Pharmacology: Endocrine Pharmacology - Hypothalamic and Pituitary

What portal system connects hypothalamus to anterior pituitary?

Hypophyseal portal system

Which hormones are released from the hypothalamus?

TRH, CRH, GnRH, GHRH, somatostatin, dopamine

What hypothalamic hormone inhibits prolactin?

Dopamine

What hypothalamic hormone inhibits GH?

Somatostatin

Which pituitary hormone is NOT under hypothalamic stimulation but inhibition?

Prolactin

What feedback regulates pituitary hormones?

Negative feedback from target organ hormones

What are the 6 anterior pituitary hormones?

GH, PRL, ACTH, TSH, FSH, LH

Which hormone stimulates adrenal cortex?

ACTH

Which hormone stimulates thyroid gland?

TSH

Which hormones regulate reproduction?

FSH and LH

GH is what type of molecule?

Peptide hormone

Route of GH administration?

Subcutaneous

Why is GH not oral?

Degraded in GI tract

GH acts via what mediator?

IGF-1 (somatomedin C)

GH receptor signaling pathway?

JAK-STAT

GH effect on glucose?

Increases blood glucose

GH effect on lipolysis?

Increases lipolysis

Drug of choice for GH deficiency?

Somatropin

Recombinant GH is called?

Somatropin

GH deficiency in children leads to?

Short stature

GH therapy adverse effect?

Pseudotumor cerebri

GH excess in adults causes?

Acromegaly

GH excess in children causes?

Gigantism

Drug that inhibits GH release?

Octreotide

GH receptor antagonist?

Pegvisomant

Dopamine agonist used in acromegaly?

Bromocriptine

FSH and LH are what type of proteins?

Glycoproteins

Structure type of FSH and LH?

Dimeric (α and β subunits)

Which subunit determines specificity?

Beta subunit

FSH stimulates what in females?

Follicular development

LH triggers what?

Ovulation

LH stimulates what in males?

Testosterone production

Which hormone mimics LH in pregnancy?

hCG

hCG source?

Placenta

Use of FSH/LH drugs?

Infertility treatment

Adverse effect of gonadotropins?

Ovarian hyperstimulation syndrome (OHSS)

Pulsatile GnRH effect?

Stimulates FSH/LH

Continuous GnRH effect?

Suppresses FSH/LH

Example GnRH analog?

Leuprolide

Use of leuprolide?

Prostate cancer

Initial effect of GnRH analogs?

Flare phenomenon

Example GnRH antagonist?

Ganirelix

Advantage of GnRH antagonist over agonists?

No flare effect

Most common cause of Hyperprolactinemia?

Prolactinoma

Drug cause of hyperprolactinemia?

Antipsychotics

Dopamine effect on prolactin?

Inhibits secretion

Drug of choice for Hyperprolactinemia?

Cabergoline

Alternative treatment for Hyperprolactinemia?

Bromocriptine

Oxytocin is what type of peptide?

Nonapeptide

Route of oxytocin?

IV

Oxytocin effect on uterus?

Contraction

Oxytocin receptor type?

Gq protein-coupled

Main use of Oxytocin?

Induce labor

Postpartum use?

Prevent hemorrhage

Major toxicity of Oxytocin?

Uterine rupture

Another adverse effect of Oxytocin?

Water intoxication

Oxytocin antagonist?

Atosiban

Vasopressin is what type?

Nonapeptide

V1 receptor effect?

Vasoconstriction

V2 receptor effect?

Water reabsorption

Second messenger of V2?

cAMP

Route of desmopressin?

Intranasal/oral

Drug of choice for central DI?

Desmopressin

Use in von Willebrand disease?

Desmopressin

Use in nocturnal enuresis?

Desmopressin

Major toxicity of Vasopressin?

Hyponatremia

Dangerous complication of Vasopressin?

Water intoxication

V2 receptor antagonist?

Tolvaptan

Use of tolvaptan?

SIADH

Another antagonist of Vasopressin?

Conivaptan

Drug for SIADH?

Tolvaptan

Drug for acromegaly blocking receptor?

Pegvisomant

Drug mimicking somatostatin?

Octreotide

Hormone responsible for milk letdown?

Oxytocin

Hormone responsible for milk production?

Prolactin

Dopamine agonists treat?

Hyperprolactinemia

Continuous GnRH leads to?

Hypogonadism

Pulsatile GnRH treats?

Infertility

GH increases which growth mediator?

IGF-1

ADH deficiency leads to?

Diabetes insipidus

Tall child with elevated GH → diagnosis?

Gigantism

Enlarged hands/jaw in adult → diagnosis?

Acromegaly

Polyuria, responds to desmopressin → diagnosis?

Central DI

Polyuria, no response → diagnosis?

Nephrogenic DI

Infertility + high prolactin → treatment?

Cabergoline

Prostate cancer hormone therapy?

Leuprolide

Immediate suppression of testosterone needed?

GnRH antagonist

Why desmopressin preferred over vasopressin?

Selective V2 action

Why continuous GnRH suppresses hormones?

Receptor downregulation

Major complication of gonadotropin therapy?

OHSS

Drug causing galactorrhea?

Antipsychotics

Hormone with Gq signaling in uterus?

Oxytocin

Hormone increasing aquaporins?

ADH

Drug blocking GH receptor?

Pegvisomant

Best drug for SIADH hyponatremia?

Tolvaptan

Hormone stored in posterior pituitary but made in hypothalamus?

ADH

Same for uterine contraction hormone?

Oxytocin

Hormone increased by dopamine blockade?

Prolactin

Drug used to induce labor?

Oxytocin

Drug for acromegaly decreasing GH secretion?

Octreotide