Pharm Exam Four

Front 1

Somatropin - type & uses

Back 1

rhGH
-Children's GH deficiency, QPM
-Idiopathic short stature
-Short-stature homeobox-containing gene
-Adult GH deficiency

Front 2

Somatropin - SEs

Back 2

*few in children
*hyperglycemis NOT common
In adults:
-peripheral edema
-myalgias, arthralgias
-carpal tunnel syndrome

Front 3

Mecasermin - type & uses

Back 3

Identical to IGF-1
-skeletal, muscle, organ growth
-long-term Tx of growth failure
-children with severe primary IGF-1 deficiency (GH is normal)
--mutations in GH receptor
--Post-GHR signaling pathway defects
--IGF-1 gene defects
-Children with GH gene deletion show have developed neutralizing Abs to GH

Front 4

Mecasermin - MOA

Back 4

1. IGF-1 receptor binding (tetrameric receptor similar to insulin receptor)
2. Receptor autophosphorylation
3. Signaling cascade
4. Mitogenic/antiapoptotic effects

Front 5

Mecasermin - contraindications

Back 5

1. Not used after closure of epiphyses
2. Not used in presence of neoplasia

Front 6

Somatropin - MOA

Back 6

Same as Growth Hormone:
1. Specific membrane receptors - cytokine receptor superfamily
2. IGF-1 expression (mitogenic and antiapoptotic effects)
3. Metabolic effects (TG hydrolysis, protein synthesis, insulin resistance)

Front 7

Octreotide - type and uses

Back 7

Somatostatin analog (SRIF analog)

Uses:
1. Acromegaly
2. Carcinoid tumors - intestinal tumors with somatostatin receptors
3. Pancreatic cell tumors - VIPomas

Front 8

Octreotide - MOA and actions

Back 8

MOA same as somatostatin:
-Gi protein-coupled receptors
-inhibits cAMP and Ca production
-thereby inhibits GH secretion

Actions:
-inhibit GH secretion
-inhibit basal & TRH-stimulated TSH secretion
-inhibit GI peptide hormone secretion

Front 9

Octreotide - adverse effects

Back 9

1. Reduction in bile production and GB contractility
2. GI - pain, nausea, diarrhea

Front 10

Pegvisomant - type and uses

Back 10

rhGH - GH antagonist
Used for acromegaly

Front 11

Pegvisomant - adverse effects

Back 11

-well-tolerated
-some pt will have increased hepatic aminotransaminase (contraindicated if pt has pre-existing 3X increased ATs_
-interaction with opioids requires higher dose to be effective

Front 12

What are some causes of prolactin deficiency?

Back 12

Prolactin deficiency is very rare.
Usually caused by absence of hypothalamic input (panhypopituitarism)

Front 13

What are the physiological consequences of excess prolactin release?

Back 13

Hypogonadism
Females - shortened luteal phase, anovulation, oligomenorrhea, amenorrhea
Males - decreased testosterone secretion and decreased spermatogenesis

Front 14

Bromocriptine - type and uses

Back 14

Dopamine agonist
Used for GH and prolactin hypersecretion

Front 15

Bromocriptine - adverse effects

Back 15

N/V/D, dizziness, hypotension