Ph2010.03.11- Hypothalamic & Pituitary Hormones

Front 1

List the 5 hypothalamic-ant pituitary target axes, including:
--AP hormone
--hypothalamic hormone(s)
--which type of receptors are bound by AP hormones? (2)

Back 1

Front 2

Describe the 3 types of target organ feedback in the hypothalamic-pituitary axis

Back 2

Front 3

Contrast the physiological actions of growth homone in:
1. childhood
2. adulthood

Back 3

1. promote growth of long bones (linear), cartilage, muscle, organs

2. metabolic: increase protein synth & bone density, increase lipolysis, promote gluconeogenesis, blocks insulin effects

Front 4

List features of GH axis dss in:
1. children (2)
2. adults (5)

Back 4

Front 5

List 3 types of drugs used to tx GH deficiency and why they're used

Back 5

1. synthetic GHRH (Sermorelin): defective GHRH release, NL AP)

2. recombinant GH (Somatropin, Somatrem)

3. Recombinant IGF1 (Mecasermin): in Laron dwarfism w/ GH receptor mutation

Front 6

6 drug indications for Somatropin & Somatrem

Back 6

(recombinant GH)

1. documented growth failure in kids w/ GH deficiency, chr renal failure, Prader Willi, Turner's

2. small for gestational age

3. idiopathic short stature (>2.25 SD)

4. adult GH deficiency

5. AIDS wasting

6. short bowel syndrome

Front 7

5 SEs of recombinant hGH

Back 7

1. leukemia, rapid melanocytic growth

2. hypothyroidism

3. insulin resistance

4. arthalgia

5. induce P450 enzymes

Front 8

4 contraindications and 2 tx considerations in using recombinant hGH

Back 8

Front 9

Name for GH excess in:
1. children
2. adults

Back 9

1. gigantism: longitudinal bone growth

2. acromegaly: bone thickening

Front 10

3 types of drugs to tx GH excess

Back 10

1. somatostatin analogues (Octreotide)

2. GH receptor antag (Pegvisomant)

3. DA receptor ag (bromocriptine)

Front 11

1. Benefit of using octreoside over recombinant somatostatin
2. 3 drug indications for use

Back 11

1. octreoside is more potent and has longer half life

2. --control pituitary adenomas,
--control carcinoid syndrome,
--secretory diarrhea from VIP secreting tumor

Front 12

For octreotide, list:
1. 4 SEs
2. 1 contraindication
3. 3 tx considerations

Back 12

Front 13

Describe the MOA of pegvisomant by comparing it to GH

Back 13

GH: binds 2 receptor molecules causing dimerization and JAK/STAT cascade

Pegvisomant: compet antag of GH by only binding 1 receptor, preventing dimerization

Front 14

For pegvisoment, list:
1. 2 SEs
2. 1 contraindication
3. 2 tx considerations

Back 14

Front 15

Describe the effects of GnRH in:
1. pulsatile release
2. continuous release

Back 15

1. promotes AP release of LH/FSH

2. inhibits AP

Front 16

Describe the effects of FSH in women:
1. in follicular stage of menstrual cycle
2. main fxn overall

Back 16

1. stimulates conversion of androgens to estrogens in Granulosa cells

2. ovarian follicle development

Front 17

Describe the effects of LH in women:
1. in follicular stage
2. in luteal phase

Back 17

1. stimulates androgen production in Thecal cells

2. control estrogen & progesterone production

Front 18

In men, describe the effects of:
1. FSH (2)
2. LH

Back 18

1. regulate spermatogenesis, increase Sertoli cell production of androgen binding protein

2. stims testosterone production by Leydig cells

Front 19

List types of drugs used in dss of gonadal axis:
1. stimulation (2)
2. inhibition (2)

Back 19

1. gonadotropins, GnRH/gonadorelin (analogue, pulsatile)

2. long half-life GnRH analogues, GnRH receptor antags

Front 20

3 drug indications of gonadaotropins to stimulate gonadal axis

Back 20

1. ovulation induction

2. controlled ovarian hyperstim in assisted reproductive procedures

3. infertility in males

Front 21

Describe source of these gonadotropins:
1. menotropins
2. hCG
3. urofollitropin
4. follitropin

Back 21

1. urine of menopausal women containing FSH & LH

2. placental hormone

3. purified FSH from urine of postmenopausal women

4. recombinant human FSH

Front 22

List 5 SEs and 5 contraindications of gonadotropin stimulation of gonadal axis

Back 22

Front 23

3 indications of pulsatile GnRH agonists

Back 23

1. stimulate ovulation

2. male infertility

3. dx hypogonadism

Front 24

1. MOA of inhibiting gonadal axis by using GnRH agonists
2. Describe biphasic response

Back 24

1. use analogs that are more potent and longer lasting than GnRH or gonadorelin...

2. --transient increase in gonadal hormones (7-10 day flare) from agonist effect
--long-lasting suppression of gonadal hormones

Front 25

List 6 drug indications for sustained GnRH agonist inhibition of gonadal axis

Back 25

Front 26

1. List 3 GnRH receptor antags
2. benefit of use over sustained GnRH agonists
3. 2 indications

Back 26

1. ganirelix, cetrorelix, abarelix

2. no transient flare effect

3. --ganirelix & centrorelix: keep LH surge low in controlled ovarian hyperstim
--abarelix: metastatic prostate cancer

Front 27

Regulation of PRL secretion:
1. inhibiting factor
2. releasing factor
3. describe feedback mechs

Back 27

1. DA from hypothalamus

2. TRH

3. no neg feedback since mammary glands release no hormones

Front 28

Strategy to tx hyperPRL

Back 28

DA receptor ags (bromocriptine)

Front 29

3 drug indications of bromocriptine

Back 29

1. acromegaly if pit adenoma secretes PRL & GH

2. Parkinson's dz

3. hyper PRL