Growth Hormone and Prolactin Pharmacology

  1. Pituitary hormone ligands bind ____ receptor and dimerizes, and phosphorylates ____ would lead to regulating ______ in the nucleus.
    • JAK-2
    • STAT
    • Transcription
  2. GH receptors in the _______, would lead to stimulation and secretion of IGF-1. What could IGF-1 do once it is stimulated?
    • Liver
    • Linear bone growth
    • Oxidation of free fatty acid
    • Protein synthesis for muscle
    • And decrease GH level once it is high enough
  3. Somatropin is used to treat which hormone deficiency?
    Growth hormone
  4. What used for growth hormone deficiency?
  5. Which drug is a recombinant form of GH?
  6. Therapeutic indication for somatropin:
    • GH deficiency
    • Pediatric patients short stature
  7. Which drug does Kaydee need to be on that isn’t Adderall?
    Somatropin, iono maybe it'll help her get taller?
  8. ADR somatropin:
    • Arthralgia
    • Myalgia
    • Peripheral edema
    • Slipped capital femoral epiphysis (children)
  9. What drug is contraindicated when there is active malignancy?
  10. Which drug has adverse effects that include joint, muscle ache and peripheral edema?
  11. Which hormonal drug can increase P450 activity?
    Somatropin (recombinant GH)
  12. Contraindications for somatropin:
    • Acute critical illness
    • Active malignancy
  13. Somatropin pharmacokinetics:
    • IM or subcutaneous
    • Increase P450 enzymes
  14. T/F: Recombinant IGF-1 can be used for chronic renal insufficiency, in addition to GH deficiency
    False; recombinant growth hormone (ie somatropin) is used to treat chronic renal insufficiency, as well as Prader-willi, Turner, in addition to GH deficiency
  15. Prader-Willi Syndrome, Turner syndrome and chronic renal insufficiency can be treated with______
    Recombinant human growth hormone – somatropin (recombinant GH)
  16. MOA for Mecasermin:
    Recombinant human IGF-1, bound to IGFBP-3
  17. What is an agent of IGF-1 agonist?
  18. T/F: Mecasermin primarily binds to IGFBP-1 binding protein
    False; it is an IGF-1 agonist that mostly (80%) binds to IGFBP-3 binding protein
  19. Short children not responding to somatropin, use:
    Mecasermin (recombinant human IGF-1)
  20. Therapeutic Indications for Mecasermin?
    Severe IGF-1 deficiency / GH therapy ineffective
  21. ADR mecasermin (recombinant human IGF-1)?
    • Intracranial hypotension
    • Hypoglycemia
  22. What needs/should be done to patient on mecasermin to avoid hypoglycemia?
    Eat carbohydrates 20 minutes before/after drug administration
  23. Which drug can have adverse effect hypotension and hypoglycemia?
    Mecasermin (recombinant human IGF-1)
  24. What typically shows up on MRI in patients with acromegaly?
    Pituitary tumors
  25. What is acromegaly?
    Disorder of IGF-1 which causes excessive growth of the hands, feet, jaw, and internal organs in adulthood
  26. T/F: Acromegaly is a disorder of GH deficiency which occurs in childhood
    False; acromegaly is a disorder of IGF-1 and occurs in adulthood. Symptoms include excessive growth of the hands, feet, jaw, and internal organs
  27. Large pituitary adenomas can lead to what CNS effect?
    Disturbance of visual field
  28. What is the negative feedback for pituitary secretion of growth hormone?
  29. Somatostatin inhibits release of which 5 hormones?
    GH, TSH, glucagon, insulin and gastrin
  30. T/F: somatostatin analogs have longer half-live than somatostatin, and it targets only GH inhibition
    False; somatostatin has inhibition effects on multiple hormones (not just GH), including GH, TSH, Glucagon, insulin and gastrin. It's true that it does have longer half-live, though
  31. What are some somatostatin analogs?
    • Octreotide – potent somatostatin, not as much effect on release of insulin than endogenous somatostatin
    • Lanreotide (just know that this also exists)
  32. Which medication can be used to locate neuroendocrine tumors?
    • octreotide
    • (somatostatin analog)
  33. What are the therapeutic indications for octreotide?
    • reduce symptoms hormone-secreting tumors: acromegaly, carcinoid syndrome, glucagonoma
    • (somatostatin analog)
  34. ADR of octreotide:
    • GI complaints, n/v
    • Cardiac effects
    • >6 months: biliary sludge and gallstones
    • >12 months: vitamin B12 deficiency
    • (somatostatin analog)
  35. Which drug should Kaydee definitely avoid taking, especially long term, for reason other than that she is already vertically challenged?
    • Octreotide (somatostatin analog)
    • Because if on this for over a year, can lead to B12 deficiency, and we don't want that since she's vegan and might already be on her way to developing that?
    • That, and also we don't want more somatostatin in her, inhibiting GH
  36. Which medication when on it for over 1 year, can lead to B12 deficiency?
    Octreotide (a somatostatin analog)
  37. Which medication when on it for over 6 months can lead to biliary sludge and gallstones?
    Octreotide (a somatostatin analog)
  38. What is pegvisomant?
    GH receptor antagonist
  39. What is an agent for GH receptor antagonist?
  40. T/F: Pegvisomant is a growth receptor agonist
    False; it is a growth receptor antagonist
  41. Which drug is used to treat acromegaly?
    • Pegvisomant, (GH receptor antagonist)
    • Somatostatin analogs: ie Octreotide
    • Dopamine agonist
  42. ADR for pegvisomant?
    • Elevated GH and liver enzymes
    • Adenoma growth
    • (GH receptor antagonist)
  43. Which drug could potentially lead to adenoma growth?
    pegvisomant (a GH antagonist)
  44. Hyperprolactinemia is treated with ____ agonist
  45. What are agents of dopamine agonist:
    • Ergot derivatives
    • Bromocriptine
    • Cabergoline
  46. Therapeutic use for dopamine agonist (ie Bromocriptine)
    • Acromegaly
    • Hyperprolactinemia
  47. Which drug could be given either orally or vaginally?
    dopamine agonist ie Bromocriptine
  48. ADR for Dopamin agonists (Bromocriptine)?
    • Nausea, HA
    • Orthostatic hypotension, fatigue
  49. Contraindication for dopamine agonist?
    Small adenomas during pregnancy
  50. Which drug is contraindicated when you are pregnant and have small adenomas?
    dopamine agonists (ie Bromocriptine)
Card Set
Growth Hormone and Prolactin Pharmacology
Endo Exam 1