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Pharmacology > Hypothalmic and Pituitary Hormones > Flashcards

Hypothalmic and Pituitary Hormones Flashcards

1
Q

hormones released from the posterior pituitary

A

ADH

Oxytocin

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2
Q

another name for growth hormone

A

somatotrophin

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3
Q

how does GHRH (growth hormone releasing hormone) stimulate the release of GH

A

GHRH binds to its receptor which couples with Gs protein causing an increasing in cAMP and Ca2+ –> GH synthesis and secretion

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4
Q

what inhibits secretion of GH and mechanism

A
  • GH: via somatostatin (SST) by binding to Gi and causing a decrease in cAMP
  • IGF-1: acts directly on the anterior pituitary inhibiting release of GH
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5
Q

things that stimulate the release of GH

A
  • Dopamine, 5-HT, and alpha 2 receptor agonist
  • hypoglycemia
  • stress
  • emotional excitement
  • protein rich meals
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6
Q

things that inhibit release of GH (other than GH and IGF-1)

A

Beta agonists

Free Fatty acids

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7
Q

mechanism of interaction of GH with its receptor

A
  • GH interacts with two identical receptors forming a ligand occupied receptor dimer
  • Dimer provides docking site for two molecules of JAK2
  • This lead to trans phosphorylation and auto-activation of JAK2
  • Also there is tyrosine phosphorylation of cytoplasmic proteins that mediates downstream signaling events
  • These include STAT proteins, SHC, IRS-1 and IRS-2
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8
Q

positive physiological effects of GH

A
  • causes longitudinal growth in children
  • increases bone density in adults
  • increased muscle mass
  • increase GFR
  • stimulates preadipocytes to adipocytes
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9
Q

negative (used loosely) effects of GH

A
  • anti insulin effects (esp in liver and peripheral sites such as adipocytes and muscle) –> hyperinsulinemia
  • increases lipolysis
  • stimulates gluconeogenesis
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10
Q

what happens with patients who are given IGF-1 due to being GH resistant

A

IGF-1 has pro-insulin effect –> hypoglycemia

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11
Q

physiological effects of those who are GH deficient

A
  • they fail to reach their predicted adult height
  • experience hypoglycemia due to unopposed effect of insulin (since lack of anti insulin GH)
  • low lean body mass
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12
Q

what glucose transporters does GH inhibit

A

GLUT-1 and GLUT-4 (adipose tissue and muscle)

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13
Q

what are the two forms of GH that are used in GH deficient children

A

Somatotrophin (recombinant form, identical to human GH)

Somatrem (derivative of GH with additional methionine at the amino terminus)

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14
Q

Other than GH deficiency, what other conditions is GH used to treat

A
  • wasting in AIDS patient

- Short Bowel Syndrome in those receiving specialized nutritional support

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15
Q

used to treat IGF-1 deficiency

A

Mecasermin (IGF-1 analogue)

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16
Q

adverse effect of Mecasermin

A

hypoglycemia

17
Q

side effects of GH in children

A

HI VIP

  • Headache
  • Increased incidence of Type 2 DM
  • Visual changes
  • Intracranial hypertension
  • Papilledema
18
Q

side effects of GH in adults

A

CAMP

  • Carpal tunnel Syndrome
  • Arthralgia
  • Myalgia
  • Peripheral Edema
19
Q

who is GH contraindicated in

A

active malignancy

20
Q

what does GH excess cause

A
  • if epiphyseal hasn’t sealed, increased longitudinal growth –> gigantism
  • in adults –> acromegaly
21
Q

what is used to treat GH excess

A
  • Somatostatin analogues
  • Dopamine agonists
  • GH receptor antagonist
22
Q

what is the somatostatin analogue and what is its mechanism

A

Octreotide is TIGGG

Octreotide - inhibits release of TSH, Insulin, GH, Glucagon, and Gastrin

23
Q

adverse effect of GH in Turner Syndrome

A

Otitis Media

24
Q

clinical application of Octreotide

A
  • Reduce the release of TIGGG –> TSH, Insulin, Gastrin, GH, and Glucagon
  • Secretory Diarrhea
  • Bleeding in esophageal varices
25
Q

adverse effects of Octreotide

A
  • Constipation

- Gallstones

26
Q

if dopamine agonist stimulate the release of GH, how then does it decrease GH secretion

A

it somehow paradoxically does, and best works in patients whose tumors secrete GH and prolactin

27
Q

what are the dopamine agonists and what else can they be used to treat

A

Bromocriptine and Cabergoline —> both have high affinity for dopamine D2 receptors

used to treat hyperprolactinemia (dopamine inhibits prolactin release)

28
Q

side effects of dopamine agonists (name them)

A

bromocriptine and cabergoline

nausea, vomiting, headache, postural hypotension

29
Q

what is the GH receptor antagonist and its use

mechanism

A

Pegvisomant - treatment of acromegaly

binds GH receptor –> does not activate JAK/STAT pathway or IGF-1 secretion

30
Q

use of prolactin and way to decrease it secretion if prolactinoma

A
  • produces milk

- give dopamine receptor agonists, surgery, radiation

31
Q

what are the gonadotrophic hormones and what stimulates their release

A

FSH, LH, hCG –> stimulated by release of GnRH from hypothalamus

32
Q

why is long acting GnRH used to suppress gonadotropic secretions

A

continuous secretion of GnRH –> desensitization and downregulation of GnRH receptors on pituitary

it need to be secreted in pulses

33
Q

what is the synthetic GnRH and the GnRH analogues

A

synthetic naive GnRH: Gonadorelin

GnRH analogues: Leuprolide, Goserelin, and Nafarelin

34
Q

side effects of synthetic GnRH and its analogues

A 
hot flashes
sweating
headaches
decreased bone density
gynecomastia in males
35
Q

major drawback to using long acting GnRH analogues

A

at first, transient increase in sex hormone levels before lasting suppression of hormone synthesis and secretion

36
Q

Gonadorelin can be used to clinically treat what

A

short acting and if used in pulsatile fashion –> stimulates patterned gonadotropin release

used to treat female and male infertility related to hypothalmic hypogonadotropic hypogonadism and for diagnosis of LH responsiveness

37
Q

GnRH competitive receptor antagonist and mechanism

A

Ganirelix
Cetrorelix

inhibit secretion of FSH and LH

38
Q

why would GnRH competitive receptor antagonist be used in metastatic prostate cancer (name them)

A

Ganirelix and Cetrorelix

avoids initial surge of testosterone caused by treatment with GnRH agonists

39
Q

what is estrogen and progesterone under the control of? what takes over during pregnancy

A

under control of LH

hCG takes over during pregnancy

Pharmacology (79 decks)

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