DB30 - Pituitary Pharmacology

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  Pituitary Pharmacology The anterior pituitary produces GH, TSH, ACTH, Prolactin, and FSH/LH.The posterior pituitary stores and releases ADH and oxytocin, both produced in the hypothalaus. Reducing GH secretion GH production is stiulated by GH!H and inhibited by somatostatin . le#ated GH causes acroe$aly.GH stiulates peripheral production o%  IGF-1, which is used to guage GH levels .GH!H is used dia$nostically to deterine GH reser#es in the anterior pituitary.All GH anta$onists except Pegvisomant   act centrally to bloc& GH secretion.''Soatostatin (S!)F* is used to reduce GH secretion by GH'producin$ tuors.''+ctreotide (Sandostatin* is a  somatostatin analogue with longer half life . )t noralies )GF'- in0 o% patients. Side e%%ects include  gallstones  and G) syptos.''Caber$oline is a dopaine'li&e a$ent that noralies )GF'- in 120 o% patients.'' Pegvisomant  is a GH antagonist that prevents dimeriation of the GH receptor  . Thus, it acts  peripherally  to bloc& the action o% GH, rather than centrally to bloc& the synthesis o% GH. This noralies )GF'- in 30 o% patients.(!ayond reo#ed ia$e sho4in$ pe$#isoant anta$oniin$ GH'receptor dieriation.* Reducing Prolactin secretion Prolactin secretion is priarily under inhibitory control by dopamine .Prolactinoas express the D1 dopaine receptor, so they are susceptible to inhibition by dopaine.Dopainer$ic a$ents reduce prolactin synthesis/secretion as 4ell as shrin& prolactinoa tuors.''5roocriptine non'selecti#ely binds D- and D1 receptors.''Caber$oline selecti#ely binds D1 receptors, so it has %e4er side e%%ects.''Per$olide non'selecti#ely binds D- and D1 receptors. )t treats Par&inson6s and prolactinoas. Reducing Gonadotropin secretion Gonadotropins contribute to precocious puberty, prostate cancer, and endoetriosis by boostin$ sex horone production. 5loc&in$ $onadotropins causes cheical castration.Gonadotropins include LH and FSH, 4hich are secreted by the pituitary only in response to  pulsatile Gn!H stimulation #ontinuous Gn!H stimulation down-regulates secretion$ ''Leuprolide is a Gn!H analo$ue that causes cheical castration a%ter a transient rise in $onadotropin le#els. ADH pharmacology and the treatment of diabetes insipidus ''L'ar$inine #asopressin is 7ust noral ADH. )t has a short hal% li%e.''Desopressin (dDA8P* is an  %&H analogue with much longer half life and greater specificity . )GF'   -  Patients should experience polyuria each tie be%ore ta&in$ their next dose. This ensures that the dDA8P has 4orn o%%, 4hich protects a$ainst overdose . +#erdose o% dDA8P causes dan$erous euvolemic hyponatremia .
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