Summary of Drugs for Hypothalamic and Pituitary Disorders Quiz

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Questions and Answers

What is the primary mechanism of action of GnRH agonists like Goserelin and Naterelin?

They act as antagonists to the GnRH receptors in the pituitary gland

They directly suppress the production of testosterone and estrogen

They stimulate the pituitary gland to release FSH and LH in a pulsatile manner

They downregulate the GnRH receptors in the pituitary gland (correct)

Which of the following is a common side effect of prolonged treatment with GnRH agonists?

Increased bone density

Improved mood

Symptoms of menopause (correct)

Increased libido

How do GnRH agonists like Goserelin and Naterelin differ from natural GnRH in terms of potency and duration of action?

They are less potent and have a shorter duration of action

They are 15-150 times more potent and have a longer duration of action (correct)

They are less potent and have a longer duration of action

They are more potent and have a shorter duration of action

What is the rationale for using pulsatile administration of GnRH agonists?

To avoid the initial flare effect and downregulation of GnRH receptors Signup and view all the answers

Why is the use of GnRH agonists problematic in the treatment of prostate cancer in men?

It can cause an initial increase in testosterone levels Signup and view all the answers

How are GnRH agonists administered for the treatment of infertility and assisted reproductive technology procedures?

Subcutaneously or intramuscularly, with implants or injections Signup and view all the answers

What is the primary mechanism of action of somatostatin analogues like octreotide and lanreotide?

They directly inhibit the pituitary tumor. Signup and view all the answers

Which of the following is a common adverse effect of somatostatin analogues?

Hyperglycemia Signup and view all the answers

What is the primary advantage of the long-acting formulation of lanreotide compared to octreotide?

Lanreotide is administered by intramuscular injection every 4 weeks. Signup and view all the answers

How does pegvisomant differ in mechanism of action compared to somatostatin analogues?

Pegvisomant prevents growth hormone from activating its signaling pathways. Signup and view all the answers

What is the primary mechanism of action of dopamine agonists like bromocriptine and cabergoline?

They inhibit the secretion of prolactin from the pituitary. Signup and view all the answers

Which of the following is a common adverse effect associated with the use of dopamine agonists?

Dizziness and postural hypotension Signup and view all the answers

What is the primary advantage of cabergoline over bromocriptine in the treatment of hyperprolactinemia?

Cabergoline has fewer gastrointestinal side effects. Signup and view all the answers

What is the primary therapeutic use of growth hormone releasing hormone (GHRH)?

To differentiate between pituitary and hypothalamic causes of dwarfism. Signup and view all the answers

Which of the following is a common adverse effect associated with the use of growth hormone agonists like somatropin?

Hyperglycemia Signup and view all the answers

What is the primary route of administration for growth hormone agonists like somatropin?

Subcutaneous Signup and view all the answers

What is the main advantage of GnRH receptor antagonists over agonists?

They produce a more complete suppression of gonadotropin secretion. Signup and view all the answers

Which of the following is a common adverse effect observed with the use of GnRH receptor antagonists in prostate cancer treatment?

Allergic reactions and hypotension. Signup and view all the answers

What is the main difference between human menopausal gonadotropins (hMG) and purified FSH preparations?

hMG has a shorter half-life but is more effective at stimulating estrogen secretion. Signup and view all the answers

What is the primary clinical use of human chorionic gonadotropin (hCG)?

Maintaining pregnancy by stimulating the corpus luteum to secrete progesterone. Signup and view all the answers

Which of the following is the main reason why progesterone analogs are preferred over hCG for infertility treatment?

Progesterone analogs have a lower risk of causing ovarian hyperstimulation syndrome (OHSS). Signup and view all the answers

What is the main clinical application of thyroid-stimulating hormone (TSH)?

Monitoring thyroid carcinoma recurrence. Signup and view all the answers

What is the primary purpose of administering adrenocorticotropic hormone (ACTH) in clinical practice?

To challenge the adrenal glands to produce cortisol. Signup and view all the answers

What is the main advantage of desmopressin over natural vasopressin?

Desmopressin has a higher anti-diuretic to pressor ratio. Signup and view all the answers

What is the primary mechanism of action of oxytocin in the body?

Promoting uterine contraction and the initiation of labor. Signup and view all the answers

What is the main concern with the excessive use of oxytocin during labor and delivery?

Fetal distress and placental abruption. Signup and view all the answers

Study Notes

GnRH Agonists

Goserelin and Naterelin primarily act by stimulating the release of gonadotropins from the pituitary gland, initially increasing testosterone and estrogen levels.
Prolonged treatment can lead to hypoestrogenism in women and hypogonadism in men due to desensitization of GnRH receptors.
GnRH agonists are more potent and have longer durations of action than natural GnRH due to structural modifications that enhance stability and receptor binding.
Pulsatile administration mimics natural rhythms of GnRH release, promoting normal gonadal function and fertility.
In prostate cancer treatment, prolonged use of GnRH agonists can lead to testosterone flare, which can worsen symptoms before lowering testosterone levels.

Administration for Infertility

GnRH agonists for infertility and assisted reproductive technologies are typically administered via subcutaneous injection or nasal spray to regulate hormone levels.

Somatostatin Analogs

Octreotide and Lanreotide primarily inhibit the secretion of growth hormone and insulin by acting on somatostatin receptors.
Common adverse effects of somatostatin analogs include gastrointestinal issues like diarrhea and nausea.
Lanreotide's long-acting formula offers sustained effects, making it more convenient than octreotide, which may require more frequent dosing.

Pegvisomant

Pegvisomant works by blocking growth hormone receptors, preventing growth hormone action, unlike somatostatin analogs that inhibit hormone release.

Dopamine Agonists

Bromocriptine and Cabergoline primarily reduce prolactin levels by stimulating dopamine receptors in the pituitary gland.
Common adverse effects include nausea and dizziness.
Cabergoline has a longer half-life and improved tolerance compared to bromocriptine, providing better compliance in hyperprolactinemia treatment.

Growth Hormone Releasing Hormone (GHRH)

The primary therapeutic use of GHRH includes stimulating growth hormone release in patients with growth hormone deficiency.
Common adverse effects of growth hormone agonists like Somatropin include joint pain and edema.
Somatropin is primarily administered via subcutaneous injection for effective absorption.

GnRH Receptor Antagonists

GnRH receptor antagonists offer an advantage over agonists by providing immediate suppression of gonadotropin release without the initial stimulation period.
Common adverse effects include local injection site reactions and headache.

Gonadotropins and hCG

Human menopausal gonadotropins (hMG) contain both LH and FSH, while purified FSH preparations contain only FSH, offering more targeted treatment options.
The primary clinical use of hCG is in triggering ovulation during fertility treatments.

Progesterone Analogs

Progesterone analogs are preferred over hCG for infertility treatment to better support the luteal phase without causing multiple pregnancies.

Thyroid-Stimulating Hormone (TSH)

TSH is primarily used to diagnose and treat hypothyroidism and to monitor thyroid function.

Adrenocorticotropic Hormone (ACTH)

ACTH is administered to evaluate adrenal function and to treat conditions like adrenal insufficiency.

Desmopressin

Desmopressin is more selective for V2 receptors, providing a significant advantage over natural vasopressin in treating conditions like diabetes insipidus without causing vasoconstriction.

Oxytocin

Oxytocin primarily stimulates uterine contractions during labor and milk ejection during breastfeeding.
Excessive use during labor can lead to complications such as uterine hypertonicity or rupture and fetal distress.

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Description

Test your knowledge on drugs and hormones used to treat hypothalamic and pituitary disorders, including their descriptions, pharmacokinetics/pharmacodynamics, indications, adverse effects, and contraindications. Learn about growth hormone releasing hormone, growth hormone agonists, and more.