Where are PSN abd SNS dominant?
What are the Ganglionic Blocking agents?
When are they used?
•Hexamethonium (HXM), Mecamylamine, Trimethaphan.
•It is used in treatment of hypertensive crisis and dissecting aortic aneurysm.
What are the effects of Ganglion Blocking agents?
•Ganglion blocking agents block the reflex changes in heart rate elicited by increase / decrease in blood pressure.
- •Hexamethonium will block the reflex bradycardia that occurs when phenylephrine causes vasoconstriction, but it will not block a bradycardia that results from direct activation of muscarinic receptors in heart.
Hypothalamic hormones includes?
-Thyrotropin releasing hormone (TRh)
- -Corticotropin releasing hormone (CRh)
- -Gonadotropin releasing hormone (GnRh)
- -Prolactin-inhibitory hormone (Dopamine)
- -GH releasing hormone (GHRh)
- -GH inhibiting hormone (Somatostatin)
Growth hormone-releasing hormone is used for?
Used rarely as a diagnostic test for GH
Thyrotropin-releasing hormone is used in?
Used rarely to diagnose hyper- or hypothyroidism
Corticotropin-releasing hormone is used in?
Used rarely to distinguish Cushing's disease from ectopic ACTH secretion
Gonadotropin-releasing hormone is used in?
(GnRH,gonadorelin, leuprolide, nafarelin)
Used rarely in pulses to treat infertility caused by hypothalamic dysfunction. Long-acting analogs are used to inhibit gonadal function in men with prostate cancer and in women with endometriosis and undergoing assisted reproductive technology (ART)
Pulsitile administration leads to?
Continus administration leads to?
-Pulsatile administration is used to stimulate the release of FSH and LH from the anterior pituitary.
-In contrast, continuous administration leads to decreased FSH and LH secretion, after initially stimulation.
GnRH agonist preparations:
- -Gonadorelin – short acting
- -Leuprolide, Nafarelin, Goserelin – long acting
GnRH antagonist preparation:
Uses of GnRH agonist (long acting)/ antagonist:
What adverse effects?
GnRH agonist (long acting) and GnRH antagonist are used in the treatment of precocious puberty, prostate cancer, breast cancer and endometriosis.
Adverse effects: Estrogen deficiency
What is Somatostatin?
What does it do?
It is a GH inhibitory hormone
- It inhibits GH and TSH secretion, and also decreases gastrin and VIP secretion.
- It inhibits bile flow, mesenteric blood flow and decrease GIT motility.
What is Octreotide?
What are its funtions?
It is a Somatostatin anolog= GH inhibitory hormone. It is 45 times more potent.
Used for acromegaly, refractory diarrhea (carcinoid syndrome and VIPoma), esophageal varices.
It is associated with gall stones.
What is Ianreotide?
What is it approved for?
It is a long acting analog of Somatostatin.
approved for treatment of acromegaly.
What is POMC?
Is it Proopiomelanocortin, which is the precursor for ACTH and MSH.
Where does ACTH act?
it mainly stimulates the zona faciculata and zona reticularis to produce the cortisol and adrenal androgens.
What is released from the Zona Glomerulosa? what regulates its release?
Aldosterone is released.
It is regulated mainly by Plasma angiotensin II and Potassium levels
In Primary Adrenal failure what will you see?
What will you see in Secondary Adrenal Failure?
- A decrease in both Aldosterone and Cortisol
- A decrease in only cortisol
What is Cosyntropin?
What is it used for?
- synthetic form of human ACTH
- and is employed in diagnostic tests:
- -To diagnose congenital adrenal hyperplasia.
- -To diagnose adrenal insufficiency in a test that measures cortisol before and after cosyntropin injection.
What happens to GH as you age?
What recepters does it act on?
GROWTH HORMONE mediates its effects via cell surface receptors of the JAK/STAT receptor superfamily
What are the Effects of GH (somatotropin)?
-It has direct and indirect actions on the target organs.
-Most of the indirect actions of GH are mediated by somatomedins(IGF-1) produced in the liver.
These somatomedins stimulate skeletal growth and cell proliferation.
GH directly stimulates lipolysis and antagonize insulin so as to elevate blood sugar level.
What is Mecasermin?
What does it do?
It is recombinant IGF-1
- Is an effective treatment for GH insensitive patients (Laron dwarfism) and also approved for GH deficiency.