The document discusses hormones of the hypothalamus, pituitary gland, and thyroid gland. It describes how hormones such as growth hormone-releasing hormone, somatostatin, gonadotropin-releasing hormone, and thyroid-stimulating hormone regulate the release of other hormones from these glands. It also summarizes the actions, therapeutic uses, and side effects of hormones including growth hormone, gonadotropins, antidiuretic hormone, oxytocin, and thyroid hormones.
This document summarizes hormones produced by the anterior pituitary gland. It discusses growth hormone, gonadotropins (FSH, LH, HCG), thyroid stimulating hormone, and adrenocorticotropic hormone. It describes the mechanisms and clinical uses of various hormone agonists and antagonists that target the anterior pituitary, including somatropin, octreotide, and gonadotropin analogs. Side effects of these drugs are also mentioned. The document provides context on the hypothalamus-pituitary axis and control of various metabolic processes.
The anterior pituitary gland secretes six major hormones that are controlled by the hypothalamus: growth hormone, gonadotropins (FSH, LH, HCG), thyroid stimulating hormone, and adrenocorticotropin. These hormones regulate metabolism, growth, reproduction, and other physiological processes. Somatropin and mecasermin are used to treat growth hormone deficiency and resistance, while somatostatin analogs and GH receptor antagonists treat excess GH levels as seen in acromegaly. Gonadotropins such as menotropins are used for controlled ovarian hyperstimulation and hypogonadism. TSH levels monitor thyroid carcinoma recurrence and ACTH helps diagnose adrenal
This document discusses the hypothalamic-pituitary hormones and their regulation and functions. It summarizes the hormones secreted by the anterior pituitary gland including growth hormone, prolactin, follicle-stimulating hormone, luteinizing hormone, thyroid-stimulating hormone, and adrenocorticotropic hormone. It then provides more detailed information about growth hormone, prolactin, the gonadotropins, and their regulators and clinical uses.
Endocrine lecture HYPOTHALAMUS AND PITUITARY HORMONES 2023.pptxHarunMohamed7
1. The document discusses drugs that affect the endocrine system, focusing on the hypothalamus and pituitary hormones.
2. It provides an overview of the hypothalamus and anterior pituitary hormones, describing how the hypothalamus regulates the pituitary gland and the roles of hormones like growth hormone, gonadotropins, prolactin, and adrenocorticotropic hormone.
3. The summary highlights the interactions between the hypothalamus and pituitary gland and some of the pharmacological effects and clinical uses of specific anterior pituitary hormones.
Pharmacology Lecture Slides on Introduction to Anterior pituitary and Thyroid hormones by Sanjaya Mani Dixit Assistant Professor of Pharmacology at Kathmandu Medical College
Introduction to the endocrine system
Growth hormone: Mechanism of Action, secretion, regulation.
Prolactin
Sex hormones
Oral contraceptives
Corticosteroids
James is a 5-year old boy who is smaller than his classmates and has experienced a marked drop in growth rate over the past year. His bone age is that of a 3-year old. Biochemical tests appropriate to investigate this boy would include tests of anterior pituitary hormones like growth hormone, TSH, and ACTH, as deficiencies in these hormones could cause stunted growth. The anterior pituitary is controlled by hormones from the hypothalamus and secretes hormones including growth hormone, TSH, ACTH, prolactin, FSH, and LH that regulate growth, metabolism, and reproduction.
This document summarizes hormones produced by the anterior pituitary gland. It discusses growth hormone, gonadotropins (FSH, LH, HCG), thyroid stimulating hormone, and adrenocorticotropic hormone. It describes the mechanisms and clinical uses of various hormone agonists and antagonists that target the anterior pituitary, including somatropin, octreotide, and gonadotropin analogs. Side effects of these drugs are also mentioned. The document provides context on the hypothalamus-pituitary axis and control of various metabolic processes.
The anterior pituitary gland secretes six major hormones that are controlled by the hypothalamus: growth hormone, gonadotropins (FSH, LH, HCG), thyroid stimulating hormone, and adrenocorticotropin. These hormones regulate metabolism, growth, reproduction, and other physiological processes. Somatropin and mecasermin are used to treat growth hormone deficiency and resistance, while somatostatin analogs and GH receptor antagonists treat excess GH levels as seen in acromegaly. Gonadotropins such as menotropins are used for controlled ovarian hyperstimulation and hypogonadism. TSH levels monitor thyroid carcinoma recurrence and ACTH helps diagnose adrenal
This document discusses the hypothalamic-pituitary hormones and their regulation and functions. It summarizes the hormones secreted by the anterior pituitary gland including growth hormone, prolactin, follicle-stimulating hormone, luteinizing hormone, thyroid-stimulating hormone, and adrenocorticotropic hormone. It then provides more detailed information about growth hormone, prolactin, the gonadotropins, and their regulators and clinical uses.
Endocrine lecture HYPOTHALAMUS AND PITUITARY HORMONES 2023.pptxHarunMohamed7
1. The document discusses drugs that affect the endocrine system, focusing on the hypothalamus and pituitary hormones.
2. It provides an overview of the hypothalamus and anterior pituitary hormones, describing how the hypothalamus regulates the pituitary gland and the roles of hormones like growth hormone, gonadotropins, prolactin, and adrenocorticotropic hormone.
3. The summary highlights the interactions between the hypothalamus and pituitary gland and some of the pharmacological effects and clinical uses of specific anterior pituitary hormones.
Pharmacology Lecture Slides on Introduction to Anterior pituitary and Thyroid hormones by Sanjaya Mani Dixit Assistant Professor of Pharmacology at Kathmandu Medical College
Introduction to the endocrine system
Growth hormone: Mechanism of Action, secretion, regulation.
Prolactin
Sex hormones
Oral contraceptives
Corticosteroids
James is a 5-year old boy who is smaller than his classmates and has experienced a marked drop in growth rate over the past year. His bone age is that of a 3-year old. Biochemical tests appropriate to investigate this boy would include tests of anterior pituitary hormones like growth hormone, TSH, and ACTH, as deficiencies in these hormones could cause stunted growth. The anterior pituitary is controlled by hormones from the hypothalamus and secretes hormones including growth hormone, TSH, ACTH, prolactin, FSH, and LH that regulate growth, metabolism, and reproduction.
Growth hormone and prolactin are peptide hormones produced by the pituitary gland. Growth hormone promotes growth and development while prolactin promotes breast development and milk production. Their secretion is regulated by hormones from the hypothalamus such as growth hormone releasing hormone and prolactin inhibiting hormone (dopamine). Abnormal levels can cause diseases - high growth hormone causes gigantism or acromegaly, low growth hormone causes dwarfism, and high prolactin causes infertility. Somatostatin and octreotide inhibit growth hormone and prolactin secretion and are used to treat conditions caused by their excess.
This document provides information about GnRH agonists and antagonists. It begins with an introduction to gonadotropin-releasing hormone (GnRH) and how it regulates the reproductive system. It then discusses GnRH agonists like goserelin and leuprolide, which are used to treat conditions like prostate cancer and endometriosis. While they initially stimulate hormone release, continuous use causes downregulation and inhibition of hormone production. Side effects include hot flashes and loss of libido. The document also briefly mentions GnRH antagonists which immediately inhibit hormone secretion.
The document summarizes several endocrine hormones produced by the anterior pituitary gland, including their target tissues and regulation. It discusses the six hormones produced by the anterior pituitary - prolactin, growth hormone, thyroid stimulating hormone, adrenocorticotropic hormone, follicle-stimulating hormone, and luteinizing hormone. It also describes the hypothalamic-pituitary feedback loops that regulate hormone production and secretion.
The summary is as follows:
1. The hypothalamus produces releasing and inhibiting hormones that regulate the pituitary gland, which secretes hormones that control other endocrine glands and tissues.
2. Pituitary hormones include growth hormone, thyroid-stimulating hormone, adrenocorticotropic hormone, gonadotropins, prolactin, oxytocin, and antidiuretic hormone.
3. Hypothalamic hormones and pituitary hormones are used clinically for various purposes such as diagnosing endocrine disorders, stimulating growth, and controlling hormone-secreting tumors.
The anterior pituitary gland secretes several important hormones. Growth hormone promotes growth and development. Prolactin stimulates lactation. Gonadotropins such as LH and FSH regulate the reproductive system. ACTH regulates cortisol production and TSH controls thyroid function. These hormones are regulated by hypothalamic factors and provide feedback control of their target organs. Disorders can arise from excess or deficiency of anterior pituitary hormones, leading to important diseases like acromegaly, Cushing's syndrome, and hypothyroidism.
The anterior pituitary produces six hormones: prolactin, growth hormone, thyroid stimulating hormone, adrenocorticotropic hormone, follicle-stimulating hormone, and luteinizing hormone. These hormones are regulated by feedback from their target organs/tissues on the hypothalamus and pituitary. The document discusses the cell types that produce each hormone, their targets, and mechanisms of feedback regulation. It also covers specific hormones and conditions in more detail, including ACTH regulation and diseases like Cushing's syndrome and Addison's disease.
The anterior pituitary produces six hormones: prolactin, growth hormone, thyroid stimulating hormone, adrenocorticotropic hormone, follicle-stimulating hormone, and luteinizing hormone. These hormones are regulated by feedback from their target organs/tissues. Negative feedback maintains homeostasis by inhibiting hormone production when levels are sufficient. The hypothalamus controls the anterior pituitary through releasing and inhibiting hormones like CRH and somatostatin.
The document discusses drugs that act on the pituitary gland. It describes:
1. The anterior pituitary hormones that regulate other endocrine glands and growth.
2. The hypothalamic hormones that control anterior pituitary function.
3. The posterior pituitary hormones oxytocin and vasopressin, and their clinical uses including diabetes insipidus and bleeding disorders.
The document discusses hormones of the hypothalamic-pituitary-thyroid axis. It describes how thyroid stimulating hormone regulates thyroid hormone synthesis and secretion, the mechanisms of action of thyroid hormones, and their effects on increasing metabolism. The hormones discussed include thyroid stimulating hormone, thyroxine, and triiodothyronine.
Introduction of hormone & Anterior pituitary drugs Manoj Kumar
The document discusses hormones secreted by the hypothalamus and anterior pituitary gland. It describes how these hormones regulate growth, metabolism, and sexual development/function by binding to receptor sites in target tissues. The hormones are released into the bloodstream and can affect multiple organs. The hypothalamus regulates hormone secretion through releasing or inhibiting factors. Some key anterior pituitary hormones discussed include growth hormone, prolactin, gonadotropins, and their functions.
The document discusses several hormones produced by the anterior pituitary gland, including their physiological functions, regulation, pathological involvement, and clinical uses. Growth hormone promotes body growth, while prolactin induces milk production. Gonadotropins like FSH and LH regulate the reproductive system. TSH stimulates thyroid hormone production. ACTH regulates steroidogenesis in the adrenal cortex. The secretion of these hormones is controlled by hormones from the hypothalamus through G-protein coupled receptors to maintain homeostasis. Imbalances can result in disorders like acromegaly, hyperprolactinemia, infertility, hypothyroidism, and Cushing's syndrome.
This document summarizes pituitary and hypothalamic hormones. It describes how the hypothalamus regulates the anterior pituitary through releasing factors. The anterior pituitary then regulates other endocrine glands through six main hormones: growth hormone, thyroid stimulating hormone, adrenocorticotropic hormone, follicle stimulating hormone, luteinizing hormone, and prolactin. The posterior pituitary secretes oxytocin and antidiuretic hormone. Each hormone's structure, function, and role in feedback loops controlling hormone release is summarized.
This document summarizes molecular and cellular mechanisms of growth hormone, prolactin, thyroid hormones, and sex hormones. It discusses the physiology, regulation of secretion, pathological involvements, uses and adverse effects of each hormone. Growth hormone promotes growth and metabolism. Prolactin induces milk production. Thyroid hormones include thyroxine and triiodothyronine which increase metabolism. Gonadotropins like FSH and LH regulate gamete production and sex hormone secretion.
The document summarizes the hormones of the hypothalamic-pituitary axis. It describes the major classes of hormones, their functions, regulation, and pharmacological applications. The hypothalamus controls the pituitary gland, which secretes hormones like growth hormone, prolactin, thyroid-stimulating hormone, and adrenocorticotropic hormone to regulate other endocrine glands. Gonadotropin-releasing hormone controls the release of follicle-stimulating hormone and luteinizing hormone from the pituitary. The posterior pituitary secretes oxytocin and vasopressin/antidiuretic hormone in response to physiological signals.
This document discusses drugs used to treat infertility and erectile dysfunction. It begins by defining infertility and describing its various causes in men and women. It then discusses various drug classes used to treat female infertility, including gonadotropins, clomiphene, aromatase inhibitors, and metformin for PCOS. For male infertility, it covers testosterone replacement therapy. The document also defines erectile dysfunction and its causes before discussing treatment options, including PDE5 inhibitors like sildenafil and tadalafil, as well as other therapies. Side effects and important considerations for various drugs are provided.
This document discusses the anterior pituitary hormones. The anterior pituitary gland secretes several hormones including growth hormone, prolactin, follicle-stimulating hormone, luteinizing hormone, thyroid-stimulating hormone, and adrenocorticotropic hormone. These hormones are regulated by hypothalamic-releasing hormones that stimulate or inhibit their secretion. The roles, regulation, and clinical uses of some key anterior pituitary hormones like growth hormone, prolactin, and gonadotropins are described in further detail.
Growth hormone and prolactin are peptide hormones produced by the pituitary gland. Growth hormone promotes growth and development while prolactin promotes breast development and milk production. Their secretion is regulated by hormones from the hypothalamus such as growth hormone releasing hormone and prolactin inhibiting hormone (dopamine). Abnormal levels can cause diseases - high growth hormone causes gigantism or acromegaly, low growth hormone causes dwarfism, and high prolactin causes infertility. Somatostatin and octreotide inhibit growth hormone and prolactin secretion and are used to treat conditions caused by their excess.
This document provides information about GnRH agonists and antagonists. It begins with an introduction to gonadotropin-releasing hormone (GnRH) and how it regulates the reproductive system. It then discusses GnRH agonists like goserelin and leuprolide, which are used to treat conditions like prostate cancer and endometriosis. While they initially stimulate hormone release, continuous use causes downregulation and inhibition of hormone production. Side effects include hot flashes and loss of libido. The document also briefly mentions GnRH antagonists which immediately inhibit hormone secretion.
The document summarizes several endocrine hormones produced by the anterior pituitary gland, including their target tissues and regulation. It discusses the six hormones produced by the anterior pituitary - prolactin, growth hormone, thyroid stimulating hormone, adrenocorticotropic hormone, follicle-stimulating hormone, and luteinizing hormone. It also describes the hypothalamic-pituitary feedback loops that regulate hormone production and secretion.
The summary is as follows:
1. The hypothalamus produces releasing and inhibiting hormones that regulate the pituitary gland, which secretes hormones that control other endocrine glands and tissues.
2. Pituitary hormones include growth hormone, thyroid-stimulating hormone, adrenocorticotropic hormone, gonadotropins, prolactin, oxytocin, and antidiuretic hormone.
3. Hypothalamic hormones and pituitary hormones are used clinically for various purposes such as diagnosing endocrine disorders, stimulating growth, and controlling hormone-secreting tumors.
The anterior pituitary gland secretes several important hormones. Growth hormone promotes growth and development. Prolactin stimulates lactation. Gonadotropins such as LH and FSH regulate the reproductive system. ACTH regulates cortisol production and TSH controls thyroid function. These hormones are regulated by hypothalamic factors and provide feedback control of their target organs. Disorders can arise from excess or deficiency of anterior pituitary hormones, leading to important diseases like acromegaly, Cushing's syndrome, and hypothyroidism.
The anterior pituitary produces six hormones: prolactin, growth hormone, thyroid stimulating hormone, adrenocorticotropic hormone, follicle-stimulating hormone, and luteinizing hormone. These hormones are regulated by feedback from their target organs/tissues on the hypothalamus and pituitary. The document discusses the cell types that produce each hormone, their targets, and mechanisms of feedback regulation. It also covers specific hormones and conditions in more detail, including ACTH regulation and diseases like Cushing's syndrome and Addison's disease.
The anterior pituitary produces six hormones: prolactin, growth hormone, thyroid stimulating hormone, adrenocorticotropic hormone, follicle-stimulating hormone, and luteinizing hormone. These hormones are regulated by feedback from their target organs/tissues. Negative feedback maintains homeostasis by inhibiting hormone production when levels are sufficient. The hypothalamus controls the anterior pituitary through releasing and inhibiting hormones like CRH and somatostatin.
The document discusses drugs that act on the pituitary gland. It describes:
1. The anterior pituitary hormones that regulate other endocrine glands and growth.
2. The hypothalamic hormones that control anterior pituitary function.
3. The posterior pituitary hormones oxytocin and vasopressin, and their clinical uses including diabetes insipidus and bleeding disorders.
The document discusses hormones of the hypothalamic-pituitary-thyroid axis. It describes how thyroid stimulating hormone regulates thyroid hormone synthesis and secretion, the mechanisms of action of thyroid hormones, and their effects on increasing metabolism. The hormones discussed include thyroid stimulating hormone, thyroxine, and triiodothyronine.
Introduction of hormone & Anterior pituitary drugs Manoj Kumar
The document discusses hormones secreted by the hypothalamus and anterior pituitary gland. It describes how these hormones regulate growth, metabolism, and sexual development/function by binding to receptor sites in target tissues. The hormones are released into the bloodstream and can affect multiple organs. The hypothalamus regulates hormone secretion through releasing or inhibiting factors. Some key anterior pituitary hormones discussed include growth hormone, prolactin, gonadotropins, and their functions.
The document discusses several hormones produced by the anterior pituitary gland, including their physiological functions, regulation, pathological involvement, and clinical uses. Growth hormone promotes body growth, while prolactin induces milk production. Gonadotropins like FSH and LH regulate the reproductive system. TSH stimulates thyroid hormone production. ACTH regulates steroidogenesis in the adrenal cortex. The secretion of these hormones is controlled by hormones from the hypothalamus through G-protein coupled receptors to maintain homeostasis. Imbalances can result in disorders like acromegaly, hyperprolactinemia, infertility, hypothyroidism, and Cushing's syndrome.
This document summarizes pituitary and hypothalamic hormones. It describes how the hypothalamus regulates the anterior pituitary through releasing factors. The anterior pituitary then regulates other endocrine glands through six main hormones: growth hormone, thyroid stimulating hormone, adrenocorticotropic hormone, follicle stimulating hormone, luteinizing hormone, and prolactin. The posterior pituitary secretes oxytocin and antidiuretic hormone. Each hormone's structure, function, and role in feedback loops controlling hormone release is summarized.
This document summarizes molecular and cellular mechanisms of growth hormone, prolactin, thyroid hormones, and sex hormones. It discusses the physiology, regulation of secretion, pathological involvements, uses and adverse effects of each hormone. Growth hormone promotes growth and metabolism. Prolactin induces milk production. Thyroid hormones include thyroxine and triiodothyronine which increase metabolism. Gonadotropins like FSH and LH regulate gamete production and sex hormone secretion.
The document summarizes the hormones of the hypothalamic-pituitary axis. It describes the major classes of hormones, their functions, regulation, and pharmacological applications. The hypothalamus controls the pituitary gland, which secretes hormones like growth hormone, prolactin, thyroid-stimulating hormone, and adrenocorticotropic hormone to regulate other endocrine glands. Gonadotropin-releasing hormone controls the release of follicle-stimulating hormone and luteinizing hormone from the pituitary. The posterior pituitary secretes oxytocin and vasopressin/antidiuretic hormone in response to physiological signals.
This document discusses drugs used to treat infertility and erectile dysfunction. It begins by defining infertility and describing its various causes in men and women. It then discusses various drug classes used to treat female infertility, including gonadotropins, clomiphene, aromatase inhibitors, and metformin for PCOS. For male infertility, it covers testosterone replacement therapy. The document also defines erectile dysfunction and its causes before discussing treatment options, including PDE5 inhibitors like sildenafil and tadalafil, as well as other therapies. Side effects and important considerations for various drugs are provided.
This document discusses the anterior pituitary hormones. The anterior pituitary gland secretes several hormones including growth hormone, prolactin, follicle-stimulating hormone, luteinizing hormone, thyroid-stimulating hormone, and adrenocorticotropic hormone. These hormones are regulated by hypothalamic-releasing hormones that stimulate or inhibit their secretion. The roles, regulation, and clinical uses of some key anterior pituitary hormones like growth hormone, prolactin, and gonadotropins are described in further detail.
Similar to 1 Pituitary and Thyroid pharmacology, Naim Kittana.pptx (20)
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Does Over-Masturbation Contribute to Chronic Prostatitis.pptxwalterHu5
In some case, your chronic prostatitis may be related to over-masturbation. Generally, natural medicine Diuretic and Anti-inflammatory Pill can help mee get a cure.
These lecture slides, by Dr Sidra Arshad, offer a quick overview of the physiological basis of a normal electrocardiogram.
Learning objectives:
1. Define an electrocardiogram (ECG) and electrocardiography
2. Describe how dipoles generated by the heart produce the waveforms of the ECG
3. Describe the components of a normal electrocardiogram of a typical bipolar lead (limb II)
4. Differentiate between intervals and segments
5. Enlist some common indications for obtaining an ECG
6. Describe the flow of current around the heart during the cardiac cycle
7. Discuss the placement and polarity of the leads of electrocardiograph
8. Describe the normal electrocardiograms recorded from the limb leads and explain the physiological basis of the different records that are obtained
9. Define mean electrical vector (axis) of the heart and give the normal range
10. Define the mean QRS vector
11. Describe the axes of leads (hexagonal reference system)
12. Comprehend the vectorial analysis of the normal ECG
13. Determine the mean electrical axis of the ventricular QRS and appreciate the mean axis deviation
14. Explain the concepts of current of injury, J point, and their significance
Study Resources:
1. Chapter 11, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 9, Human Physiology - From Cells to Systems, Lauralee Sherwood, 9th edition
3. Chapter 29, Ganong’s Review of Medical Physiology, 26th edition
4. Electrocardiogram, StatPearls - https://www.ncbi.nlm.nih.gov/books/NBK549803/
5. ECG in Medical Practice by ABM Abdullah, 4th edition
6. Chapter 3, Cardiology Explained, https://www.ncbi.nlm.nih.gov/books/NBK2214/
7. ECG Basics, http://www.nataliescasebook.com/tag/e-c-g-basics
- Video recording of this lecture in English language: https://youtu.be/kqbnxVAZs-0
- Video recording of this lecture in Arabic language: https://youtu.be/SINlygW1Mpc
- Link to download the book free: https://nephrotube.blogspot.com/p/nephrotube-nephrology-books.html
- Link to NephroTube website: www.NephroTube.com
- Link to NephroTube social media accounts: https://nephrotube.blogspot.com/p/join-nephrotube-on-social-media.html
Rasamanikya is a excellent preparation in the field of Rasashastra, it is used in various Kushtha Roga, Shwasa, Vicharchika, Bhagandara, Vatarakta, and Phiranga Roga. In this article Preparation& Comparative analytical profile for both Formulationon i.e Rasamanikya prepared by Kushmanda swarasa & Churnodhaka Shodita Haratala. The study aims to provide insights into the comparative efficacy and analytical aspects of these formulations for enhanced therapeutic outcomes.
TEST BANK For Basic and Clinical Pharmacology, 14th Edition by Bertram G. Kat...rightmanforbloodline
TEST BANK For Basic and Clinical Pharmacology, 14th Edition by Bertram G. Katzung, Verified Chapters 1 - 66, Complete Newest Version.
TEST BANK For Basic and Clinical Pharmacology, 14th Edition by Bertram G. Katzung, Verified Chapters 1 - 66, Complete Newest Version.
TEST BANK For Basic and Clinical Pharmacology, 14th Edition by Bertram G. Katzung, Verified Chapters 1 - 66, Complete Newest Version.
TEST BANK For Basic and Clinical Pharmacology, 14th Edition by Bertram G. Katzung, Verified Chapters 1 - 66, Complete Newest Version.
6. 1. Agents Affecting Growth Hormone (Somatotropin)
– Growth hormone-releasing hormone (GHRH)
• Released from the hypothalamus
• Binds to specific membrane GHRH receptors on pituitary.
• GHRH rapidly elevates serum growth hormone (somatotropin)
levels with high specificity.
6
8. Growth hormone (GH)
• Hypersecretion causes
gigantism in children and
acromegaly in adults
• Hyposecretion in children
causes pituitary dwarfism.
8
9. 1. Agents Affecting Growth Hormone (Somatotropin)
– Somatotropin release-inhibiting hormone (SST, somatostatin)
• Example of SST analogue: Octreotide
• Inhibits the release of Somatotropin (GH) & TSH from the pituitary
• Inhibits the release of glucagon and insulin from the pancreas.
• Inhibits the secretion of gut peptides such as vasoactive intestinal
polypeptide (VIP) and gastrin
• It inhibits the growth and proliferation of many cell types.
9
10. 1. Agents Affecting Growth Hormone (Somatotropin)
• Octreotide is an SST analog administered by SC, IM, or IV injection.
• Octreotide is used to treat:
– Acromegaly
– Severe diarrhea associated with hypersecretory states such as VIP-
secreting tumors (VIPomas)
– Gastrinoma
– Glucagonoma
– TSH-secreting adenomas
– Variceal and upper GI bleeding (mediated by a splanchnic vasoconstrictive effect)
10
12. 2. Gonadotropin-releasing Hormone (GnRH) and Analogs
Pulsatile administration
– Short-term or pulsatile administration of GnRH agonists (every 1–4 h)
by computerized pump increases the synthesis and release of both LH
& FSH
– Treatment of certain types of infertility
12
13. Chronic administration
– 2–4 weeks of daily administration of GnRH inhibits the release of both
LH & FSH
– Caused by a reduction in the number of GnRH receptors on the
anterior pituitary.
– Leads to reduced production of gonadal steroids; Androgens &
Estrogens (chemical castration).
13
2. Gonadotropin-releasing Hormone (GnRH) and Analogs
14. Chronic administration
• Useful in the treatment of
– Precocciuos puberty
– Hormone-dependent cancers and hyperplasias such as prostate
cancer, breast cancer, endometriosis, and fibroids.
• Available as implantable formulation
14
2. Gonadotropin-releasing Hormone (GnRH) and Analogs
15. Adverse effects in Women:
– Hot flushes and sweating
– Diminished libido and depression
– Ovarian cysts
– Contraindicated in pregnancy and breast-feeding
15
2. Gonadotropin-releasing Hormone (GnRH) and Analogs
16. Adverse effects in Men:
– Hot flushes and edema
– Bone pain due to initial rise in testosterone levels
– Diminished libido
– Gynecomastia
16
2. Gonadotropin-releasing Hormone (GnRH) and Analogs
17. – Common example:
• Ganirelix
• Abarelix
• Cetrorelix
• GnRH antagonists competitively and reversibly bind to GnRH receptors in
the pituitary gland, blocking the release of LH and FSH from the pituitary.
17
GnRH Receptor Antagonists
18. • In men, the reduction in LH subsequently leads to rapid suppression
of testosterone release from the testes
• In women it leads to suppression of estrogen release from the ovaries.
• GnRH antagonists have an immediate onset of action, rapidly reducing sex
hormone levels without an initial surge
• This is unlike the GnRH agonists, which cause an initial surge in
testosterone or estrogen levels
18
GnRH Receptor Antagonists
19. • Prostate cancer
• Hormone-sensitive breast cancer
• Some benign disorders such as endometriosis and uterine fibroids
• Some cases of infertility: Prevents premature LH surge
19
Clinical Uses of GnRH Receptor Antagonists
20. 3. Prolactin-releasing factor (PRF) and prolactin-inhibiting
factor (PIF)
– Secretion of prolactin from the pituitary is controlled by both:
• Stimulation (mediated by PRF)
• Inhibition (mediated by PIF = dopamine)
20
21. Prolactin-releasing factor (PRF)
• Drugs that reduce CNS dopaminergic activity (antidopaminergics) cause an
increase in prolactin secretion:
₋ Antipsychotics
₋ Antidepressants
₋ Anti-anxiety
• Drugs that promote prolactin secretion can be used to treat lactation
failure.
21
22. Prolactin-inhibiting factor (PIF) (dopamine agonists)
• Inhibition of prolactin secretion can be produced by a number of dopamine
agonists:
– Bromocriptine acts as an agonist of dopamine D2-receptors and an
antagonist of D1-receptors.
– Cabergoline (DOSTINEX ®)
A potent D2 agonist with greater D2 selectivity.
It is more effective in reducing hyperprolactinemia than bromocriptine
Has a long half-life that permits twice-weekly dosing.
22
23. Prolactin-inhibiting factor (PIF) (dopamine agonists)
– Therapeutic uses of PIF:
• Inhibition of prolactin secretion in amenorrhea, galactorrhea, and
prolactin-secreting tumors
• The correction of female infertility secondary to hyperprolactinemia
• Treatment of Parkinson disease.
23
25. Growth hormone
– Growth hormone agonists: (GH, somatotropin), methionyl-growth
hormone (somatrem)
– GH is released in a pulsatile manner, with the highest levels during sleep
– GH secretion decreases with increasing age
– Administered SC or IM
– Half-life: 25 min, but sufficient to induce IGF-1 release by the liver, which
is responsible for the GH-like actions
25
26. – Therapeutic uses of GH:
• Replacement therapy in children with GH deficiency before
epiphyseal closure
• Growth failure due to Prader-Willi syndrome
• To stimulate growth in patients with Turner syndrome
• Other approved uses include long-term replacement of GH
deficiency in adults, treatment of cachexia and AIDS wasting
26
Growth hormone
27. – Side effects of GH:
• Edema
• Arthralgias and myalgias
• Flue-like symptoms
• Increase the risk of Diabetes
• Should not be given to children with closed epiphysis
27
Growth hormone
28. Growth hormone antagonists
– Pegvisomant
• Pegvisomant is a GH receptor antagonist
• Blocks the action of endogenous GH
• Used specifically for the treatment of acromegaly
• Pegvisomant is administered SC
28
29. Gonadotropins (LH & FSH)
• Gonadotropins (Luteinizing hormone and follicle-stimulating hormone)
– Actions and pharmacologic properties:
• In women,
– LH increases estrogen production in the ovary and is required for
progesterone production by the corpus luteum after ovulation
– FSH is required for normal development and maturation of the
ovarian follicles
• In men,
– LH induces testosterone production by the interstitial (Leydig) cells
of the testis
– FSH acts on the testis to stimulate spermatogenesis and the
synthesis of androgen-binding protein
29
31. – FSH and LH of pituitary origin are not used pharmacologically.
– Menotropins (human menopausal gonadotropins, hMG) :
• Isolated from the urine of postmenopausal women
• Contain a mixture of LH and FSH
• Urofollitropin (Bravelle) is immunologically purified FSH from the
urine of pregnant women.
– Follitropin α/β are recombinant FSH products
31
Gonadotropins (LH & FSH)
32. – hCG:
• hCG is nearly identical in activity to LH
• Produced by the placenta and can be isolated and purified from the
urine of pregnant women
• The alpha subunit is made by recombinant DNA technology
(choriogonadotropin α)
– All of these hormones must be administered parenterally (SC or IM)
32
Gonadotropins (LH & FSH)
33. • Therapeutic uses of hCG:
– hCG can be used in both M &F to stimulate gonadal steroidogenesis in
cases of LH insufficiency
– hCG can be used to induce external sexual maturation and
spermatogenesis in men with secondary hypogonadism, but this may
require months of treatment
33
Gonadotropins (LH & FSH)
– In the absence of an anatomic block,
hCG can also promote the descent of
the testes in cryptorchidism
34. • Therapeutic uses of hMG:
– Menotropins (hMG) are used in concert with hCG to stimulate
ovulation in women with functioning ovaries:
Injection of hMG or FSH products over a period of 5-12 days causes
ovarian follicular growth and maturation,
then hCG is injected one day after the last dose of FSH to induce
ovulation.
34
Gonadotropins (LH & FSH)
35. • Adverse effects of Menotropins and hCG
– Ovarian enlargement in about 20% of treated women
– Ovarian life-threatening hyperstimulation syndrome in up to 1% of
patients:
– Ascites
– Hypovolemia and shock
– Acute respiratory distress
35
Gonadotropins (LH & FSH)
37. Anti-diuretic Hormone (ADH, Vasopressin)
– ADH is synthesized in the hypothalamus and stored in the posterior pituitary
– ADH is released in response to increasing plasma osmolarity or hypotension
– The actions of ADH are mediated by three types of specific receptors:
• V1a: located in vascular smooth muscle, myometrium, and kidney
• V1b: located in the CNS and adrenal medulla
• V2: located in renal tubules
37
38. Anti-diuretic Hormone (ADH, Vasopressin)
• In renal tubules, ADH causes the permeability of water to increase and also
increases the transport of urea in the inner medullary collecting duct, which
increases the urine-concentrating ability of the kidney
• ADH causes vasoconstriction at higher doses
• ADH stimulates the hepatic synthesis of coagulation factor VIII and
von Willebrand factor.
38
39. – ADH preparations
• Aqueous vasopressin (Pitressin),
a short-acting preparation
Acts on both V1 and V2 receptors,
is administered parenterally and lasts 2–6 hours
• Desmopressin acetate (DDAVP, Stimate)
longer lasting (10–20 h) preparation
administered intranasally, parenterally, or orally
Selective on V2 receptors
39
Anti-diuretic Hormone (ADH, Vasopressin)
40. – Therapeutic uses
• Desmopressin is the most effective treatment for severe central diabetes
insipidus
because its V2 activity is 3,000 times greater than its V1 activity;
but it is not effective in the nephrogenic form of the disease
• Desmopressin is useful in nocturnal enuresis by reducing nighttime urine
production
• Vasopressin is included in the advanced cardiac life support protocol as a
substitute for epinephrine in cardiac arrest with asystole
40
Anti-diuretic Hormone (ADH, Vasopressin)
41. Syndrome of inappropriate antidiuretic hormone secretion
(SIADH)
• Hyponatremia is the most frequent electrolyte disorder.
• Therapeutic modalities include nonspecific measures:
• –fluid restriction
• –hypertonic saline
• Vasopressin receptor antagonists, called Vaptans (like Tolvaptan), have been
introduced as specific and direct therapy of SIADH.
• The side effects are thirst, polydipsia and frequency of urination.
41
42. Oxytocin
– Oxytocin is synthesized in the hypothalamus and secreted by the
posterior pituitary.
– Actions and pharmacologic properties
• Elicits milk ejection from the breast.
• Stimulates contraction of uterine smooth muscle.
• The plasma t1/2 of oxytocin is 5–10 minutes.
– Therapeutic uses
• Is used for induction and maintenance of labor.
• Stimulates milk ejection from the breast.
• Postpartum uterine bleeding.
42
45. Synthesis of thyroid hormones
• Steps:
1. Iodide (I-) is trapped by sodium-iodide
2. Iodide is oxidized by thyroidal peroxidase to iodine (I.)
3. Tyrosine in thyroglobulin is iodinated and forms MIT & DIT
4. Iodotyrosines condensation
MIT+DIT→T3; DIT+DIT→T4
45
47. Physiological actions of thyroid hormones
• To normalize growth and development, body temperature, and energy
levels
• Eitiology of hypothyroidism:
Hashimoto disease
Simple goiter
After surgery and ablation of thyroid after surgery
Congenital
• Insufficiency (Hypothyroidism) causes:
Cretinism (infant & child)
Myxedema (adult)
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49. Goiter
• An enlarged protruding thyroid gland
• Occurs if myxedema results from lack of Iodine
• The follicular cells produce colloid but cannot
iodinate it and make functional hormones.
• The pituitary gland secretes increasing amounts
of TSH in an attempt to stimulate the thyroid to
produce TH, but the only result is that the
follicles accumulate more and more unusable
colloid.
49
50. Cretinism
• Severe hypothyroidism in infants
• The child is mentally retarded and has a short, disproportionately sized
body and a thick tongue and neck
• Thyroid hormone replacement therapy can prevent cretinism if
diagnosed early enough
50
51. Physiological actions of thyroid hormones
• Excess secretion of thyroid hormone (Hyperthyroidism) most commonly
results from: Graves disease and toxic goiter
• Severe Hyperthyroidism: results in thyrotoxicosis (thyroid storm)
51
52. Graves’ disease
• The most common hyperthyroid disease
• It is an autoimmune condition
• Abnormal antibodies are directed against thyroid follicular cells.
• Rather than marking these cells for destruction as antibodies normally
do, these antibodies mimic TSH and continuously stimulate TH release.
52
53. Typical symptoms of Graves’ disease
• Elevated metabolic rate
• Sweating
• Rapid and irregular heartbeat
• Nervousness
• Weight loss despite adequate food
• Eyeballs may protrude (exophthalmos) if the
tissue behind the eyes becomes edematous
and fibrous
53
54. 54
• Some of T4 are converted to T3
in kidney and liver
• The actions of T3 on several
organ systems are shown
• Mechanism of actions of thyroid
hormones
T3, via its nuclear
receptor, induces new
proteins generation
which produce effects
BMR: basal metabolic rate
55. Thyroid drugs
55
• Representative drugs: levothyroxine (L-T4), liothyronine (T3)
Clinical use:
1. Hypothyroidism: cretinism & myxedema;
2. simple goiter
3. Others
Adverse reactions:
Overdose leads to thyrotoxicosis and angina or MI (usually in ageds)
57. Thioamides
57
Mechanism of action: All thioamides inhibit
Peroxidase-catalyzing reactions
Iodine organification
Iodotyrosines condensation
Propylthiouracil also inhibit T4 conversion into T3
Pharmacological action: They inhibit thyroid hormone synthesis
58. Thioamides
58
• Thioamaides have no effects on thyroglobulin already stored in the gland,
• As a result the clinical effects appears slowly until thyroglobulin stores are
depleted.
• Methemazole is preferred over PTU because it has a longer t1/2 (given once
daily)
• PTU is recommended during the first trimester of pregnancy, due to a
greater risk of teratogenecity associated with methimazole.
59. Clinical use of Thioamides
• Mild hyperthyroidism
• For those surgery & 131I are not permitted
• Operation preparation
• Thyroid crisis (comprehensive therapy).
59
60. Adverse effects of Thioamides
• Long-term use leads to thyroid hyperplasia
• Pruritic maculopapular rash is the most common adverse reaction
• Agranulocytosis
60
61. Iodides (NaI, KI)
• Pharmacological action (Wolff-Chaikoff effect): Inhibition of T3 & T4
release and synthesis.
• This effect lasts only for few weeks
• Decrease of size & vascularity of the hyperplastic gland
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62. Iodides (NaI, KI)
Clinical use
• Treatment of Thyroid Storm
• Prior to surgery (Decrease of size & vascularity of the gland)
62
Adverse reactions
• Acneiform rash
• Swollen salivary glands
• Mucous membrane ulcerations
63. Radioactive iodine (131I)
• 131I is the only isotope for treatment of thyrotoxicosis.
• Its therapeutic effect depends on emission of β rays
• It has an effective half-life of 5 days & a penetration range of 0.4-2 mm.
• Woman in pregnancy or lactation is forbidden!
63
Octreotide acetate injection is indicated to reduce blood levels of growth hormone and IGF-I (somatomedin C) in acromegaly patients who have had inadequate response to or cannot be treated with surgical resection, pituitary irradiation, and bromocriptine mesylate at maximally tolerated doses. The goal is to achieve normalization of growth hormone and IGF-I (somatomedin C) levels. In patients with acromegaly, Octreotide acetate injection reduces growth hormone to within normal ranges in 50% of patients and reduces IGF-I (somatomedin C) to within normal ranges in 50% to 60% of patients. Since the effects of pituitary irradiation may not become maximal for several years, adjunctive therapy with Octreotide acetate injection to reduce blood levels of growth hormone and IGF-I (somatomedin C) offers potential benefit before the effects of irradiation are manifested.
the mechanisms of action of somatostatin and octreotide in the therapy of bleeding oesophageal varices are mainly mediated by a splanchnic vasoconstrictive effect. Furthermore, gastric acid suppression and potential enhancement of platelet aggregation may contribute to the beneficial outcome after treatment of oesophageal varices with somatostatin
esophageal varices (or oesophageal varices) are extremely dilated sub-mucosal veins in the lower third of the esophagus . They are most often a consequence of portal hypertension , commonly due to cirrhosis ; patients with esophageal varices have a strong tendency to develop bleeding
In people who have cirrhosis, high blood pressure in the veins that carry blood from the intestines to the liver (portal hypertension) causes many problems. One serious complication of portal hypertension is variceal bleeding. When blood pressure increases in the portal vein system, veins in the esophagus, stomach, and rectum enlarge to accommodate blocked blood flow through the liver.
Short-term or pulsatile administration of GnRH agonists: by computerized pump
Precocciuos puberty: unusually early puberty can have adverse effects on social behavior and psychological development, can reduce adult height potential, and may shift some lifelong health risks. Central precocious puberty can be treated by suppressing the pituitary hormones that induce sex steroid production. Can be Central: If the cause can be traced to the hypothalamus or pituitary.
Peripheral: gonadal tumors, adrenal tumors, germ cell tumor, congenital adrenal hyperplasia, McCune–Albright syndrome,
Prader-Willi syndrome a rare congenital disorder characterized by learning difficulties, growth abnormalities, and obsessive eating, caused especially by the absence of certain genes normally present on the copy of chromosome 15 inherited from the father.
Turner syndrome (TS) also known as 45,X, is a condition in which a female is partly or completely missing an X chromosome
After ovulation, the anterior pituitary hormones FSH and LH cause the remaining parts of the dominant follicle to transform into the corpus luteum. It continues to grow for some time after ovulation and produces significant amounts of hormones, particularly progesterone
abnormalities can result from disease of the testes (primary hypogonadism) or disease of the pituitary or hypothalamus (secondary hypogonadism).
About 1 to 2 percent of women undergoing ovarian stimulation develop a severe form of ovarian hyperstimulation syndrome. Severe OHSS can be life-threatening. Complications may include:
Fluid collection in the abdomen and sometimes the chest
Electrolyte disturbances (sodium, potassium, others)
Blood clots in large vessels, usually in the legs
Kidney failure
Twisting of an ovary
Rupture of a cyst in an ovary, which can lead to serious bleeding
Breathing problems
Pregnancy loss from miscarriage or termination because of complications
Rarely, death
V1a causes smooth muscle contractions
In the medulla, ADH stimulates catecholamine secretion
ADH acts as a neuropeptide that is capable of influencing a wide variety of brain functions such as social behavior, emotionality, learning and memory, and thermoregulation
Response time and the initiation of cardiopulmonary resuscitation (CPR) remain the most important factors determining successful revival. During resuscitation, sympathomimetics are given to enhance cerebral and coronary perfusion pressures in an attempt to achieve restoration of spontaneous circulation.
Agranulocytosis: a deficiency of granulocytes in the blood, causing increased vulnerability to infection.