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36 Cards in this Set
- Front
- Back
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Releasing Hormones:
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- GHRH: growth hormone
- TRH: Thyrotropin - Corticotropin: CRH - Gonadotropin: GnRH - LRH (luteinzing ) |
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Inhibitory Hormones:
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- GHIH, somatostatin
- Prolactin inhibitory hormone (PIH, dopamine) |
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Anterior Pituitary Hormones:
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- GH
- Thyroid Stimulating Hormone (TSH) - Adrenocorticotropic hormone (ACTH) - Follicle Stimulating Hormone (FSH) - Thyroid STimulating Hormone (TSH) - Adrenocorticotropic Hormone (ACTH) - Prolactin - Luteinzing Hormone (LH) |
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Posterior Pituitary Hormone:
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Oxytocin and Vasopressin
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Growth Hormone Releasing HOrmone:
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- 1-29 amino terminal seg.
- stimulates synthesis and release of GH from the hypothalamus. - Receptor Coupled w/ Gs protein, activates adenylate cyclase - isolated both as 40 and 44 a.a. peptide. |
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Sermorelin (GEREF): I.V. TX.
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- acetate salt of synthetic 29 a.a. peptide that is amino terminal seg. of GHRH.
- USE: IDOPATHIC GH deficiency --> NOT WORK.in pt. whose GH deficiency results from DEFECT IN ANTERIOR PITUITARY. |
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Somatostatin (GHIH)
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- 14 a.a.
- inhibits GH release. - Can inhibit release of INSULIN, GLUCAGON, GASTRIN. - Produce numerous actions and has short half-life. |
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OCTREOTIDE (Somatostatin)
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- 8 a.a. synthetic analog of somatostatin.
- long half-life - 45x INHIBITING GH release - 2x reducing insulin secretion. |
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Octreotide use:
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Acromegaly:
- arthropathy - carpal tunnel syndrome - visceromegaly - HTN - glucose intolerance - ha. - lethargy - sleep apnea - excess perspiration. |
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Adverse Effects of Octreotide:
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- Nausea
- Diarrhea - Abdominal pain (all 50%) - BILIARY SLUDGE - GALLSTONE (ALL 25%) |
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What is the inf. susp called?
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octreotide acetate --> Sandostatin (LAR)
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GH (Somatropin: Serostim)
191 a.a. PEPTIDE |
MOA: DIRECT:
1. INCREASE LIPOLYSIS IN ADIPOCYTES, STIMULATES GLUCONEOGENSIS IN HEPATOCYTES. INDIRECT: 1. ANABOLIC and growth promoting effects through induction of IGF , IGF, IGF, (SOMATOMEDINS) GH stimulates the synthesis of somatomedins: 1. Uptake of glucose 2. Uptake of a.a. 3. decreased lipolysis 4. bone and cartilage growth. |
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IGF
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1 AND 2
mostly it is IGF-1 made in the LIVER. - more dependent on GH and appears to be principal mediator. |
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Indications of GH
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1. GH deficiency in children (deficiency - congenital or acquired)
2. Children w/ chronic renal insufficiency. 3. Girls w/ Turner's Syndrome 4. Adults with GH deficiency. |
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Adverse Effects of GH in children and adults:
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Children:
1. intracranial HTN 2. HA, N/V. 3. Visual disturbances. Adults: 1. Peripheal edema 2. Carpal tunnel syndrome 3. Myalgia 4. Arthralgia 5. Hypoglycemia. |
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Pegvisomant (Somavert)
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GH antagonist
- used in acromegaly. Adverse effect: 1. Tumor growth 2. Elevated Liver enzymes |
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Thyrotropin alpha (rhTSH)
Thyroid Stimulating Hormone (TSH) |
Released from hypothalamus.
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PROTIRELIN (Thyrotropin releasing hormone )
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- causes anterior pituitary to release TSH.
- TSH stimulates thyroid to T4 T3,thyroglobulin. |
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What can be used for diagnosis of THYROID function?
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- Protirelin (thyrotropin releasing hormone)
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Thyrotropin alpha (rhTSH) THYROGEN
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RECOMBINANT TECHNOLOGY
- binds to TSH - STIMULATES: adenylyl cyclase activity --> increase cAMP...increases iodine uptake and increased production of thyroid hormones. |
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Uses of rhTSH
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W/ I 131 -> treat metastatic diff. thyroid cancer in presence of high serum TSH.
- determination of follow-up after total thyroidectomy ( |
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Adverse efects
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- ASTHENIA
- n/ha. |
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Adrenocorticotropic Hormone (ACTH)
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- released by CRH.
- STIMUATES production of glucocorticods, mineralcorticoids, adrenal androgens. - AMINO TERMINAL PORTION CONTAINING A.A. 1-24 NECESS. FOR full biological activity. |
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Synthetic ACTH 1-24:
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- Cosyntropin.
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Diagnostic uses: ADRENAL INSUFFICIENCY
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- ACTH (COSYNTROPIN)
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Sustained non-pulsatile manner of GnRH inhibits:
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release of FSH and LH in men and women --> causes DOWN REGULATION AND DESENTIZATION OF GnRH receptors.
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Gonadorelin HCl (FACTREL)
USES: |
1. (DIAGNOSIS) To distingush b/w consititutional delay in puberty and hypogonadotropic hypogonadism (diagnosis)
2. Reproductive disorders secondory to GnRH deficiency or disordered secretion of GnRH --> pulsatile adm. |
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Adverse Effects of GONADORELIN:
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- HA
- LIGHT-HEADNESS - N - FLUSHING - LOCAL SWELLING - GENERALIZED hypersenitivity reactions after long-term SC adm. |
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GnRH agonists should CONTINUOUSLY be given to:
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- Prostate Cancer
- Uterine Fibroid - Endometriosis - Precocious Puberty - In vitro fertization. |
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GnRH agonist
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Leuprolide (LUPRON)
Nafarelin (SYNAREL) Goserelin (ZOLADEX)--implant |
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Indication for GnRH agonist:
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1. Leuprolide (LUPRON)
- Endometrosis - Uterine fibriod - Prostate cancer - Central precocious puberty 2. Nafarelin (SYNAREL) - Endometrosis - Central precocius puberty - Uterine Fibroids 3. Goserelin (Zoladex) implant: - Endometrosis - Prostate Cancer - Dysfunctional uterine bleeding - Breast Cancer. |
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Common S/E of GnRH agonist in WOMEN
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- HOT FLUSHES, SWEATS, HA.
- Rhinitis (for Nafarelin) - Ovarian cysts, osteoporsis, elevated cholestrol and TG. |
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Common S/E of GnRH agonist in MEN:
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- Flushes and sweats
- edema - Increases testertone (bone metastasis) - Vertebral metastasis - Worsens urinary obstruction - Gynecomastia - Decreased Libido/hematocrit - Asthenia |
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Contraindications w/ GnRH agonist:
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- Breast Feeding
- Pregnancy Nasal decongestants not good with Nafarelin (synarel) |
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Gonadotropins:
FSH LH |
FSH: WOMEN:
1. GAMETOGENSIS and follicular development. MEN: Spermatogensis -> stimulates production of androgen - binding protein. |
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LH affects women and men:
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Women: LH stimulate follicular growth (in concert with FSH)
1. INDUCES ovulation 2. Stimulates corpus luteum to produce progesterone and andrognes. MEN: acts on testicular LEYDIG CELLS to stimulate testosterone production. |
