Term
| Drugs for Growth Hormone Deficiency |
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Definition
| rhGH - Somatotropin; GHRH - Sermorelin Acetate (Geref) |
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Term
| Treatment of growth hormone resistance |
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Definition
| rh-IGF-1, Somatomedin C (Mescasermin, Increlex)- Administer Daily SC preferably with a meal |
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Term
| Definitive Treatment of Acromegaly |
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Definition
| ablation of pituitary adenoma by surgery and/or radiation therapy |
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Term
| Indications for acute use of drugs in treatment of Acromegaly |
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Definition
| decreased symptoms prior to ablation therapy; decreased persistent, elevated GH release following surgery |
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Term
| Pharmacological strategies for Acromegaly |
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Definition
| Blockade of GH release (success limited by responsiveness of GH-secreting tissue); GH receptor antagonist (potentially more effective since not dependent on tumor responsiveness |
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Term
| Drugs for Blockade of GH release (treatment for Acromegaly) |
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Definition
| Somatostatin analogs- Octreotide, Lanreotide, Vapreotide; Dopaminergic agonists- Bromocriptine or Caberoline |
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Term
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Definition
| Selective for SSTR 2 and SSTR 5 --> increase GH-secreting adenoma; avoid use with history of acute cholecystitis, biliary obstruction, cholestasis hepatitis, or pancreatitis |
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Term
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Definition
| used at higher doses than used for treating prolactinomas; oral bromocriptine decreases GH levels in 1-2 hours by unknown mechanism. |
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Term
| Drugs for GH receptor antagonist (treatment of Acromegaly) |
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Definition
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Term
| Pegvisomant (Somavert) MOA: |
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Definition
| hGH modified by PEG at 4-6 sites --> competitive receptor antagonist; binds to GH receptors without stimulating IGF-1 production |
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Term
| Treatment for Hyperprolactinemia |
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Definition
| Ergot derivatives that are specific dopamine agonists |
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Term
| Available oral dopaminergic drugs |
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Definition
| Bromocriptine (daily admin, acute treatment); Cabergoline (weekley admin, chronic treatment) |
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Term
| Side effects of Bromocriptine and Cabergoline |
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Definition
| nausea, hadache, dizziness, fatigue |
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Term
| Causes of Drug-Induced hyperprolactinemia |
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Definition
| Dopamine receptor antagonists - phenothiazines, haloperidol; dopamine storage inhibitors- Reserpine; Dopamine synthesis inhibitors- alpha methyldopa; dopamine release inhibitors- Verapamil; Opiates, H2 antagonists, Imipramines |
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Term
| Adult Treatment of Panhypopituitarism |
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Definition
| Replace deficiencies with the appropriate target gland hormone. Adult doses of GH, levothyroxin, and cortisol. Estrogen for women and testosterone for men. |
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Term
| Prepubertal children Treatment of Panhypopituitarism |
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Definition
| Replace GH appropriate for age levothyroxine, cortisol; use lower levels of estrogens or androgen to induce appropriate maturation but not to prematurely induce puberty |
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Term
| If total pituitary function is lost in prepubertal children: |
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Definition
| replace ADH and use oxytocin to facilitate delivery, as necessary |
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Term
| Treatment of Gonadotropic Hormone deficiency |
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Definition
| rhFSH (Metrodin or Urofollitropin), hMG or Pergonal; rhCG; GnRH analogs (Gonadorelin); Clomiphene |
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Term
| Has FSH and LH activities |
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Definition
| human menopausal gonadotropin (hMG)or Pergonal |
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Term
|
Definition
| human chorionic gonadotropin (rhCG) |
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Term
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Definition
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Term
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Definition
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Term
| Interrupts estrogen negative feedback at hypothalamus/anterior pituitary --> stimulates GnRH/GnH release |
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Definition
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Term
|
Definition
| Induces ovulation b decreasing destrogen antagonism of GnH release |
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Term
| Adverse effects of Clomiphene: chronic administration and/or high doses lead to: |
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Definition
| menopausal symptoms, ovarian enlargement due to GnH stimulation can be severely painful and lead to polycystic ovary disease |
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Term
| Primary cause of Diabetes Insipidus |
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Definition
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Term
| Treatment Considerations for Central Diabetes Insipidus |
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Definition
| increase oral intake of water; ADH analog replacement -> increase expression of AQP2 |
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Term
| ADH analog replacements (treatments for Central Diabetes Insipidus) |
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Definition
| Vasopressin injection; Desmopressin intranasal or oral |
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Term
| Drug of Choice for treatment of symptoms of central diabetes insipidus |
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Definition
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|
Term
| Patients with cardiovascular problems that have diabetes insipidus are usually treated with: |
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Definition
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Term
| Treatment of nephrogenic diabetes insipidus (very rare incidence, identified in newborns by excessive polyuria and normal levels of ADH) |
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Definition
| increase fluid intake, low sodium diet, HCT improves concentrating ability of kidney and decreased drate of urine formation; indomethacin can be used to enhance effect; amiloride can be added to decrease potassium wasting |
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Term
| MOA of Thiazide diuretics |
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Definition
| causes diureses by decreased distal convoluted tubule sodium and water reuptake--> decreases plasma volume. This decreases GFR and increases absorption of sodium and water in the proximal nephron. Since less fluid reaches the distal nephron --> overall fluid conservation is improved |
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Term
| Acute management strategies of SIADH |
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Definition
| restrict fluids, loop diuretics, increase dietary salt intake or slow infusion of saline; antagonize action of ADH (Demeclocycline- unkonwn post receptor mechanism; ADH receptor antagonists Conivaptan, Tolyaptan, Lixivaptan) |
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