Growth Hormone and Drugs for Adrenal Disorders

What drug is a recombinant human growth hormone that mimics endogenous growth hormone?

Somatropin

What drug is contraindicated in active malignancy, acute critical illness, respiratory failure, diabetic retinopathy, or closed epiphyses in pediatric patients?

Somatropin

What drug has interactions with glucocorticoids and increases CYP 450 activity?

Somatropin

What drug can cause hyperglycemia, edema, intracranial hypertension, progression of scoliosis, and slipped femoral epiphysis in children/adolescence?

Somatropin

What drug can cause carpal tunnel syndrome, peripheral edema, hyperglycemia, gynecomastia, myalgia, and arthralgia in adults?

Somatropin

What drug is recombinant human IGF-I that mimics endogenous IGF-I?

Mecasermin

What drug is indicated in severe IGF-I deficiency and non-response to somatropin?

Mecasermin

What drug is contraindicated for IV administration, closed epiphysis, and malignancy?

Mecasermin

What drug has the adverse effective hypoglycemia and is recommended to be taken with carbohydrate containing snacks/meal within 20 minutes of dose (can also cause intracranial hypertension, and increased liver enzymes)?

Mecasermin

What drugs are used as treatment for growth hormone deficiency?

Somatropin and mecasermin

Which drugs are first line for treatment of acromegaly/gigantism?

Octreotide, lanreotide, pasireotide

What drugs are somatostatin analogues?

Octreotide, lanreotide, pasireotide

What second line treatment of acromegaly/gigantism is a growth hormone receptor antagonist?

Pegvisomant

What second line treatment of acromegaly/gigantism is a dopamine agonist?

Bromocriptine and cabergoline

What drugs mimic endogenous somatostatin to reduce the secretion of growth hormone, and have a longer action than endogenous GHIH?

Octreotide, lanreotide, pasireotide

What drug inhibits ACTH secretion leading to decreased cortisol?

Pasireotide

What drug is used to treat diarrhea associated with vasoactive intestinal peptide secreting tumor?

Octreotide

What drug is used to treat Cushing syndrome and mimics growth hormone inhibiting hormone?

Pasireotide

What drug is used to treat Gastroenteropancreatic neuroendocrine tumor?

Lanreotide

What drug has interactions with drugs that prolong QT interval and adverse effects of GI upset, arrhythmias, and cholelithiasis?

Octreotide, lanreotide, pasireotide

Which somatostatin analog has the adverse effect of causing hyperglycemia?

Pasireotide

What second line agent is a growth hormone receptor antagonist that prevents the activation of growth hormone signaling pathway and reduces IGF-I without inhibiting growth hormone secretion?

Pegvisomant

What drug has the adverse effects of increased liver enzymes and flu like symptoms?

Pegvisomant

What drugs decrease growth hormone production in acromegaly and may not be effective if an adenoma does not also secrete prolactin but also also act on dopamine receptors?

Bromocriptine and cabergoline

What drug is contraindicated in pregnancy, hypersensitivity to ergot derivatives, syncopal migraine, breast-feeding, and uncontrolled hypertension?

Bromocriptine and cabergoline

What drug has the adverse effect of orthostatic hypotension?

Bromocriptine and cabergoline

What drug should not be used with anti-migraine triptans due to increased risk of prolonged vasospastic reactions?

Bromocriptine

What drug inhibits multiple enzymes involved in adrenal and gonadal steroidogenic and his indicated off label for the treatment of Cushing's?

Ketoconazole

What drug is contraindicated in pregnancy and has several drug drug interactions because it is a potent 3A4 inhibitor?

Ketoconazole

What drug has the adverse effects of hypogonadism, hepatotoxicity, hypoadrenalism, and G.I. upset?

Ketoconazole

What drug inhibits 11-B hydroxylase leading to decreased cortisol production and inhibits aldosterone synthase leading to decreased aldosterone?

Osilodrostat

What drug indicated in the treatment of Cushing's is contraindicated with strong 3A4 inhibitors due to increased QT risk and has the adverse effects of hypokalemia and adrenal insufficiency?

Osilodrostat

What drug is a progesterone and glucocorticoid receptor antagonist that induces abortion in early stage of pregnancy (less than 50 days) and improves metabolic parameters (hyperglycemia) in Cushing's?

Mifepristone

What is the primary treatment in secondary and tertiary adrenocortical insufficiency?

Hydrocortisone

What drug besides hydrocortisone may also be required in the treatment of secondary and tertiary adrenocortical insufficiency?

Fludrocortisone

What drug is a synthetic mineralocorticoid indicated in primary adrenal insufficiency (Addison's disease) and congenital adrenal hyperplasia (CAH)?

Fludrocortisone

What drug has major side effects of hypokalemia, edema, and heart failure, and requires monitoring of serum potassium and blood pressure?

Fludrocortisone

What drug has the highest salt retaining effect?

Fludrocortisone

What short acting drug has an equal anti-inflammatory and salt retaining effect?

Hydrocortisone

What drug has the adverse effects of iatrogenic Cushing syndrome, osteoporosis, emotional disturbances, hypokalemia, and hyperglycemia with long-term use?

Hydrocortisone

What drug has interactions with live attenuated vaccines and itraconazole?

Hydrocortisone

What drug can suppress the hypothalamic pituitary adrenal axis when used for more than two weeks leading to serious adverse effects upon abrupt discontinuation, and requires slow tapering over weeks to months to discontinue?

Hydrocortisone