SECTION 3 — ANTERIOR PITUITARY HORMONE DRUGS

What is the prototype anterior pituitary hormone drug?

Somatropin.

How is somatropin made?

Recombinant DNA technology.

What is somatropin equivalent to?

Endogenous GH.

What is the main clinical use of somatropin?

GH deficiency in children.

Can somatropin be used in adults?

Yes, for adult GH deficiency.

How is somatropin absorbed?

Well absorbed SC or IM.

How is it metabolized?

Liver and kidneys.

Excretion of somatropin?

Urine.

What tissues does somatropin stimulate?

Skeletal, muscle, organs.

How does it affect fat?

Decreases fat mass.

How does it affect lean mass?

Increases lean body mass.

Does somatropin increase RBCs?

Yes — via EPO stimulation.

Does somatropin affect glucose?

Yes — increases hepatic glucose output.

What are other uses of somatropin?

CKD growth failure, Turner syndrome, Prader-Willi, idiopathic short stature.

Is it effective after epiphyses close?

No.

Route of somatropin administration?

SubQ preferred; can also be IM.

When should it not be started?

During critical illness, active malignancy, active intracranial lesions.

Main adverse effect in children?

Intracranial hypertension.

Adverse effects in adults?

Edema, hyperglycemia, joint pain.

What risk exists in Prader-Willi patients?

Fatal respiratory events.

BLACK BOX warning for somatropin?

Fatalities in Prader-Willi with obesity/respiratory issues.

Monitoring required?

Height/weight, thyroid function, glucose.

Risk in diabetics?

Hyperglycemia — may need insulin adjustment.

Why monitor for hip/knee pain?

Risk of slipped capital femoral epiphysis.

Why rotate injection sites?

To avoid tissue damage.

Is it safe in pregnancy?

Should be discontinued during pregnancy.

Breastfeeding risk?

None reported.

How soon should growth improvement occur?

Within first year.

When should treatment stop?

When growth stops or epiphyses close.

Does somatropin cause scoliosis progression?

It can in predisposed children.

How often is dosage given?

Daily.

Storage of reconstituted somatropin?

In refrigerator.

Signs of intracranial hypertension?

Headache, vision changes, nausea.

How to monitor therapy success?

Height & weight tracking, bone age studies.

When should glucose monitoring be done?

Periodically, especially in diabetics.

Should solution be clear before injection?

Yes — discard if cloudy.

What is required with dialysis patients?

Dose timing adjustment.

Can antibodies to somatropin form?

Yes — rarely affects efficacy.

What can limit somatropin response?

Corticosteroid use.

Which conditions contraindicate use?

Active malignancy, critical illness.

What lab abnormalities may occur?

Hypercalciuria.

What to report to HCP?

Lack of growth, hip/knee pain, limp.

Can it cause visual changes?

Yes — intracranial pressure effect.

Is dosage weight-based?

Yes — mg/kg/week.

What does somatropin increase in GI tract?

Nutrient absorption.

Is it used long-term?

Yes — often years.

Is bone age monitored?

Yes — helps determine treatment endpoint.

What form is long-acting GH?

Lonapegsomatropin.

What are key patient teaching points?

Monitor for side effects, follow up regularly, rotate sites.

Is somatropin titrated?

Yes — based on response & side effects.