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What are the uses of Somatropin?
- -Treatment of growth failure due to GH
- deficiency, chronic renal failure and turner’s syndrome.
-Wasting in patients with HIV/AIDS.
What are some Adverse effects of Growth hormone (somatropin) treatment?
- Adverse effects includes:
- edema,carpal tunnel syndrome, rarely ↑ ICT (pseudotumor cerebri).
What is Pegvisomant (Somavert)?
What is it used for?
Why can it be toxic?
- -It is a growth hormone receptor antagonist
- -Useful for the treatment of acromegaly.
-Toxicity: Increased liver enzymes
What other drugs are useful in treating Acromegaly?
Dopamine agonists like cabergoline and bromocriptine
List the treatments of Acromegaly
Primary-- Surgery, radiotherapy, domamine agonists, somatostatin analogues
Secondary--- GH-receptor antagonists
What determines which gonadotropin is secreted?
The frequency and amplitude of the GnRH pulses
What do LH and FSH share?
Have the same α subunit but differ in β subunit.
What are the effects of FSH in females? in males?
What are the effects of LH in females? in males?
FSH: Females--- stimulates follicle maturation and estrogen synthesis. In males in stimulates spermatogenesis.
LH: in females it induces Ovulation. In males it stimulates leydig cells in the testes to produces Tostosterone.
What is Urofollitropin/ Follitropin?
What is Menotropins(hMG)?
What is hChorionic Gonadotropin?
- FSH agonist
- contains FSH and LH
- is a LH agonist
What are the uses of Gonadotropin preparations?
- 1. Ovulation
- induction : The gonadotropins are used to induce
- ovulation in women with anovulation that is secondary to hypogonadotropic hypogonadism, polycystic ovary
- syndrome and obesity.
2. Male infertility :hCG is used.
what is a posible toxicity when dealing with Gonadotropin preparations?
- ovarian hyperstimulation syndrome and
- multiple pregnancies
what are the effects of Dopamine antagonists?
what are the effects of excessive prolatin secretion?
-They increase the levels of Prolactin.
- Leads to galactorrhea and infertility
what are Bromocriptine and Cabergoline?
What are they used for?
They are Dopamine agonists
-To treat hyperprolatinoma
What are the effects of TRH and Estrogens on Pituitary prolactin?
They promote prolatin's release.
What are Oxytocin (Pitocin)'s effects?
- -Causes the contraction of uterus and myoepithelial cells of the breast.
- - Also prevents post partum hemorrhages
- - Lets down milk
What are Oxytocin (Pitocin)'s adverse effects?
Name some Oxytocin antagonists: What is it used for?
Seizures and hyponatremia
Atosiban---- used for the treatment of preterm labor.
Arginine Vasopressin (AVP) or (ADH), when is it secreted?
What is an other odd effect?
What is its mechanism of effect?
- -Secreted in response to a decrease in ECF volume or an increase in plasma osmolarity.
- - Mediates the release of Factor VIII and vWF
- -Interacts with two types of vasopressin - V1 and V2 receptors.
What is the effect of ADH binding to V1?
Binding to V2?
- Vasoconstiction--> Increased Arterial Pressure
-Renal Fluid reabsorption--> increased blood volume
What is Desmopressin (DDAVP)?
What are its effects?
Why is this drug prefered?
- It is a vasopressin analogue
- -increase water reabsorption from renal
- collecting ducts (V2) and also stimulates release of VIII and vWF from endothelial cells.
-Desmopressin is more stable than vasopressin and has little effect on blood pressure.
When would you used Desmopressin?
What is an adverse effect of this drug?
- -Central Diabetes insipidus.
- -Nocturnal enuresis in children, mild hemophilia and Von-Willibrand disease.
-The most common adverse effect is water intoxication.
Name 2 vassopressin receptor antagonists.
When are they used clinically?
- Conivaptan, Tolvaptan-Used in the treatment of Hyponatremia due to SIADH.
A patient has central diabetes insipidus, what can you give them?
A patient has Nephrogenic diabetes insipidus, what can you give them?
•Thiazides (for non-Li+ induced)