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What are the primary Endocrine organs
- Pineal
- Hypothalamus
- Pituitary
- Thyroid
- Parathyroids
- Adrenals
- Pancreas
- Ovaries
- Testes
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What are the secondary endocrine organs
- Heart
- Stomach
- Liver
- Kidney
- Adipose
- Small Intestine
- Skin
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Neurohormone
- Hormone produced by neurons and secreted
- Example: Antidiuretic hormone (ADH)
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What is the difference in the distribution of hydrophilic and hydrophobic hormone transportation
- Hydrophilic - transported free in blood
- Hydrophobic - circulated in blood bound to plasma proteins
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What is the job of Binding proteins
Bind to hormones to deliver them and protect them until they arrive at the target tissue
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What hormone has one of the longest half lifes
T4 (6-7 days)
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What are some of the ways that hormones are eliminated
- Urine
- Biliary excretion
- Metabolic degredation
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What is the eventual effect of releasing GnRH
- FSH & LH release causing ovulation, progesterone, and estrogen release in women
- Spermatogenesis and testosterone release in men
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What is the result of releasing GHRH
- Insulin Growth Factor (IGF) released from liver
- Increased protein synthesis and metabolism of carbohydrates and lipids
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What is the effect of releasing CRH
Adrenocorticotropic hormone (ACTH) is released to cause the Adrenal cortex to secrete Cortisol stimulating gluconeogenesis
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What are the different levels of hormone feedback loops
- "Ultra short" - Negative feedback from the hormone released from the hypothalamus to the hypothalamus
- "Short" - Negative feedback from the pituitary to the hypothalamus
- "Long" - Negative feedback from the target gland hormone to the Anterior pituitary or Hypothalamus
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Tropic Hormone
Hormone released from Pituitary to the target gland
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Growth Homone (GH) has what effect on Adipose tissue
- Decrease Glucose uptake
- Increases Lipolysis
- Decrease Adiposity
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What effect does GH have on muscle
- Decrease Glucose uptake
- Increase amino acid uptake
- Increase protein synthesis
- Increase lean body mass
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What effects does GH have on the liver
- Increase in:
- RNA synthesis
- Protein synthesis
- Gluconeogenesis
- IGFs (insulin growth factor)
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GH has what effect on bone, heart, and lung
- Increase in protein synthesis
- Incease in RNA synthesis
- Increase in DNA synthesis
- Increase in cell size and number
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Insulin Growth Factor (IGF) has what metabolic effects
- Decrease in:
- Plasma glucose
- Gluconeogenesis
- Glycogenolysis
- Lipolysis
- Increase in:
- Insulin sensitivity
- Glucose uptake
- Protein synthesis
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Under what conditions does GH secretion peak
Strenuous exercise and sleeping
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What happens if GH is in excess before and after closure of the epiphyses
- Before - Gigantism
- After - Acromegaly
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What are the effects of Somatropin administration
Increase linear growth of someone with dwarfism
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What are some of the side effects of Somatropin
- Headaches
- Scoliosis due to rapid growth
- Diabetes mellitus
- Edema
- Arthritis
- Carpal tunnel
- "C HEADS"
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How is Somatropin administered
Parenterally
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Pegvisomant
- GH antagonist
- Used to treat Acromegaly
- "Peg down the GH"
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Mecasermin
- Recombinant IGF-1
- Used when there is a lack of response to GH due to disfunctional GH receptor
- Side effect is hypoglycemia, should be given directly after a snack
- "The Meca of GH alternatives"
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Sermorelin
- Growth Hormone Releasing Hormone (GHRH)
- Used for diagnosis purposes
- There is an orphan of it used for GH deficiency and weight loss caused by AIDS
- "Give a sermon on GHRH"
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Octreotide
- Somatostatin analog but 45x more potent
- Administered subcutaneously 3x/day
- Used for Acromegaly and suppression of ectopic hormone production
- "Octamom uses this for her Acromegaly"
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What are the side effects of Octreotide
- Gastrointestinal issues
- Gall stones
- Vit B12 deficiency
- Cardiovascular problems
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Bromocriptine
- Dopamine (D2) agonist
- Prototype drug used to treat hyperprolactinemia
- Reduces the circulation of prolactin, at higher doses it reduces GH
- Requires large doses
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What are the side effects of Bromocriptine
- GI issues
- Nausea and Vomiting
- Vaginal administration circumvents it
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Metoclopramide
- D2 antagonist
- Turning on prolactin
- Antipsychotic that can cause hyperprolactemia and therefore gynecomastia and galactorrhea
- "Don't medal with D2 antagonists"
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What is the role of the posterior pituitary
- Does not synthesize hormones
- Stores and releases hormones made by hypothalamus
- Hormones are transported along the hypothalamo-hypophyseal tract
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How are Oxytocin and Vasopressin (ADH) structurally different
They differ by only 2 amino acids
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What are the effects of Oxytocin
- Uterine contraction
- Milk Ejection
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What are the effects of ADH
- Increase in water reabsorption and vasoconstriction
- Increae BP
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What happens in ADH deficiency
Diabetes insipidus
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What are the two different types of diabetes insipidus and there effects
- Central - Tumors, Trauma, Surgery to Pituitary
- Nephrogenic - Renal disease, ADH-unresponsive kidney, Drugs (lithium)
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What is a hallmark of diabetes insipidus
- Polyuria
- Polydipsia
- Dehydration
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SIADH
- Syndrome of Inappropriate ADH secretion
- ADH excess
- Often caused by a small cell carcinoma in the lungs, hypothalamus, or pituitary
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How is Oxytocin administered, and for what
- IV
- Internasal is also available
- Used for milk let down
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What are the different receptors for Vasopressin (ADH)
- V1 - Constriction of arterioles using IP3/DAG & calcium as second messengers
- V2 - Antidiuretic effects through cAMP on kidneys
- Extrarenal V2 - mediate the release of von willebrand factor
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What is the function of Vasopressin as a drug
- Decreases urine production (kidneys return more to blood)
- Decreases water loss
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Desmopressin
- Synthetic analog of Vasopressin (ADH) selective for V2 receptors
- Much more powerful then Vasopressin (ADH)
- Used for Central diabetes insipidus
- Decreases water loss in kidneys
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How is Desmopressin administered
- Orally
- Intranasally
- Parenterally
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What are the adverse affects of Desmopressin
Hyponatremia
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What are the additional uses for Desmopressin
- Von Willebrand disease
- Nocturnal enuresis (peeing the bed)
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Conivaptan
- Nonpeptide vasopressin antagonist with high affinity for V2
- Used for SIADH
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