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- Glands of endocrine system (7)
- 1. Pituitary 2. Thyroid 3. Parathyroid 4. Adrenal 5. Pancreas 6. Gonads 7. Placenta
- 1 major morphological feature of endocrine glands
- They are ductless
- Hormones are potent and rapidly degraded. Where (4) and t1/2?
- 1. ciruclation 2. liver 3. kidney 4. target cell; t1/2=10-30minutes
- Define: Autocrine action
- hormone acts on same cell it is produced
- Define: Paracrine action
- hormone acts on neighboring cells
- Define: Endocrine action
- hormone acts on distant cell
- In the Hypo-Pituitary-Target Gland, which is part of the nervous system and which is part of the endocrine system?
- Hypo=nervous system, Pituitary=endocrine system
- In the Hypo-Pituitary-Target Gland, what provides negative feedback to decrease secretion of Hypo and Pituitary?
- The hormone that the target gland secretes
- 5 disorders of endocrine system
- 1. hyper 2. hypo 3. abnormalities in hormone receptors on target cells 4. abnormal biochemical pathways 5. hormone resistance
- 3 causes of hyperactivity
- 1. malignancies 2. anti-receptor antibodies stimulating receptor 3. ingestion of exogenous hormones for non-endocrine disease
- 2 causes of hypoactivity
- 1. destructive process in gland where hormone is produced 2. genetic defects in hormone formations
- Define hormone resistance
- Hormone normal or inclrease but no physiological action
- 4 causes of hormone resistance
- 1. defect in receptor 2. reduction in number of receptors 3. antibodies to hormone or receptors 4. defects in post-receptor signal transduction mechanism
- 4 clinical uses of hormones
- 1. HRT 2. Inhibit release of other hormones 3. Tx non-endocrine disease 4. Diagnositic agent to assess function of target tissues
- What does hypothalamus regulate in the body (5)
- 1. temp 2. water balance 3. biological rhythms 4. drives 5. motions
- Describe the pituitary-hypothalamus relationship
- Neurons in hypo produce small peptides to bloodstream then travel to ant. Pituitary and stimulate/inhibit relese of a hormone
- 6 hypothalamic hormones and which pituitary hormone they act on
- 1. GHRH --> GH 2. GHIH (somatostatin) -->GH 3. CRH-->ACTH (adrenocorticotropin) 4. GnRH/LHRH --> (FSH/LH) 5. TRH--> TSH 6. PIH (dopamine) --> PRL (prolactin)
- Another name for pituitary
- Hypophysis
- Another name for anterior pituitary
- adenohypophysis
- Another name for posterior pituitary
- neuralhypophysis
- Which part of pituitary is connected to braine?
- Posterior via neural pathway, anterior is not directly connected to brain
- GH targets which tissues?
- Mostly all tissues but main effects on skeletal muscle and bone
- 3 things that causes GH to increase
- 1. GHRH 2. Dopaminergic agents 3. Hypoglycemia
- 4 things that would cause GH to decrease
- 1. GHIH (somatostatin) 2. dopaminergic blockers 3. hyperglycemia 4. Elevated IGF-1/GH
- T/F-GH action on its target tisses is mostly direct
- False, it's action is mostly indirect
- MOA of GH to promote bone and tissue growth
- 1. GH released in ant pituitary 2. Goes to liver to secrete somatomedins (IGF-1) 3. IFG-1 promotes bone and tissue growth
- What receptor does GH act through?
- IGF-1 receptor (RTK)
- Feedback mechanism of GH
- IGF-1 causes feedback to pituitary hypotalamus to shut off GH secretion
- What is hypersecretion of GH mostly causes by, and two ways to tx?
- 1. Almost always caused by pituitary tumors 2. Tx by surgery or radiation therapy
- First and second line therapy for pituitary tumors?
- 1. First line is to remove tumor 2. Second line is drug therapy
- What is gigantism and when does it occur?
- In children, normal body proportions but abnormally tall due to hypersecretion of GH
- What is acromegaly and when does it occur?
- After puberty, enlargement and thickening of bony areas responsive to hypersecretion of GH (feet, fingers, face)
- 3 types of drugs to tx hypersecretion of GH
- 1. Somatostatin (GHIH) analogs 2. Dopamine agonists 3. GH antagonist
- 2 GHIH analogs and fxn
- 1. Octreotride 2. Lanreotide; inhibit GH release with longer t1/2 than natural somatostatin
- How is dopamine agonist effect in hypersecretion of GH? Name one drug.
- Bromocriptine; Lowers but doesn't normalize GH levels; usually dopamin stimulates GH secretion but in tumors, it inhibits GH secretion
- Name one GH antagonist
- Pegvisomant (Somavert)
- What therapy may be useful for acromegaly?
- Combo w/Octreotride and Bromocriptine when monotherapy does not help
- Hyposecretion GH effects on adults and on children?
- Usually no effect in adults; In children=pituitary dwarfism
- 2 GH prep for hyposecretion of GH and 2 approved indications
- 1. Somatropin 2. Somatrem; Approved for GH deficient children and treatment of short stature in Turner's syndrome
- In hyposecretion of GH, what is available if liver is irresponsive to GH?
- 1. mecasermin 2. increlex; For IGF-1 deficiency due to GH gene deltion, GH receptor abnormalities and antibodies to GH
- What is a GHRH analog and its use
- Sermorelin, increase short-term gorwth velocity and used for diagnostic purposes (not as effective as GH)
- PRL effect on females and males
- Females=stimulate enzyme for milk production; Males=potentiate effect of testosterone
- 2 things that increase PRL
- 1. TRH 2. Estrogen
- 1 thing that inhibit PRL and a drug
- PIH (dopamine) and bromocriptine (dopamine agonist)
- 4 drug induced hyperproactinemia (too much lactation)
- 1. dopamine receptor blockers 2. SSRI (haloperidol) 3. Estrogen/progesterone 4. GnRH analogs (benzodiazepens, methyldopa, reserpine)
- What can be used to treat hypersecretion of PRL (hyperprolactinemia)
- Bromocriptine (parodel)-D2 agonist
- Uses of bromocrytine
- lower PRL levels to suppress lactions after stillbirth, abortion, or normal delivery for women who will NOT be breastfeeding