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Pharm Exam 5: Anterior Pituitary
n/a
55
Court Reporting
Professional
04/20/2011

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Cards

Term
What is a Hormone?
Definition
chemical from one cell -> cell via the blood.
Term
What is an Endocrine?
Definition
hormone from endocrine cell -> bloodstream -> distant target cell.
Term
What is a Neurocrine?
Definition
hormone from neuron -> bloodstream -> distant target cell.
Term
What is a Paracrine?
Definition
chemical from one cell type -> neighboring different cell type.
Term
What is a Autocrine?
Definition
chemical -> neighboring identical cells or same cell.
Term
Hypothalamus: Key regulator of the body through its influence on the ____ & _____
Definition
pituitary and ANS
Term
Hypothalamus is a _________ - receives inputs from numerous brain regions and sends appropriate responses
Definition
Relay station
Term
Hypothalamus Involved in: (8)
Definition
heat regulation
feeding
sexual activity
growth
metabolic rate
circadian rhythms
water balance
autonomic function
Term
Three Major Hypothalamic-Pituitary Axes:
Definition
H-P-Adrenal Axis
H-P-Thyroid Axis
H-P-Gonadal Axis
Term
Pituitary comes from ectodermal tissues from roof of mouth (_____ pituitary) and from brain (_____ pituitary)
Definition
anterior
posterior
Term
Pituitary affects the Gonads (Ovary or Testes) via (3)
Definition
Estrogen
Progesterone
Testosterone
Term
Pituitary affects the Adrenal gland (Cortex or medulla) via (4)
Definition

Cortex

Glucocorticoid

Mineralocorticoid

Sex hormones

 

Medulla

NE

Term
Pituitary affect the thyroid via (2)
Definition
T3
T4
Term
Pharmacotherapy: Drugs that mimic or block the effects of hypothalamic and pituitary hormones are used for 3 reasons:
Definition
1.) Replacement for hormone deficiency states
2.) Antagonists for diseases that result in excess production
3.) Diagnostic tools for identification of endocrine abnormalities
Term
Anterior Pituitary Hormones: (4)
Definition
Thyroid Stimulating Hormone (TSH) (aka thyrotropin)
Follicle Stimulating Hormone (FSH)
Leutenizing Hormone (LH)
Adrenocorticotropic Hormone (ACTH)
Term
Hypothalamic releasing factor for Thyroid Stimulating Hormone (TSH) (aka thyrotropin)?
Definition
Thyrotropin Releasing Hormone (TRH)
Term
Hypothalamic releasing factor for Follicle Stimulating Hormone (FSH)?
Definition
Gonadotropin Releasing Hormone (GnRH)
Term
Hypothalamic releasing factor for Leutenizing Hormone (LH)?
Definition
Gonadotropin Releasing Hormone (GnRH)
Term
Hypothalamic releasing factor for Adrenocorticotropic Hormone (ACTH)?
Definition
Corticotropin Releasing Hormone (CRH)
Term
Special Anterior Pituitary Hormones: (2)
Definition
Growth Hormone (GH)
Prolactin
Term
Hypothalamic Releasing Factors for Growth Hormone (GH)?
Definition
1.) Growth Hormone Releasing Hormone (GHRH) stimulates production
2.) Somatostatin (SST) inhibits production
Term
_______ stimulates production of Growth Hormone (GH)
Definition
Growth Hormone Releasing Hormone (GHRH)
Term
_____ inhibits production of Growth Hormone (GH)
Definition
Somatostatin (SST)
Term
Prolactin release is inhibited by ______
Definition
dopamine
Term
Growth Hormone is an Absolute requirement in ___ and early ____ for normal adult size.
Definition
childhood
adulthood
Term
GH is not required by ___, but is absolute requirement once you are born.
Definition
fetus
Term
GH major target= ______
Definition
insulin factor1
Term
Important effects of GH postnatally: ____ & ____ metabolism, ____ body mass
Definition
lipid and carbohydrate
lean
Term
GH deficiency in Children is due to ___ basis or damage to ___ or _____. Results in ___ stature and ____.
Definition
Genetic
hypothalamus or pituitary
Short
adiposity
Term
Examples of GH deficiency conditions: (3)
Definition
Prader-Willi syndrome
Turner syndrome
idiopathic short stature
Term
GH hormone deficiencies treated with ___. Children dosed 5-10 times higher than adults.
Definition
rhGH
Term
Adult GH deficiency results in disproportionately increased ____ and small ___ body mass, reduced ____
Definition
body fat
lean
cardiac output
Term
Aging results in natural drop in ___ secretion in early adult life, with a greater drop in later life
Definition
GH
Term
Unsubstantiated evidence supporting these GH affects: (2)
Definition
anti-aging effects of GH
muscle mass increases and performance enhancement in athletes
Term
______: Shortened analog of GHRH, with full biological activity
Definition
Sermorelin
Term
Sermorelin Does NOT work if GH deficiency is _____ to ____ defect
Definition
secondary
anterior pituitary
Term
Sermorelin is ___ than GH, but may not be as ___
Definition
Cheaper
effective
Term
Side Effects of GH and Sermorelin:
VERY few side effects in children- ____, rarely ____
More side effects in adults- (4)
No definitive link to increase CA risk, but GH contraindicated in ____
Definition
scoliosis
intracranial hypertension

peripheral edema
myalgias
arthralgias
carpal tunnel syndrome

malignancy
Term
Excess GH AFTER the end of puberty (closed long bone growth plates)= _____, growth of periosteal bone: widened fingers, toes, hands, and feet, long jaw and prominent forehead. Increases in organ size (____), accelerated _____.
Definition
acromegaly
heart
atherosclerosis
Term
Excess GH BEFORE end of puberty = ________ -> very tall stature, with long arms and legs
Definition
gigantism
Term
Excess GH can be caused by Hypersecretion of GH by ____ tumors. Definitive treatment is surgical removal or Treatment with GH RELEASING antagonists: (2)
Definition
pituitary

octreotide (somatostatin analog)
bromocriptine (D2 receptor agonist)
Term
_____: Very useful somatostatin analog- treatment of acromegaly as well as other hormone secreting tumors
Definition
Octreotide
Term
Octreotide:
Given __ every four weeks
Side effects: (5)
Costly
Definition
SQ

GI problems
gall stones
bradycardia
conduction disturbances
Vit. B12 deficiencies
Term
Prolactin is Primarily involved in stimulating ___ development and ___ production, some effects on ___
Definition
breast
milk
reproduction
Term
Hypothalamus has no stimulation on prolactin secretion from anterior pituitary, but inhibitory control through ___ release via ___ Receptors in pituitary. Prolactin exerts (-) feedback control by enhancing ___ synthesis in the hypothalamus
Definition
DA
D2
DA
Term
Stimulation and release of prolactin: (4)
Definition
Thyrotropin-releasing hormone (TRH)
oxytocin
5-HT
suckling (estrogen enhances actions of other mediators)
Term
Development and further hyperplasia of breast tissue during pregnancy is regulated by: (5)
Definition
prolactin
estrogen
progesterone
cortisol
GH
Term
During pregnancy, (4) cause development of alveolar lobules that produce milk
Definition
prolactin
estrogen
progesterone
cortisol
Term
After birth, (3) stimulate milk synthesis
Definition
prolactin
insulin
cortisol
Term
Nursing period: ___ & ____ maintain milk secretion
Definition
prolactin and oxytocin
Term
Hyperprolactinemia Causes:
Hypothalamic or pituitary disease that interferes with ___
____ failure
Primary ______
Pituitary _____
Definition
DA
Renal
Hypothyroidism -> (increased TRH due to dec. T3 & T4)
Adenomas = Primary cause
Term
Effects of Hyperprolactinemia:
____ in women
Negative feedback of the H-P-G axis:
____ & ____ in women
____ & ____ in men
Definition
Galactorrhea
Amenorrhea and infertility
Loss of libido and infertility
Term
Treatment of Hyperprolactinemia:
_____ is the prototype agent
Shrinks ____
Less effective with ____
Given orally or vaginally
Side Effects: Headache, nausea, vomiting, orthostatic hypotension, psychiatric problems
Definition
Bromocriptine (D2 Dopamine Receptor Agonist)
adenomas
macroadenomas
Term
Administration of anti-psychotic medications that ANTAGONIZE D2 receptors (chlopromazine, haloperidol, risperidone) can cause _____
Definition
hyperprolactinemia
Term
D2 receptor agonists -> use discontinued post-partum in women who do not want to nurse -> CV toxicity
Definition
Not sure what this means. D2 receptor agonists are used to treat Hyperprolactinemia. So if they are discontinued, then you could continue to have hyperprolactinemia which wouldn't be good for women who DON'T want to nurse...
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