Hypothalmic drugs

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kyleannkelsey
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266460
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Hypothalmic drugs
Updated:
2014-03-14 14:01:53
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Hypothalmic drugs
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Hypothalmic drugs
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  1. What drugs are available to treat pituitary dwarfism?
    Somatropin (a group of drugs) and Mecasermin
  2. What kind of drug is Mecasermin?
    Recombinant IGF-1
  3. What are the adverse effects of Somatropin?
    • Hyperglycemia
    • High SBP
    • interacts w/ glucocorticoids
    • Neutralizing antibodies
  4. What are the adverse effects of Mecasermin?
    • Hypoglycemia
    • Allergic reactions
    • Hypertrophy or tonsils
    • Overgrowth of fat, kidneys and facial bones
  5. Would you use Mecasermin or Somatropin if a patient has non-functional GH receptors?
    Mecasermin (IGF-1 analog)
  6. Would you use Mecasermin or Somatropin if a patient has functioning GH receptors, but low GH levels?
    Somatropin
  7. At what point in a childs growth would it not be useful to give Somatropin?
    After epiphysis have closed
  8. Why can you develop allergic reactions to Mescarmin?
    It is a protein
  9. What drugs should you not give with Somatropins and why?
    Glucocorticoids, reverse the effects of GH
  10. Why do neutralizing antibodies develop against Somatropin?
    If person is making some GH themselves, they may develop antibodies against the “invading” ones being given
  11. What group of drugs would you use to treat acromegaly/gigantism?
    Somatostatin analogs or GH receptor antagonists
  12. What are the somatostatin analogs?
    • Octreotide (Sandostatin)
    • Lanreotide
  13. What are the GH receptor antanogists?
    Pegvisomant
  14. By what mechanism do Somatostatin analogs like octrotide and lanreotide act?
    • Work through Somatostatin receptor ligands (SRLs)
    • Operate similarly to Somatostatin Growth hormone inhibiting release hormone
  15. Why do Somatostatin analogs (Octreotide and Lanreotide) cause GI side effects?
    b/c there are somatostatin receptors in our stomach
  16. What mechanisms cause Somatostatin analogs (Octreotide and Lanreotide) to have injection site reactions?
    • They are a protein
    • They prevent lipolysis, so can create fatty acid deposits
  17. GH receptor antagonists like Pegvisomant are similar to what naturally occurring hormone?
    GH
  18. What rugs should you not give with GH receptor antagonists like Pegvisomant?
    Opioids, reason unknown, but they reduce Pegvisomont’s effects
  19. What are the side effects for GH receptor antagonists like Pegvisomant?
    • GI issues
    • Injection site reactions
    • Abdominal pain
    • Gallstones
    • Hypo- or hyperglycemia
    • Bradycardia (lanreotide)
  20. What are the side effects for Somatostatin analogs (Octreotide and Lanreotide)?
    • GI issues
    • lipohypertrophy at injection site reactions
    • opioid analgesic interaction
  21. What drugs can increase DA or stimulate the DA receptor in the anterior pituitary, causing a decrease in prolactin?
    • L-DOPA
    • Bromocriptine
    • Cabergoline
  22. What drugs can decrease DA or inhibit the DA receptor in the anterior pituitary, causing as increase in prolactin?
    • Reserpine
    • Antipsychotics
    • Alpha-methyl dopa
  23. What types drugs can be used to treat hyperprolactinemia?
    • Dopaimine agonists:
    • Ergot-alkaloids from plants
    • Non-ergot derived
  24. What drugs are Ergot-alkaloids from plants, increase DA release and treat hyperprolactinemia?
    Cabergoline (D2) and Bromocriptine (D2 and D1)
  25. Why is Cabergoline preferred over Bromocriptine for treatment of hyperprolactinemia?
    • It is more selective: Cabergoline (D2) and Bromocriptine (D2 and D1)
    • So, it has less side effects
  26. What is the MOA of Hyperprolactinemia drugs?
    Bind D2 receptors
  27. What are the side effects of Hyperprolactinemia drugs?
    N/V, HA, Dizziness, Personality changes, HYPOtension
  28. Side effects for Cabergoline (D2) and Bromocriptine (D2 and D1) are caused by what Characteristics?
    Binding to sites other than D2: such as D1 (bromocriptine), adrenergic and seratonergic receptors
  29. Vasopressin is released from where?
    Posterior Pituitary
  30. What are the vasopressin agonists?
    8-L-arginine vasopressin (Pitressin), Desmopressin and Telipressin
  31. Which Vasopressin agonist is V1A selective?
    8-L-arginine vasopressin (Pitressin) and Telipressin
  32. Which Vasopressin agonist is V2 selective?
    Desmopressin
  33. What are the routes of administration for Desmopressin?
    SQ, IV, Intranasal and Oral
  34. What are the routes of administration for 8-L-arginine?
    IM, SQ, Intranasal
  35. What is the difference between 8-L-arginine vasopressin and terlipressin?
    Terlipressin is a synthetic analog with a longer t1/2
  36. What are the vasopressin antagonists called as a group?
    Vaptans
  37. What are the Vaptans/Vasopressin antagonists?
    Conivaptan and Tolvaptan
  38. Which vaptan/vasopressin antagonist is selective for V1A and V2 receptors?
    Conivaptan
  39. Which vaptan/vasopressin antagonist is V2 selective?
    Tolvaptan
  40. What are the indications for 8-arginine vasopressin (at the V1A receptor)?
    • Postoperative ileus and abdominal distension
    • Reduce/stop bleeding from esophageal varicies
    • Reduce general bleeding
    • Diabetes insipidus
  41. What are the indications of Desmopresin (at the V2 receptors)?
    • Central Diabetes insipidus
    • Type 1 von willebrand’s disease
    • Nocturnal enuresis
    • Post lumbar puncture headache
  42. What are the adverse effects of vasopressin drugs?
    • Nausea
    • HA
    • Abdominal cramps
    • Allergic reactions
  43. Would you give a vaptan for Hyponatremia?
    Yes
  44. What is the route of administration when giving conivaptan for Hyponatremia?
    IV
  45. What is the route of administration when giving tolvaptan for Hyponatremia?
    PO
  46. What is the MOA of Oxytocin?
    • Sustained uterine contractions by acting on receptors linked to Gq/11 and Gi
    • Contracts myoepithelial cells surrounding acinar cells in the breast leading to milk ejection
  47. What are the indications for Oxytocin?
    • Induce labor (IV)
    • In utero circulation test (IV)
    • Overcome breast engorgement (Intranasal)
  48. What are the adverse effects of Oxytocin?
    HTN, uterine rupture and fetal death
  49. Where is Oxytocin released from?
    Posterior pituitary

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