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Which is the correct term when pertaining to pituitary hormones? tropic or trophic
GHRH ______ release of GH while somatostatin _______ release of GH
Dopamine ____ release of prolactin
___ directly stimulates IGF-1 release, which binds IGF1 receptors and ____ receptors in serum.
GHR activation activates IRS/PI3K pathway which affects _______ transporters
Also activates MAPK which expresses genes including _____
IGF-1 binding receptors results in many pathways being activated, including ____ which has growth effects
Both adults and children with GH deficiency can be treated with ___ however children may also be treated with ____. Treatment in children should be before bone _____ close.
GH treatment in adults is indicated for GH deficiency associated with ______, _____ associated wasting, and ____ due to short bowel syndrome.
Idiopathic short stature in children is a height that is _____ SDs below normal
Serostim, Genotropin, Humatrope, Nutropin, Norditropin, and Saizen are what kind of GH products?
GH look alikes
what is mecasermin and what is its primary use?
- used for treatment fo children with severe primary IGF-1 deficiency (gene defect)
GH in ____ side effects include edema, carpel tunnel, arthralgia.
GH in ____ side effects include impaired glucose tolerance, scoliosis, intracranial hypertension
IGF-1 side effects include insulin effects like ______ and ______, also intracranial hypertension, scoliosis
- lipohypertrophy and hypoglycemia
What 3 pharmacological treatments can be used for GH excess?
- Somatostatin analogues (octreotide, lanreotide, pasireotide)
- GH receptor antagonists; decreases IGF-1 but not GH
- Dopamine agonists
What disease results from GH excess and whats the gold standard for diagnosis
- glucose tolerance test
What are the 2 forms of somatostatin analogs?
Octreotide & lanreotide bind ____ and ____ while pasireotide binds all receptors except ____
- SST-14 and SST-28
- SSTR2 and SSTR5
Hypogonadotropic hypogonadism is...
A. Low FSH/LH and low estrogen/androgens
B. High FSH/LH and low estrogen/androgens
C. Low FSH/LH and high estrogen/androgens
D. High FSH/LH and high estrogen/androgens
lanreotide has a _____ t1/2 than octreotide
how is efficacy measured?
- glucose tolerance test (GTT)
what is pegvisomant and what is its indication
How are glucose levels effected?
- GHR antagonist for acromegaly unresponsive to surgery or SST analogs
- causes hypoglycemia
what is prolactins role? TRH will ____ prolactin secretion and Dopamine will ______ secretion
- breast development/lactation
What is the most common pituitary disorder? How does this affect GnRH?
- prolactin excess
- decreased GnRH
What are the 2 US available dopamine agonists? Which one is first choice?
bromocriptine and cabergoline (first)
Low sex steroids can stimulate GnRH release from the ____, which stimulates FSH and LH release from the _______ which act upon _____ to produce steroids and inhibin
- anterior pituitary
How is sexual underdevelopment from hypogonadotropic hypogonadism treated?
- gonadal hormones (estrogens/androgens)
- (NOT FSH/LH)
leuprolide is a type of __ ______ and can be used diagnostically for central vs peripheral _______ ________
T/F: GnRH analogs have ADEs such as decreased gonadal steroids and are considered Category B, safe for pregnancy
F: Category X, unsafe for pregnancy
What are the 2 FDA approved GnRH antagonists?
ganirelix (Antagon) and cetrorelix (Cetrotide)
hCG can be detected by ________ in the urine or by _____ in the plasma
____ can be used to complete follicle maturation and induce ovulation
_____ can be used to induce production of follicles for ovulation
Both can be used to induce mature oocyte development
what is the most common AE with gonadotropin use in males
what is cryptorchidism? what is used to treat it
- Failure of testicles to descend
urofollitropin and follitropin-alpha are forms of what
why are some preparations of hCG IM only
they are urine derived so impure