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Pharm Exam II Hypoth
Hypothalamic-Pituitary Pharm
| Question | Answer |
|---|---|
| What is Somatropin? | Recombinant Growth Hormone |
| What is the half-life of Somatropin? | 20 hrs. (due to IGF binding proteins) |
| How is Somatropin administered | Sub cu at bedtime |
| What are some pediatric indications for use of Somatropin? | Turner's Syndrome, Prader-Willi syndrome, Growth Hormone Def., or Idiopathic Short Stature |
| When can Somatropin be administered to adults? | AIDS patients to avoid cachexia, Malabsorption assoc. w/ short bowl syndrome |
| When is GH normally secreted? | If hypoglycemic, during sleep, after exercise, high protein meal |
| Where does Somatropin act? | With GH receptors on target tissues (Not G coupled receptors - JAK-STAT pathway |
| What usually causes GH excess? | Somatrope adenoma |
| What can be done to Dx GH Excess? | Give pt. glucose. If GH not suppressed, excess problem |
| What is first line Tx for acromegaly? | Transphenoidal surgery |
| What is the therapeutic agent used to treat acromegaly? | Octreotide |
| What is Octeotride? | It is a somatostatin analog |
| What other can be used to treat acromegaly? | Pegvisomant |
| What is Pegvisomant? | It is a GH receptor antagonist |
| What is Octreotide's half life? | ~12 hrs |
| What receptors does Octreotide interact with? | G-protein Coupling Receptors of SSTR family |
| What is an adverse rxn of Somatropin? | Hypoglycemia, local rxn |
| What is an adverse rxn of Octeotride? | Hyperglycemia (insulin-resistance), GI Sxs; gall bladder sludge |
| What are some non-endocrine indications for Octreotide (Somatostatin analog) | To treat GI tumor asssoc. diarrhea or Dec. portal HTN to stabilized esophageal varices |
| How does Pegvisomant work? | binds the GH receptor so no downstream signaling |
| What is Bromocriptine? | A dopamine agonist |
| What does Bromocriptine do? | Through increasing dopamine, it ultimately causes inhibition of the release of prolactin from Anterior Pituitary |
| What is an adverse effect of Bromocriptine? | Orthostatic hypotension |
| How can Bromocriptine's adverse effect be avoided | Start at low dose w/ a snack @ bedtime; Titrate upwards slowly |
| What is Cabergoline? | It is a dopamine agonist |
| What is Cabergoline indicated for? | Parkinson's at high doses or prolactinomas in low doses |
| What is an adverse effect of Cabergoline? | At the high doses of Parkinson's Tx, has been linked to valvular heart dz |
| What are non-prolactinoma causes of excess prolactin? | Pregnancy, hypothyroidism, prescribed meds (Metoclopramide or Antipsychs) |
| What is Cosyntropin? | Contains first 24 residues of human ACTH |
| What is the indication for using Cosyntropin? | To aid in ruling in or out adrenal insufficiency |
| How does Cosyntropin help figure out if there is adrenal insufficiency? | There will be no increase in serum Cortisol despite the synthetic ACTH |
| What is Leuprolide? | It is a GnRH analog |
| What does Leuprolide do? | It causes a down-regulation of GnRH receptors & shuts down gonatropin secretion |
| What is are indications for Leuprolide? | In GnRH-dependent precocious puberty to slow sexual maturation or in Prostate cancer or Breast CA ( |
| What are the two posterior pituitary hormones? | Oxytocin & Vasopressin |
| What are indications for Oxytocin | Induce labor not progressing normally & stim uterine contraction post-partum |
| What is an adverse effect of Oxytocine? | Hyperstim of uterine w/ tetany; can cause hyponatremia as H2O is retained |
| What is Desmopressin? | A vasopressin analogue |
| What is an indication for the use of Desmopressin? | Patients with central diabetes insipidus |
| What does Demopressin do? | Stimulate free water reaborption |
| Why is Desmopressin needed in patients with DI? | Their DI interferes with normal vasopressin secretion |
| What is an adverse effect if Desmopressin? | Hyponatremia, H2O intoxication |
Created by:
doggiekylesmom
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