1 hypothalamic and pituitary gland hormones and drugs

Hypothalamic-pituitary hormones and their affecting agents

Terminology

Acromegaly - disease caused by pituitary adenoma increasing:
Growth hormone = somatotropic hormone (STH), somatomedin, insulin like growth factor, IGF-1.

Hyperprolactinemia (prolactin hypersecretion) → galactorrhoea, menstrual cycle disturbances, infertility, tumor

Turner syndrome - Growth hormone deficency, change in number of chromosomes for females affecting height and sexual development.

OBS

Somatotropin -growth hormone

Somatropin - Medicin releasing growth hormone

Somatostatin = growth hormone release inhibitory hormone

Somatropin

=growth hormone

anabolic action

Growth hormone (somatotropic/STH) receptor agonist → IGF1 secretion → more peptides, blood sugar

Indication: Replacement therapy if growth hormone deficiency (Turner syndrome)

SE: gigantism, acromegaly with prolonged use.

(is a bio-drug derived from E.coli by DNAtechnology)

Pegvisomant

antisecretory action

Growth hormone (somatotropic/STH) receptor antagonists - reduses IGF-1 secreation. Dont affect STH secreation

indication: acromegaly (growth hormone over secreation),

(is a bio-drug derived from E.coli by DNAtechnology)

Octreotide

=growth hormone inhibitor

antisecretory action

inhibit: growth hormone, STH, TSH

Somatostatin (growth hormone release inhibitory hormone) receptor agonists → Inhibits STH secretion → reduces IGF-1 secretion → less peptides, blood sugar (hypoglycemia/hyperglycemia) caustion with diabetes.

Reduse TSH (thyroid stimulating hormone) secretion → hypothyroidism, bradycardia

Indication: acromegaly (growth hormone over secreation), gastroenteropacreatic carcinoid tumors (GEP), TSH secreating adenomas

SE: hypothyroidism

Bromocriptine, Cabergoline

Dopamine receptor agonists

Indication:
Used in acromegaly to Delay STH secreation (ONLY in acromegaly otherwise opposit effect)
hyperprolactinemia, malignant neuroleptic syndrome

Reduce prolactin secretion

SE: impulse control disorders, gambling, hypersexuality

Terminology

Prostate cancer- GnRH agonist, GnRH antagonist, radiation therapy, testosterone lowering therapy, surgery, androgen receptor antagonist

breast cancer- GnRH agonist, radical mastectomy, hormonal/chemotherapy

Endometriosis- GnRH agonist. endometrium implantation, hormonal therapy - progestins, surgery

Goserelin,Triptorelin

Antiproliferative effect

GnRH receptor agonists (gonadotropin)

Inhibition of LH/FSH/ovarian/testicular secretion

Downregulation - initial gonadotropin release increase (makes symptoms worse) → reduced after 2-3w estrogen/testosterone supresssion

Indication: prostate cancer, breast cancer, endometriosis

Degarelix

Antiporliferative effect

GnRH receptor antagonists

Inhibition of LH/FSH secretion and secondary Testosterone release.

Imidiate not increasing LF/FS/testosterone

Indication: prostate cancer

Oxytocin, Demoxytocin

non selective Oxytocin receptor (OXTR) and vasopressin receptor agonist.

Causes rhythmic or spastic uterus contractions

in neurohypophysis

Indication: stimulates labor, postpartum hemorrhage. Stimulates lactation

SE: water intoxication risk if overdosed

Desmopressin

Vasopressin = ADH

in neurohypophysis

Vasopressin V2 receptor agonist → increase reabsorbtion (more water in blood, increasing BP) (Vasopressor only in high doses) affect distal and collecting duct

ADH analogue, antidiuretic effect (blood clotting system)

Indication: diabetes insipdus, night enuresis

SE: hypertension, hyponatremia