Term
GH stimulates:
(somatomedin) |
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Definition
liver-glucogenesis & IGF (somatomedins)bone
adipose lypolysis (hyerglycemia
muscle- AA uptake and protein syntheis |
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Term
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Definition
| Somatomedins: produced in the liver and mediate growth. and have neg feedback on GHRH |
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Term
| GH has a direct relationship with: |
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Definition
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Term
| GH acts directly on hepatocytes to: |
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Definition
| stimulate gluconeogenesis |
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Term
| cAMP phosphorylation of GH causes: |
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Definition
| GH synthesis and increases Ca++ influx (which helps release GH out of the cell) |
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Term
| Factors increasing Growth Hormone Secretion |
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Definition
| Increase: Sleep, thyroid Hormones, estrogens or androgens (puberty), amino acids |
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Term
| Factors decreasing Growth Hormone Secretion |
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Definition
| Decrease: Corticosteroids (suppress growth), Hypothyroidism, Aging |
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Term
| Growth hormone excess in adults: |
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Definition
| Acromegaly- Connective tissue proliferation; dermal overgrowth; enlarged extremities; skull deformities; insulin resistance |
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Term
| low levels of GH in children cause: |
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Definition
| Children (Dwarfism): Decreased growth velocity and skeletal development, delayed puberty less muscle and more SQ fat exces |
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Term
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Definition
Short stature (more common than GH deficiency)
Igf is needed as a mediator to stimulate growth but not lipoysis |
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Term
| GH recombinant DNA Theraputic agents |
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Definition
| Somatotropin (Serostim, Genotropin) : pituitary dwarfism; short stature (children); GH-deficient adults |
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Term
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Definition
sermorelin
Use: increase GH to treat dwarfism, short stature)
decreased efficacy and cost vs. GH |
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Term
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Definition
somatomdin
Use: ↑ growth in children with GH insensitivity & low IGF-1 levels (stimulate growth in children) (GH resistance) |
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Term
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Definition
Bromocriptine, pergolide, cabergoline,sermorelin
Use: decrease GH secretion in acromegaly
MOA: inhibit GH
“you need more Bros Per Cab” |
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Term
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Definition
Sandostatin (Octreotide) Use: decrease GH in acromegaly Pegvisomant “eight men will stop you” |
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Term
| Dopamine and GH receptor antagonists: |
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Definition
Octreotide (Sandostatin) and pegvisomant
Dopamine antagonist- Domperidone“eight men will stop you” |
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Term
| Side effects of GH analog |
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Definition
increased glucose (hyperglycermia) diabetes type 2 (insulin resistance)
Bone deformation
Tumor genesis |
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Term
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Definition
lactation/ milk secretion
-dopamine must be inhibited |
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Term
| prolactin is inhibited by: |
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Definition
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Term
| Hyperprolactinemia symptoms: |
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Definition
Cause: pituitary Tumor
Symptoms: gynecomastia, galactorrhea, male hypogonadism, amenorrhea |
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Term
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Definition
bromocriptine (Parlodel)
Use - hyperprolactinemia
MOA: 1 D1 stimulates dopamine
2 D2 is a TRH inhibitor
Side effects: postural hypotension |
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Term
| Dopamine(D2)receptor antagonist |
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Definition
Domperidone
Use: stimulates lactation
MOA: ↑ prolactin → ↑ milk production |
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Term
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Definition
| Milk ejection, uterine contractions, abortion |
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Term
| Synthetic oxytocin use and contraindications |
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Definition
Oxytocin citrate
Uses: induce or support labor, stimulate milk ejection, induce abortion
Side effects: uterine rupture
Contraindications: Abnormal fetal position; previous uterine surgery(weakened uterine muscles); fetal distress |
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Term
| Vasopressin (ADH) Actions: |
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Definition
V1 receptor binding- vasoconstriction
V2 receptor binding-opens H2O channels |
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Term
| ADH secretion increased by: |
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Definition
high plasma osmolality
decreased blood volume |
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Term
| ADH secretion decreased by: |
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Definition
| ethanol, cold, low blood somolarity and high blood volume |
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Term
| Disorders of ADH Secretion- Diabetes insipidus symptoms: |
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Definition
| decreased ADH secretion (Diabetes increases diuretic effect) Symptoms - polyuria, polydipsia, dehydration Treatment – ADH Nephrogenic diabetes insipidus tissue insensitivity to ADH Higher doses of ADH for treatment |
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Term
| Diabetes insipidus bedwetting treatments: |
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Definition
1 Natural vasopressin (pitressin) – injection V1 and V2
Vasopressin tannate - longer acting
Lysine vasopressin
Desmopressin acetate – only V2 activity
tablets and nasal spray with prolonged effect |
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Term
| ADH treatment side effects: |
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Definition
| hyponatremia, water intoxication, uterine cramping |
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Term
| ADH V1 versus V2 treatment: |
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Definition
| WE prefer to treat desompressin nasal spray because it does not cause vasoconstriction |
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Term
| other ADH response modifier drugs: |
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Definition
Chlorpropamide - responsiveness to ADH
Carbamazepine - responsiveness to ADH
Clofibrate - ADH release |
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