DA agonist

Use: Suppress prolactin-secreting tumors i.e. hyperprolactinemia due to pituitary adenoma; GH secreting adenomas (decreases GH secretion); breast tenderness/engorgement 

PHK: daily admin.

Adverse effects: Nausea, lightheadedness, orthostatic hypotension, fatigue, psychiatric disturbances and erythromelalgia (rare)

Contraindications: pregnancy (unless necessary to control prolactin secreting tumors)

Other Drugs: Cabergoline - more effective, better tolerance; twice/week (longer acting)

GHRH Agonist (growth hormone); may not see this ever again

Use: GH deficiency diagnosis; NOT EFFECTIVE GH THERAPY

GH agonist

Use: Treat GH deficiency, chronic renal disease, Turner's syndrome, cachexia/AIDS wasting; adults c GH deficiency (improves metabolic state, increase LBM, improving sense of well being)

Pharmacokinetics: SC or IM injections, circulating T1/2 for 20 min, bio t1/2 = 9-17 hrs

Adverse Effects: fluid retention, edema, reduces with tx time, musculoskeletal pain, stiffness, hyperglycemia, hypothyroidism, increased IC pressure, papilledema, visual changes, headache, nausea/vomiting, hypoglycemia, glycosuria

Contraindication: DM, hypothyroidism, 1 yr post leukemia tx, acute critical illness (post Sx or trauma), acute respiratory insufficiency 

Other drugs: Somatrem (Protropin^®) - same with extr methionine residue; 

IGF-1 Agonist; rhIGF-1

Use: GH deficiency if pt unresponsive to GH therapy; less effective than GH; 

adverse: hypoglycemia

Contraindications: DM, hypothyroidism

Other Drugs: Mecasermin rinfabate (Iplex^®) - rhIGF-1 and IGF binding protein-3 combo, increases t1/2 of mecasermine

Somatostatin Analogue

Use: Treah GH excess (acromegaly), other hormone secreting tumors i.e. VIP secreting adenoma, carcinoma tumors, can redue tumor size/growth, Tx excessive diarrhea

Mechanism: Inhibits secretion of pituitary and GI hormones i.e. 5-HT, gastrin, vasoactive intestinal peptide  (VIP), insulin , glucagon, secretin, motilin, pancreatic polypeptide, GH, thyrotropin

Other Drugs: Lanreotide (Somatuline^®)

GH ANTagonist

Use: GH excess syndrome (acromegaly), Return to normal IGF-1 levels (97%!)

PHK: Inject SC once/day

Adverse: Growth of GH secreting sumor (lack of negative feedback); reversible hepatotoxicity

Contraindication: hepatic disease