Hypothalamic/pituitary Hormones

Front 1

Growth Hormone Releasing Hormone (SOMATORELIN)

Back 1

Natural Peptide. Stimulates rapid GH release. Activates GPCRs

Front 2

Thyrotropin-Releasing Hormone

Back 2

Tripeptide. Stimulates TSH and prolactin release. GPCRs

Front 3

Corticotropin Releasing Hormone

(Corticorelin, Acthrel [Ovine])

Back 3

Peptide, Stimulates ACTH and b-endorphin secretion from ant. pituitary. Activates GPCRs.

Uses: **Differential of Cushing's. ACTH release from pituitary in Cushing's constantly increases following CRH stimulation.

Front 4

Gonadotropin-Releasing Hormone (GnRH, LHRH, or Gonadrelin)

Back 4

Decapeptide. Pulsatile doses: stimulate LH and FSH release. Continuous dosing inhibits gonadotropin release (pharm castration)

Front 5

GnRH anaglos (Leuprolide, Nafarelin, Histrelin, Goserelin, Triptorelin).

Uses and adverse effects

Back 5

Uses: Given continuously to inhibit release. Used in Prostatic Carcinoma, Breast Cancer, Uterine Fibroids, Endometriosis, Precocious Puberty, Hirsutism. Also used in females undergoing ovarian hyperstimulation in fertility tx.

C/I: Breast feeding and preggo.

Adverse: Osteoporosis and other post menopausal effects

Front 6

GnRH Antag's ( Cetrorelix and Ganirelix)

Uses and adverse

Back 6

Uses: Inhibits premature LH surges in females undergoing controlled ovarian hyperstimulation.

Front 7

Somatostatin

Aka: Somatotropin Release Inhibiting hormone.

Aka: Growth-Hormone Inhibiting hormone

Back 7

Peptide, Inhibits GH, insulin, Glucagon, Thyrotropin, Gastrin.

Worthless due to very short half-life

Front 8

Somatostatin Analogs

Octreotide and Lanreotide. Uses and adverse effects

Back 8

Uses: Management of acromegally, carcinoid tumors, VIPomas, other endocrine tumors w.out producing hyperglycemia.

80 min half life. Lanreotide deep S.C injection.

Adverse Effects: biliary disorders.

Front 9

Prolactin Inhibiting Hormone analgos

Bromocriptine and Cabergoline

Back 9

Oral dopamine D2 agonists. Decrease prolactin secretion.

Uses: managment of hyperprolactinemia. (Galactorrhea, amenorrhea, hypogonadism, infertility, breast tenderness.)
And Prolactin Secreting Adenomas.

Front 10

Several agents that cause Hyperprolactinemia?

Back 10

Old antipsychotics: Phenothiazines and haloperidol.

Reserpine (depletes neurotransmitters)

Front 11

Growth Hormone (somatropin)

Actions, Uses, Adverse Effects, and Contra-indications

Back 11

Increases Protein Synthesis (stimulates synthesis and release of IGF-1 and 2).

Initial effects are insulin like.
Later effects are insulin antagonistic

Uses: GH deficiency, shorts stature in Turner's, short stature in Prader Willis, growth failure in Chronic Renal insufficiency, tx of HIV associated cachexia.

Adverse effects: Intracranial HTN, Gyencomastia.

C/I: Children exhibiting closed epiphysis.

Front 12

Mecasermin

Mecasermin rinfabate

Back 12

Mecasermin: rh-IGF-1

Mecasermin Rinfabate: rh-IGF-1/rh-IGFBP-3

Used in GH deletion and Primary IGF-1 deficiency

Front 13

GH antagonists

Pegvisomant

Back 13

Used for management of Acromegally. can raise hepatic enzymes.

Front 14

Thyrotropin

Inhibition?

Mechanism of action

Contraindications?

Back 14

Glycoprotein

Release inhibited by high thyroid hormone and iodide

Mechanism: Stimulate adenylyl cycalse and production of cAMP

Contraindications: heart disease or adrenocortical insufficiency

Front 15

Uses of Thyrotropin

Back 15

Thyrotropin:
Use: dx tool to differentiate Primary and Secondary Hypothyroidism
Results: an increased production of thyroid hormones is seen in Secondary Hypothyroidism

Front 16

Use of Thyrotropin Alpha

Back 16

Diagnostic tool for determining recurrence of thyroid carcinoma

Front 17

Adrenocorticotropin

Mechanism?

Use?

Adverse

Back 17

MOA: activates G-protein, stims adenylyl cyclase, increases cAMP, ACTIVATES CHOLESTEROL ESTERASE. Increases cortisol, mineralocorticoids and androgens

Use: Cosyntropin. Dx tool for addision's. **An increase in release of corticosteroids is SECONDARY ADDISON's.

Adverse: impaired wound healing, Cushing's like symptoms.

Front 18

Follicle Stimulating Hormone (urofollitropin and Follitropin)

Effects in Males and females?

Clinical Uses?

Back 18

Works thru cAMP.

Females: gametogenesis and follicular maturation. Adverse: ovarian enlargement

Males: stimulates spermatogenesis. Adverse: gynecomastia

Uses: Treatment of infertility w/ hCG. ****Use a drug that has LH and FSH activity.

Front 19

Luteinizing hormone

Effects in males and females

hCG effects?

Back 19

Females: regulates follicular development, induces ovulation, promotes biosynthesis of progesterone and androgens

Males: biosynthesis of testosterone

hCG: Stimulates biosynthesis of progesterone and testosterone. *Maintains placenta

Front 20

hCG clinical uses?

Back 20

Treat hypogonadism (triggers ovulation and testosterone production).

Tx infertility and Cryptorchidism (via undescended testes)

Adverse: depression, precocious puberty

C/I: Androgen-dependent neoplasms and precocious puberty

Front 21

Menotropins (repronex, menopur)

Effects in females and males?

Uses?

Adverse

Back 21

Partly degraded FSH and lH

Females: promotes follicular growth and maturation

Males: stimulates spermatogenesis

Uses: Tx's infertility in combo w/ hCG

Adverse: ovarian enlargement and gynecomastia

Front 22

Prolactin

Actions?

Deficiency?

Inhibition?

Back 22

Responsible for lactaion.

Deficiency causes failure to lactate.

Hyperprolactinemia causes galactorrhea and hypogonadism.

Secretion inhibited by Dopamine.

Dopamine antagonists causes hyperprolactinemia.