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Reproductive Hormones: Menotropins and Gonadotropins
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Reproductive Hormones: Menotropins and Gonadotropins

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Questions and Answers

What is the primary mechanism of action of pegvisomant in the treatment of acromegaly?

  • Blocking the action of endogenous growth hormone (correct)
  • Enhancing the sensitivity of growth hormone receptors
  • Stimulating the release of growth hormone from the pituitary gland
  • Inhibiting the production of insulin-like growth factor-1
  • Which of the following is a consequence of growth hormone deficiency in children?

  • Acromegaly
  • Cachexia
  • Hyperprolactinemia
  • Growth failure (correct)
  • What is the primary site of action of follicle-stimulating hormone in women?

  • Hypothalamus
  • Adrenal gland
  • Pituitary gland
  • Ovary (correct)
  • What is the half-life of growth hormone after administration?

    <p>25 minutes</p> Signup and view all the answers

    Which of the following is a therapeutic use of growth hormone agonists?

    <p>Replacement therapy in children with growth hormone deficiency</p> Signup and view all the answers

    What is the effect of luteinizing hormone on the ovary?

    <p>Stimulation of progesterone production by the corpus luteum</p> Signup and view all the answers

    What is the route of administration of pegvisomant?

    <p>Subcutaneous</p> Signup and view all the answers

    Which of the following is a side effect of growth hormone therapy?

    <p>Edema</p> Signup and view all the answers

    What is the effect of follicle-stimulating hormone on the testis?

    <p>Stimulation of spermatogenesis and androgen-binding protein synthesis</p> Signup and view all the answers

    Which of the following is a contraindication for growth hormone therapy?

    <p>Closed epiphysis in children</p> Signup and view all the answers

    Study Notes

    Menotropins (Human Menopausal Gonadotropins, hMG)

    • Contain a mixture of LH and FSH
    • Isolated from the urine of postmenopausal women
    • Urofollitropin (Bravelle) is immunologically purified FSH from the urine of pregnant women
    • Follitropin α/β are recombinant FSH products
    • Must be administered parenterally (SC or IM)

    Therapeutic Uses of hCG

    • Stimulates gonadal steroidogenesis in cases of LH insufficiency
    • Induces external sexual maturation and spermatogenesis in men with secondary hypogonadism
    • Promotes the descent of the testes in cryptorchidism

    Therapeutic Uses of hMG

    • Stimulates ovulation in women with functioning ovaries
    • Used in concert with hCG to stimulate follicular growth and maturation

    Adverse Effects of Menotropins and hCG

    • Ovarian enlargement in about 20% of treated women
    • Ovarian hyperstimulation syndrome in up to 1% of patients
    • Ascites
    • Hypovolemia and shock
    • Acute respiratory distress

    Anti-Diuretic Hormone (ADH, Vasopressin)

    • Synthesized in the hypothalamus and stored in the posterior pituitary
    • Released in response to increasing plasma osmolarity or hypotension
    • Acts on three types of specific receptors: V1a, V1b, and V2
    • Increases permeability of water in renal tubules and transports urea in the inner medullary collecting duct
    • Causes vasoconstriction at higher doses

    Therapeutic Uses of ADH

    • Desmopressin is the most effective treatment for severe central diabetes insipidus
    • Reduces nighttime urine production in nocturnal enuresis
    • Included in the advanced cardiac life support protocol as a substitute for epinephrine in cardiac arrest with asystole

    Gonadotropin-Releasing Hormone (GnRH) and Analogs

    • Adverse effects in women: hot flushes, sweating, diminished libido, depression, ovarian cysts
    • Adverse effects in men: hot flushes, edema, bone pain, diminished libido, gynecomastia

    GnRH Receptor Antagonists

    • Competitively and reversibly bind to GnRH receptors in the pituitary gland
    • Block the release of LH and FSH from the pituitary
    • Examples: Ganirelix, Abarelix, Cetrorelix
    • Rapidly reduce sex hormone levels without an initial surge
    • Used in prostate cancer, hormone-sensitive breast cancer, benign disorders such as endometriosis and uterine fibroids, and some cases of infertility

    Prolactin-Inhibiting Factor (PIF, Dopamine Agonists)

    • Therapeutic uses: inhibition of prolactin secretion in amenorrhea, galactorrhea, and prolactin-secreting tumors
    • Correction of female infertility secondary to hyperprolactinemia
    • Treatment of Parkinson disease

    Growth Hormone

    • Released in a pulsatile manner, with highest levels during sleep
    • Decreases with increasing age
    • Administered SC or IM
    • Half-life: 25 min
    • Induces IGF-1 release by the liver, responsible for GH-like actions

    Therapeutic Uses of GH

    • Replacement therapy in children with GH deficiency before epiphyseal closure
    • Growth failure due to Prader-Willi syndrome
    • Stimulation of growth in patients with Turner syndrome
    • Long-term replacement of GH deficiency in adults
    • Treatment of cachexia and AIDS wasting

    Growth Hormone Antagonists

    • Pegvisomant: blocks the action of endogenous GH
    • Used specifically for the treatment of acromegaly
    • Administered SC

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    Description

    Test your knowledge on menotropins, human menopausal gonadotropins, and gonadotropins, including their composition, sources, and purification methods. Learn about the differences between LH and FSH, and how they are produced and used in medical treatments.

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