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Where are PSN abd SNS dominant?
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What are the Ganglionic Blocking agents?
When are they used?
•Hexamethonium (HXM), Mecamylamine, Trimethaphan.
•It is used in treatment of hypertensive crisis and dissecting aortic aneurysm.
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What are the effects of Ganglion Blocking agents?
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•Ganglion blocking agents block the reflex changes in heart rate elicited by increase / decrease in blood pressure.
- •Hexamethonium will block the reflex bradycardia that occurs when phenylephrine causes vasoconstriction, but it will not block a bradycardia that results from direct activation of muscarinic receptors in heart.
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Hypothalamic hormones includes?
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-Thyrotropin releasing hormone (TRh)
- -Corticotropin releasing hormone (CRh)
- -Gonadotropin releasing hormone (GnRh)
- -Prolactin-inhibitory hormone (Dopamine)
- -GH releasing hormone (GHRh)
- -GH inhibiting hormone (Somatostatin)
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Growth hormone-releasing hormone is used for?
(GHRH, sermorelin)
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Used rarely as a diagnostic test for GH
responsiveness
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Thyrotropin-releasing hormone is used in?
(TRH, protirelin)
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Used rarely to diagnose hyper- or hypothyroidism
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Corticotropin-releasing hormone is used in?
(CRH, corticorelin)
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Used rarely to distinguish Cushing's disease from ectopic ACTH secretion
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Gonadotropin-releasing hormone is used in?
(GnRH,gonadorelin, leuprolide, nafarelin)
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Used rarely in pulses to treat infertility caused by hypothalamic dysfunction. Long-acting analogs are used to inhibit gonadal function in men with prostate cancer and in women with endometriosis and undergoing assisted reproductive technology (ART)
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GnRH Preparations:
Pulsitile administration leads to?
Continus administration leads to?
-Pulsatile administration is used to stimulate the release of FSH and LH from the anterior pituitary.
-In contrast, continuous administration leads to decreased FSH and LH secretion, after initially stimulation.
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GnRH agonist preparations:
- -Gonadorelin – short acting
- -Leuprolide, Nafarelin, Goserelin – long acting
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GnRH antagonist preparation:
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Uses of GnRH agonist (long acting)/ antagonist:
What adverse effects?
GnRH agonist (long acting) and GnRH antagonist are used in the treatment of precocious puberty, prostate cancer, breast cancer and endometriosis.
Adverse effects: Estrogen deficiency
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What is Somatostatin?
What does it do?
It is a GH inhibitory hormone
- It inhibits GH and TSH secretion, and also decreases gastrin and VIP secretion.
- It inhibits bile flow, mesenteric blood flow and decrease GIT motility.
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What is Octreotide?
What are its funtions?
It is a Somatostatin anolog= GH inhibitory hormone. It is 45 times more potent.
Used for acromegaly, refractory diarrhea (carcinoid syndrome and VIPoma), esophageal varices.
It is associated with gall stones.
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What is Ianreotide?
What is it approved for?
It is a long acting analog of Somatostatin.
approved for treatment of acromegaly.
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What is POMC?
Is it Proopiomelanocortin, which is the precursor for ACTH and MSH.
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Where does ACTH act?
it mainly stimulates the zona faciculata and zona reticularis to produce the cortisol and adrenal androgens.
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What is released from the Zona Glomerulosa? what regulates its release?
Aldosterone is released.
It is regulated mainly by Plasma angiotensin II and Potassium levels
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In Primary Adrenal failure what will you see?
What will you see in Secondary Adrenal Failure?
- A decrease in both Aldosterone and Cortisol
- A decrease in only cortisol
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What is Cosyntropin?
What is it used for?
- synthetic form of human ACTH
- and is employed in diagnostic tests:
- -To diagnose congenital adrenal hyperplasia.
- -To diagnose adrenal insufficiency in a test that measures cortisol before and after cosyntropin injection.
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What happens to GH as you age?
What recepters does it act on?
Decreases
GROWTH HORMONE mediates its effects via cell surface receptors of the JAK/STAT receptor superfamily
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What are the Effects of GH (somatotropin)?
-It has direct and indirect actions on the target organs.
-Most of the indirect actions of GH are mediated by somatomedins(IGF-1) produced in the liver.
These somatomedins stimulate skeletal growth and cell proliferation.
GH directly stimulates lipolysis and antagonize insulin so as to elevate blood sugar level.
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What is Mecasermin?
What does it do?
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It is recombinant IGF-1
- Is an effective treatment for GH insensitive patients
(Laron dwarfism) and also approved for GH deficiency.
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