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GH Somatropin / Somatrem
- Prader-Willi syndrome- Noonan’s syndrome- Turner
syndrome - CKD (chronic kidney disease)
IGF-1 Mecasermin
- Used when treatment when ! is not
res"ondin#- Can cause !$P%#lycemia (need to take in some C!%
a&ter
administration)
GH Antagonists (can’t use 'omatostatin due to short
hal&-li&e)
(somatostatin &rom "ancreas)
* Octreotide inhi+its the release o& !o Carcinoid
syndrome (decreases serotonin release)
o WD!, (watery diarrhea/hy"okalemia/achlorohydria)
o leedin# eso"ha#eal .arices (decreases "ortal .enous
"ressure)
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* Pegvisomant ! hormone 01C1PT%0 anta#onist (no e2ect
on! release)
o 3ndication acrome#aly
Gonadotropins
Clinical uses4
* %.ulation induction in women with ano.ulation due to4o
!y"o#onadotro"ic hy"o#onadism (nd hy"othyroidism)
o Polycystic o.ary syndrome
o %+esity
'tartin# &rom the 5rd day o& the menstrual cycle6
#i.e daily 7'!
&or 8- days* Controlled o.arian hy"er stimulation in 3975*
:ale in&ertility
;- weeks o& 7'!/
* :ulti"le "re#nancies
FSH
1. Urofollitropin / Follitropin alfa / Follitropin
eta!H
1. !"tropina* 7emale o.ulation in women / &ormation
o& cor"us luteum+* :ale stimulates &ormation o&
Testosterone
#$G "roduced +y the human "lacenta
O%&tocin
* 3nduces la+or> use&ul in4o Post maturity
o
!ealth risk to mom (dia+etes6 "reeclam"sia)o Premature ru"ture
o& mem+rane
* ,u#ment delayed la+ora* a+y that is not +orn +y week ?
5* Control uterine hemorrha#e a&ter +irth
To=icity4
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Don’t #i.e it to a "re#nant "erson +ecause it will cause uterine
contractions
+e&ore +irth* ,lso will cause @uid retention and water
into=ication*
Contraindicated in4
- 7etal distress / Prematurity / Ce"halo"el.ic dis"ro"ortion
Prolactin
H&perprolactinemia
can +e due to D0U' or ,D1:%N,s• Women amenorrhea /
#alactorrhea
• :en decreased li+ido / in&ertility
'opamine Agonists
- :ostly used in cases o& micro-
adenoma (Acm)* :acro-adenoma
would reBuire sur#ery*- Can cause !untin#ton like
sym"toms
1. (romocriptine ). $aergoline*. Pergolide
Clinical4
- These can +e used in cases o& "rolactin secretin# tumors /
lower
circulatin# "rolactin le.els and restorin# o.ulation- 'heehan’s
'yndrome4 maor hemorrha#e or hy"otension durin# the
"eri"artum "eriod6 can result in ischemia o& the a2ected
"ituitaryre#ions leadin# to necrosis*
o Need hormone re"lacement with4
Prolactin
Corticosteroids
+asopressin ,A'H
+14 .ascular smooth muscle cells .asoconstriction
+)4 renal tu+ule cells reduce diuresis
•
DeEciency leads to Ne"hro#enic Dia+etes 3nsi"idus
$entral desmo"ressin
ep#rogenic diuretics (thiaFide) hel"s with loss
o& NaG (+alancin#
+lood osmolality)
'esmopressin synthetic ,D!
- Used &or central dia+etes insi"idus
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o 3nection with this dru# will cause HIJ chan#e in urine
osmolality (dia#nosis)
$onivaptan / olvapatan ,D! anta#onists
- Used &or hy"onatremia/heart
&ailure
H&pot#alamic Hormones
,Gn0H
Natural .ersions o& the hormone is
called onadorelin +ut it’s a hu#e
"e"tide and hard to administer*
1. Goserelin). Histrelin*. !e"prolide. aferelin
The e2ect o& these dru#s will de"end on the mode
o& administration due to
"hysiolo#ical mechanisms o& action4
- Pulsatile will stimulate 7'! and
"hysiolo#ical release)- Continued inhi+its release o&
7'! and
Clinical4
* 'timulation o& #onadotro"in "roduction is use&ul
&or4o 7emale / :ale in&ertility
* 'u""ression o& #onadotro"in "roduction is use&ul
&or4o ,ssisted re"roducti.e technolo#ies
$ou don’t want to do 397 L ha.e a normal o.ulation
+ecause that increases the chance o& ha.in# multi"le
+a+ies at once* o 1ndometriosis ("resence o&
endometrial tissue outside the
uterus) 0educes estro#en and "ro#esterone concentrations
o Uterine
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- Continuous use o& n0! analo#s in women ty"ical
sym"toms o&
meno"ause- These can +e E=ed +y usin# n0! rece"tor
anta#onists4
1. Ganireli%). $etroreli%
These two dru#s "re.ent the
o.arian hy"er stimulation (&or e=am"le when you are doin#
397> can +e used
instead o& do"amine a#onists with less side e2ects)
