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30 Cards in this Set
- Front
- Back
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A deficiency in which hormone(s) can cause short stature?
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GHRH,GH, IGF-1, TSH, thyroid hormone
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In what stages is GH most commonly released?
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stage III and IV or non-REM sleep.
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what is the hormone from the hypothalamus that inhibits the release of GH from the ant. pituitary?
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somatostatin
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what is a primary GH def?
Secondary? Tertiary? |
deffect in IGH to be released
Pituitary is insuffucent in GH def in GHRH. |
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what are 2 drugs that you can give someone to that are the recombinant form of GH?
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somatropin
somatrem |
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what should not be closed prior to to giving someone GH?
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epiphyseal plate
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what are the clinical uses of somatropin/somatrem?
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GH def
turner syndorme someone with short stature athletes AIDS wasting malabsorbtion from short bowel anti-aging |
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what can happen to the femoral epiphysis if growth is to rapid?
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shear
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what are the AE of GH in adults?
Kids? |
carpel tunnel, peripheral edema, myalgia, arthalgia
hypothyroidism, scoliosis, intracranial HTN |
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why would a kid using GH get hypothyroidism?
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the excess GH triggers the release of Somatostatin. the somatostatin blocks the release of TSH thus thyroid hormone levels decrease.
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A 5-year-old girl is evaluated and determined to have short stature. A GH stimulation test revealed a normal basal level of GH, and an elevation in serum GH levels post-stimulation, but IGF-1 levels were very low in both cases. What is the most likely cause?
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she has a defective GH receptor.
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what is the name of the drug you give someone that is def in IGF?
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mecasermin
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what is the AE for mecasermin?
how do you prevent this? |
hypoglycemia
eats 20 min before taking |
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How can you stop the effects of excess growth hormone from a pituitary adenoma?
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remove the tumor, block the receptor, stop the release
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What inhibits the release of GH from the pituitary?
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somatostatin, GH, IGF
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what are 2 examples of GH antagonist/blockers?
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octreotide, lanreotide
these are somatostatin analogs |
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what is the common ending to drugs that block GH?
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-reotide
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why is it better to give someone octreotide/lanreotide than it is somatostatin?
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octreotide has a longer half life (90 min), has 45x greater blockage of GH, 2x greater blocker of insulin release.
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what are the clinical uses of octreotide/lanreotide?
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acromegaly, gigantism, carcinoid syndrome, diarrhea from pancreatin VIPoma
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what are the AE of octreotide/lanreotide?
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gallstones, biliary sludge, steatorrhea, hypo/hyperglycemia, hypothyroidism
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what is the clinical use of pegvisomat?
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acromegaly
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how does pegvisomat work?
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blocks GH receptors
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what are bromocriptine/cabergoline and what do they tx?
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bromocriptine/cabergoline are D2 agonist and at high concentrations they block the release of GH.
Last resort. |
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A 32-year-old female presents to her gynecologist because she has had no menses for the past 8 months. She reports a negative pregnancy test at home. She also has frequent headaches, a change in vision, and a milky discharge from the breast. She has no medical problems and is not taking any medications. Magnetic resonance imaging (MRI) reveals a mass, 3 mm in diameter, in the anterior lobe of the pituitary. What does she most likely have?
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hyperprolactinemia
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Why might a prolactinoma cause visual problems
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the pituitary lies next to the optic chiasma so a tumor in the ant pituitary that causes excess prolactin to be excreted may inmpinge on the optic chiasma so youll see visual changes
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what hormone normally inhibits the secretion of prolactin?
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Dopamine
binds to the D2 receptor in the ant pituitary. |
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what are the 2 D2 agonist that we know of?
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bromocriptine and cabergoline
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which D2 agonist is best for someone trying to get prego?
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bromocriptine
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person comes in with ortho hypotension and you see she is being treated for prolactinemia.
what is the possible drug that is causing the sx? |
bromocriptine/cabergoline
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CNS effects such as psychosis, hallucinations, nightmares, or insomnia. what is the possible drug AE?
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bromocriptime or cabergoline
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