Hypothalamic And Pituitary Hormones

Front 1

what are some FSH drugs

Back 1

a) Follitropin alfa
b) Follitropin beta
c) Urofollitropin

Front 2

what is a LH drug

Back 2

a) Lutropin alfa

Front 3

what is an hcg drug

Back 3

a) Choriogonadotropin alfa

Front 4

what are some gonadotropin releaseing hormone analogues

Back 4

a) Leuprolide (prototype)
b) Gonadorelin
c) Goserelin
d) Histrelin
e) Nafarelin
f) Triptorelin

Front 5

what are some6) Gonadotropin-releasing hormone antagonists
a)

Back 5

Abarelix
b) Cetrorelix
c) Degarelix
d) Ganirelix

Front 6

what are some dopamine agonists

Back 6

a) Bromocriptine
b) Cabergoline

Front 7

(a) Used in conjunction with hCG to induce ovulation and pregnancy in infertile females experiencing oligoanovulation or anovulation when the cause of anovulation is functional and not caused by primary ovarian failure
(b) Stimulation of multiple follicle development in ovulatory patients as part of an ART

Back 7

menotropins

Front 8

is purified human FSH extracted from the urine of postmenopausal women (no LH activity)

Back 8

(1) Urofollitropin (uFSH

Front 9

(1) Purified extract of FSH and LH extracted from the urine of postmenopausal women
(2) Contains an FSH-like substance (4% of the potency of FSH) and an LH-like substance

Back 9

menotropins

Front 10

are recombinant forms of FSH with amino acid sequences identical to that of human FSH

Back 10

(2) Follitropin alfa and follitropin beta (rFSH)

Front 11

what is the diff between rfsh and ufsh

Back 11

(3) rFSH preparations have a shorter half-life but stimulate estrogen secretion equal to or greater than uFSH (rFSH preparations are considerably more expensive)

Front 12

what are the clinical uses of FSH drugs

Back 12

(a) Ovulation induction in patients who previously received pituitary suppression (uFSH)
(b) Ovulation induction in patients in whom the cause of infertility is functional and not caused by primary ovarian failure (rFSH alfa and beta)
(c) Spermatogenesis induction (rFSH alfa)
(d) Development of multiple follicles with ART (uFSH, rFSH alfa and beta)

Front 13

recombinant form of human LH
(2) Only approved for use in combination with follitropin alfa for stimulation of follicular development in infertile women with profound LH deficiency

Back 13

Lutropin

Front 14

induce ovulation and pregnancy in anovulatory, infertile females; treatment of hypogonadotropic hypogonadism, prepubertal cryptorchidism; spermatogenesis induction with follitropin alfa

Back 14

extracted hcg

Front 15

induces ovulation in infertile females who have been pretreated with follicle stimulating hormones; induces ovulation and pregnancy in infertile females when the cause of infertility is functional

Back 15

rhcg

Front 16

how are all gonadotropins administered

Back 16

IM or SQ

Front 17

what are the contraindications and toxicity

Back 17

Overstim of ovary> uncomplicated ovarian enlargement,Ovarian hyperstimulation syndrome: ovarian enlargement, ascites, hydrothorax, and hypovolemia, shock, Multiple pregnancies, Risk of multiple pregnancy is 15-20% in ART patients, Multiple preg incr the risk for gestational diabetes, preeclampsia, and preterm labor

Front 18

what is the prototypical Gnrh analogue

Back 18

leuprolide ( iv admin every 1-4 hours)

Front 19

what happens to the mech of action of leuptolide in the fist 7-10 days and then after that

Back 19

first 7-10 days of admin, an agonist effect results in increased concentrations of gonadal hormones (referred to as a flare), After the first 7-10 days, the continued presence of GnRH (or analog) results in an inhibitory action that manifests as a drop in the concentration of gonadotropins and gonadal steroids (due to receptor down-regulation and changes in the signaling pathways activated by GnRH)

Front 20

what is leuprolide that supresses used to treat

Back 20

(1) Controlled ovarian hyperstimulation (e.g., to prevent premature ovulation by endogenous LH in IVF patients)
(2) Endometriosis
(3) Uterine leiomyomata (uterine fibroids)
(4) Prostate cancer
(5) Central precocious puberty

Front 21

what is leuprlide used for stimulation used to treat

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(1) Female infertility
(2) Male infertility
(3) Diagnosis of LH responsiveness

Front 22

v) Continuous GnRH agonist administration in men cause

Back 22

hot flushes, sweats, edema, gynecomastia, decreased libido, decreased hematocrit, reduced bone density, and asthenia

Front 23

i) Continuous treatment of women with a GnRH analog causes

Back 23

menopause, which include hot flushes, sweats, and headaches, depression, diminished libido, generalized pain, vaginal dryness, breast atrophy, and decreased bone density and osteoporosis with long-term use If ovarian cysts do not resolve after 3-4 months

Front 24

what is moa of gnrh recpetor antagonist

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synthetic competitive antagonists of GnRH receptors that inhibit the secretion of FSH and LH in a dose-dependent manner

Front 25

what is the role of gnrh antagonist in prostate cancer

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ii) Advanced prostate cancer (GnRH antagonists reduce concentrations of gonadotropins and androgens significantly more rapidly than GNRH agonists and avoids the testosterone surge)

Front 26

d) Ganirelix and cetrorelix are used in

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controlled ovarian hyperstimulation procedures

Front 27

e) Abarelix and degarelix are used to

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treat advanced prostate cancer

Front 28

6) DOPAMINE AGONISTS
a) Bromocriptine and cabergoline are ergot derivatives used to treat

Back 28

hyperprolactinemia (bromocriptine is also used to treat acromegaly and Parkinson disease)

Front 29

i) Dopamine agonists are the standard medical treatment for

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hyperprolactinemia as they shrink pituitary PRL-secreting tumors, lower circulating PRL levels, and restore ovulation in 70% of women with microadenomas and 30% of women with macroadenomas

Front 30

what are toxicities and contraindications of dopamine agonists

Back 30

Nausea, headache, light-headedness, orthostatic hypotension, fatigue are most common, Psychiatric manifestations occur occasionally and can take months to resolve,Pulminfiltrates may occur with chronic high-dose therapy not recommended to suppress postpartum lactation due to increased incidence of stroke or coronary thrombosis

Front 31

what is moa of oxytocin

Back 31

stimulates uterine muscle contraction after activating oxytocin receptors (G-protein coupled receptors linked to Gq, phosphoinositide-calcium second-messenger system)

Front 32

c) Stimulates the release of prostaglandins and leukotrienes that augment uterine contraction
d) Causes contraction of myoepithelial cells surrounding mammary alveoli, which leads to milk ejection
e) Indications include induction of labor at term; control of postpartum bleeding; adjunctive therapy in management of abortion

Back 32

oxytocin

Front 33

what are toxicities assoc with oxytocin

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(toxicity that does occur is due either to excessive stimulation of uterine contractions or to inadvertent activation of vasopressin receptors at high concentrations of oxytocin)

Front 34

ii) Anterior pituitary hormones are positively regulated by

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hypothalamic releasing hormones, which are released from hypothalamic neurons and reach the anterior pituitary through the hypothalamic-adenohypophyseal portal system

Front 35

iii) Anterior pituitary hormones are negatively regulated by

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hypothalamic peptides (somatostatin) and catecholamines (dopamine)

Front 36

where are hormones that are released by the post pit made

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hypothalamus

Front 37

i) Growth hormone (GH) and prolactin (PRL) are single-chain protein hormones that activate

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kinase-linked receptors of the JAK/STAT superfamily

Front 38

ii) Thyroid-stimulating hormone (TSH, thyrotropin), follicle-stimulating hormone (FSH), and luteinizing hormone (LH) are dimeric proteins that activate

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G-protein coupled receptors (GPCRs)

Front 39

iii) Adrenocorticotropic hormone (ACTH) is a single peptide, cleaved from a larger precursor containing the peptide β-endorphin, that also binds ____

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GPCRa

Front 40

ii) LH and FSH release is regulated by

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gonadotropin-releasing hormone

Front 41

iii) ACTH release is regulated by

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corticotropin-releasing hormone (CRH)

Front 42

i) TSH and TRH production is inhibited by

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thyroxine (tetraiodothyronine, T4) and triiodothyronine (T3)

Front 43

ii) FSH and LH (gonadotropins) and GnRH production is inhibited by

Back 43

estrogen and progesterone in women and androgens in men

Front 44

iii) ACTH and CRH production is inhibited by

Back 44

cortisol

Front 45

growth hormone Production is stimulated by growth hormone-releasing hormone (GHRH) and inhibited by

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the peptide somatostatin (SST)

Front 46

ii) GH and _____ feedback to inhibit GH release

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insulin-like growth factor-1 (IGF-1)

Front 47

(2) FSH stimulates the conversion of

Back 47

androgens to estrogens by granulosa cells

Front 48

(1) LH stimulates androgen production by

Back 48

theca cells in the follicular stage of the menstrual cycle

Front 49

iv) hCG is a placental protein nearly identical with LH and its actions are mediated through

Back 49

Lh receptors

Front 50

concentrations in the vicinity of developing sperm by stimulating

Back 50

the production of androgen-binding protein by Sertoli cells

Front 51

(2) FSH stimulates the conversion of testosterone to estrogen by

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sertoli cell

Front 52

g) Receptors selective for estrogens, progestins, and androgens are __ __

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nuclear receptors

Front 53

ii) LH is the main stimulus for the production of testosterone by

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leydig cells