Prolactin & Growth Hormones
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- Hyperprolactinemia causes
-
infertility
Suppresses LH and FSH - What stimulates prolactin
-
TRH
Estrogen - Inhibits prolactin
- Dopamine
- Tx for hyperprolactinemia
- Bromocriptine
- Half life of bromocriptine
- 3hours
- SE of bromocriptine
-
Nausea, Dizzines, Orthostatic hypotension
Psychosis in small percent - How do you minimize SE of bromocriptine
- Start low and go slow
- Three drugs that act on the pituitary GH secretion
-
GHRH (stim)
Ocetotride (inhib)
Bromocriptine (inhib) - Use for GHRH
-
Enhance growth hormone secretion
Diagnostic for pituitary function - Effect of continuous (non-pulsitile) GHRH administration
-
Continuous GH secretion by somatotropes
Contrast with GnRH which desensitizes receptors if given continuously - Most effective inhibitor of GH secretion
-
Octeotride
Bromocriptine also works, but not as well - effects of somatostatin and the synthetic analog used for therapy
-
Brain: Inhibits GH secretion
GI: inhibits gastric motility, reductions splanchnic flow and inhibits hormones (insulin, glucagon, VIP)
Octeotride is somatistatin analog -
Use for octeotride
SE? -
Acromegaly
VIPomas (pancrease)
Carcinoids tumors
Variceal bleeding
SE are GI & gall stones - Recombinent GH
- somatropin
- GH peak levelsq
- At night, during first deep sleep
- Conditions that enhance GH release
- Androgens, cortisol, exercise, hypoglycemia
- Main effect of GH
- Secret IGF
- Laron-type dwarf
-
Normal to high GH but mutated GH receptor so low IGF
Give IGF - Uses for somatropin
-
GH deficiency (kids, adult)
Gonadal dysgenesis (45 X,0)
growth failure from renal failure - SE of GH
- hyperglycemia leading to Diabetes mellitus
- Effects of IGF
-
bone growth
tissue growth
cell differentiation - Use of IGF
-
Laron type dwarfism
Second-line (after GH) for hypopituitary dwarfism - SE of IGF
-
hypoglycemia
(insulin-like)