

What is GnRH?

Answer 8

Gonadotropin-releasing hormone

Question 9

Basic definition of Pan Hypopitiuitism

Answer 9

2+ hormones secreted by the PITUITARY are not being made

a collection of many disorders

Question 10

Who manages Pan Hypopituitism?

Answer 10

endocrinology

Question 11

When to suspect Pan Hypopituitism?

Answer 11

when a patient has deficiencies of more than one hypothalamic hormone

Question 12

Treatment of Pan Hypopituitism

Answer 12

replacement medications for deficient hormones

Question 13

What is the typical cause of Pan Hyperpituitism?

Answer 13

tumor

Question 14

When to suspect Pan Hyperpituitism?

Answer 14

when a patient has symptoms and lab findings that suggest excess of more than one hypothalamic hormone

Question 15

How is Pan Hyperpituitism treated?

Answer 15

usually surgery

meds can suppress hormone secretion while awaiting surgery

Question 16

What is GH?

Answer 16

growth hormone

Question 17

What is TSH?

Answer 17

thyrotropin

Question 18

What is ACTH?

Answer 18

adrenocorticotropin

Question 19

What is FSH?

Answer 19

follicle-stimulating hormone

Question 20

What is LH?

Answer 20

leutenizing hormone

Question 21

Name the anterior pituitary hormones

Answer 21

GH
TSH
ACTH
FSH
LH

Question 22

For what is GH needed?

Answer 22

height/growing tall
brain development
strong bones
metabolism of cholesterol/lipids
muscle mass

Question 23

What drugs treat GH deficiency?

Answer 23

somatotropin

mecasermin

Question 24

For what is mecasermin used?

Answer 24

IGF-I deficiency

Question 25

What does "tropic" mean?

Answer 25

make it grow

Question 26

What is IGF-1, and what does it do?

Answer 26

insulin-like growth factor facilitates use of glucose to grow GH --> increases IGF-1 production in liver, bone, cartilage, muscle, kidney, other tissues

Question 27

What is pseudotumor cerebri?

Answer 27

higher pressures in the brain (increased ICP) that normalize with removal of medication that causes it

Question 28

Somatotropin can cause the increase in P450 metabolism. What does the mean for other drugs?

Answer 28

other drugs metabolized by P450 will need to be prescribed in higher doses

Question 29

For whom is somatotropin absolutely contraindicated?

Answer 29

any malignancy (somatotropin makes things grow)

Question 30

Adverse effect of mecasermin, what what to do about it?

Answer 30

hypoglycemia; give with a snack within 20 minutes of dose

Question 31

Diseases of GH excess

Answer 31

gigantism | acromegaly

Question 32

What does "statin" imply?

Answer 32

stopping something

Question 33

What does somatostatin do?

Answer 33

``` inhibits paracrine factor which inhibits release of: GH TSH glucagon insulin gastrin ```

Question 34

Why can't we use somatostatin to treat GH excess?

Answer 34

the half life is too short (1-3 minutes)

Question 35

What do we use to treat GH excess?

Answer 35

octreotide (Sandostatin)

Question 36

What does octreotide do?

Answer 36

Inhibits release of GH and insulin

Question 37

For what is octreotide indicated?

Answer 37

secretory diarrhea (more fluid than PO intake) to decrease portal pressure symptom relief for hormone-secreting tumors (to decrease hormone secretion while awaiting surgery)

Question 38

For what is an octreotide drip used?

Answer 38

esophageal variceal bleeding

Question 39

adverse effects of octreotide

Answer 39

bradycardia, arrhythmias | abdominal cramps, nausea, flatulence, steatorrhea, large BMs

Question 40

What is pegvisomant (Somavert)?

Answer 40

GH receptor antagonist

Question 41

What does pegvisomant do/not do?

Answer 41

DOES: blocks GH action | DOES NOT: inhibit GH release

Question 42

If pegvisomant blocks GH action, what does it treat? What does it not treat?

Answer 42

acromegaly | NOT gigantism

Question 43

What is the only reported adverse effect of pegvisomant?

Answer 43

elevated LFTs