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42 Cards in this Set
- Front
- Back
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what carries out the fxn of GH and what receptor does GH bind to
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IGF-1 carries out the functions
GH binds to a tyrosine kinase receptor |
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what inhibits GH/GHRH productions
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somatostatin
IGF-1 |
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what promotes GH/GHRH productions and how does it do it
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Ghrelin
Ghrelin comes from the stomach and causes us to feel hungry so we can eat, this is done during times of growth |
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what inhibits somatostatin
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ghrelin
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how do you treat GHRH deficiency
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can give GHRH or GH
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how do you treat GH deficiency
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treat by giving GH
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how do you treat GH Rc defect
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give IGF-1
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how do you treat IGF-1 Rc defect
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no treatment
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what is the result of GH over production
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acromegaly/giantism
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how can you treat giantism/acromegaly
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somatostatin
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what drug can be given to treat GHRH defeciency
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Sermorelin (analog of GHRH)
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what drug is given to treat GH defeciency
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Somatropin and GH analogs
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why isn't natural GH given to treat GH deficiency
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due to natural GH not being very stable due to its short half life
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what drug is given to treat IGF-1 defeciency
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Mercasermin
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what is Mercasermin composed of and why is it given that way
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mercasermin is made of IGF1 + IGF BP3
normally GH binding to its receptor stimulates the production of IGF-1 along with a binding protein which serves as a carrier protein therefore giving IGF-1 a longer half life THEREFORE IF THE PERSON DOESN'T HAVE ANY GH ACTION (Rc) AND NO IGF-1 THEN THERE WON'T BE ANY BINDING PROTEIN |
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what drug is given to treat GH over production
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dopamine
somatostatin analogs (octreotide) pegvisomat |
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why can dopamine be given to treat GH over production
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normally dopamine stimulates GH production but when GH is being over produced dopamine inhibits GH production
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where does somatostatin bind
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GPCR in anterior pituitary
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why is natural somatostatin not given
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synthetic somatostatin is prefered b/c it has a longer half life and there are fewer GI effects
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what are some of the adverse effects of somatostatin and its analogs
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cholelithiasis (gall stones) and/or gall bladder sludge (occurs before gall stones)
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how can somatostatin and its analogs cause hyperglycemia
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since somatostatin is also found in the pancreas it is capable of suppressing insulin secretion
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what supresses glucagon
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somatostatin
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how does Pegvisomant work
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it is a GH Rc competitive antagonist. in order for a signal to be sent two GH receptors must bind GH and dimerize. Pegvisomant binds to those receptors instead and stops the sending of signals
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what are the side effects of hyperprolactenemia in men and women
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men - infertility, impotence, insulin resistance, loss of libido
female - infertility, lost of libido, galactorrhea, insulin resistance, amenorrhea |
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what are some of the causes of hyperprolactenemia
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impaired dopamine release, pituitary tumors, hypothyroidism (TRH is the stimulator of prolactin release), renal failure
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what drugs can be given to treat hyperprolactenemia
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bromocriptine/cabergrolin THESE ARE BOTH D2 AGONIST
they reduce the growth of pituitary tumors and decrease prolactin levels |
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what happens to women suffering from hyperprolactenemia once they over come it
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ovulation can resume
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what are the adverse reactions of Dopamine agonist
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Cardiac (Myocardial infarction), sinus bradycardia, ventricular tachycardia
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what do the Dopamine agonist interact with
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estrogen and Levodopa (dopamine analog, therefore have additive effect)
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what happens if someone is given GnRH and they don't produce LH and how do you treat it
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they have a pituitary defect THIS IS A DEFINITIVE RESULT
treat by giving them gonadotropins |
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what happens if someone is given GnRH and they do produce LH
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may be a defect of the gonads or hypothalamus
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what happens if you have a GnRH defect
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no puberty due to the lack of gonadotropins
females - amenorrhea males - idiopathic hypogonadism (can't make sperm) |
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what happens if you have GnRH over production
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precocious puberty
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what are some situations where we might need to suppress the production of endrogens/androgens
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Endometriosis (due to excess estrogen the uterus grows in places it shouldn't)
Prostate cancer (need to turn off androgens since prostate cancer will have receptors for those androgens causing the tumor to continue to grow) idiopathic precocious puberty |
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what can be given to shut down the pulse generator
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estrogen/androgen
chronic GnRH |
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why is chronic GnRH the best way to turn off the production of gonadotropins
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GnRH binds to a GPCR in the anterior pituitary and chronic stimulation of a GPCR leads to desensitization leading to loss of gonadotropin production
pulsatile GnRH gives the GPCR of the anterior pituitary a chance to recover |
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what occurs in ovarian hyperstimulation
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too many follicles are produced and they begin to secrete substances that increase vascular permeability in the abdomen leading to people having fluid in their abdomen/lungs/heart
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what can be given to treat ovarian hyperstimulation
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ganirelix/cetrorelix
they also suppress LH release but OVARIAN HYPERSTIMULATION IS THEIR PRIMARY PURPOSE |
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what does oxytocin/pitocin do and how is it given
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they induce uterin contractions (induce labor)
given slowly via IV to prevent the uterus from rupturing they can also be given to contract the uterus and expel the placenta afterbirth |
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how does oxytocin/pitocin cause water toxicity
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since oxytocin/pitocin must be given at such a high concentration and due to their similarity to ADH/vassopressin it may lead to the suppression of diuresis
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what is a oxytocin receptor antagonist and what does it do
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atosiban
used to prevent premature contractions |
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what stimulates the release of oxytocin
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sudenefil (viagra)
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