pharm 1- hypothalamus + pituitary

drugs for GH def

mecasermin

tesamorelin

somatotropin

AE of mecasermin

hypoglycemia

intracranial HTN

MAO of mecasermin

recombinant human IGF-1 (rhlGF-1)

CU for mecasermin

primary and secondary GH def

what things can be administered to determine etiology of GH def

glucagon

arginine

clonidine

insulin

if GH deficient children respond to GHRH (sermorelin), where is the problem

hypothalamus

MOA of somatotropin

recombinant human GH

AE of somatotropin

paresthesia

somatotropin is CI in pts with

active malignancy

MOA of tesamorelin

GHRH analogue

CU for tesamorelin

HIV pts with lipodystrophy

AE of tesamorelin

injection site reaction

drugs for GH excess

somatostatin R agonists

dopamin agonsits

GH R antagonists

mainstay of treatment for GH excess

somatostatin analogues

somatostatin analogues

octreotide

lanreotide

pasireotide

MOA of somatostatin analogues

inhibits GH secretion

other CU for octreotide

esophageal varices

other hormone secreting tumors

AE of somatostatin analogues

gallstones

lightheadedness

MOA of dopamine agonists in acromegaly

paradoxical dec in GH

MOA of dopamine agonists in prolactinomas

suppress prolactin release

what are the dopamine agonists

bromocriptine

cabergoline

AE of dopamine agonists

N/V

category B for pregnancy

CU for dopamine analogues

acromegaly

prolactinomas

MOA of pegvisomant

GH R antagonist

prevents receptor dimerization

dec IGF-1

CU of pegvisomant

acromegaly

AE of pegvisomant

liver AE

treatment of acromegaly

1. somatostatin

2. cabergoline

3. pegvisomant

MOA of leuprolide

GnRH agonist

CU for leuprolide

in vitro fertilization

endometriosis

uterine fibroids

precocious puberty

androgen dependent prostate cancer

main drawback of leuprolide

gonadotroph suppression is not immediate

transient inc in sex hormones

MOA of cetrorelix and ganirelix

GnRH antagonists

CU for cetrorelix and ganirelix

assisted reproduction

AE of cetrorelix and ganirelix

HS reaction

ovarian hyperstimulation

drugs used for SIADH

conivaptan

tolvaptan

tetracycline

MOA of conivaptan

V1, V2 receptor antagonist

MOA of tolvaptan

V2 vasopressin receptor antagonist

MOA of tetracycline

block insertion of aquaporin 2

interference with adenylate cyclase and cAMP

treatment for neurogenic DI

desmopressin

hydrochlorothiazide

amiloride

MOA of desmopressin

ADH analogue

stimulates V2

reduces thirst

inc water reabsorption

oxytocin can be released IM to control

postpartum bleeding

CU for oxytocin

induce early labor in special cases