1.
Anterior pituitary drugs: Cosyntropin
Somatropin
Somatrem
Octreotide
2.
cosyntropin (Cortrosyn): ( = adrenocorticotropic hormone)
Cortisol release from adrenal cortex
ANTI-INFLAMMATORY effect
For diagnosis of adrenocortical insufficiency
Renal retention of sodium
AEs: edema, HTN
3.
cosyntropin (Cortrosyn): implications: HYDRATION
Decr Na & K intake
NO vaccinations
4.
desmopressin: ( = ADH)
Diabetes insipidus
blood disorders
nocturnal enuresis
5.
octreotide (Sandostatin): ( = GH)
(B)
Reduces profuse watery diarrhea, flushing, & severe hypotension caused by VIP/carcinoid crisis
CAUTION: renal impairment, hypoglycemia
AEs: impaired gallbladder fcn, hyperglycemia in type 2 diabetes, NVD, dyspnea, conduction abnormalities, faituge, headache
Interactions: Ciprofloxacin (prolong QTc)
6.
octreotide (Sandostatin): implications: REPORT abdominal pain (impairs gallbladder fcn)
CAUTION: renal impairment
MONITOR GLUCOSE LEVELS
Thyroid function tests
7.
Pituitary drugs: indications: (1) Replacement therapy (hormone deficiency)
(2) Drug therapy (to produce specific hormone)
(3) Diagnostic aids (to determine hypo/hyperfunction of specific hormonal function
AUGMENTS or ANTAGONIZES natural effects of pituitary hormones
8.
Pituitary hormones: implications: DO NOT stop abruptly
9.
Posterior pituitary drugs: Vasopressin
Desmopressin
10.
somatropin & somatrem: ( = GH)
Skeletal growth
Hypopituitary dwarfism
HIV wasting
AEs: headache, hyperglycemia, hypothyroidism, hypercalciuria, rash, antibodies to GH, inflammation at injection site, flulike syndrome
Give at NIGHT (grow more when asleep)
11.
Therapeutic effects: COSYNTROPIN: no pain associated with inflammation, increased comfort & muscle strength in patients with MS
SOMATROPIN: increase growth in children
DESMO/VASOPRESSIN: reduce severe thirst, decrease urinary output
OCTREOTIDE: reduce symptoms of carcinoid crisis
12.
vasopressin/desmopressin: AEs: HTN, NAUSEA, DROWSINESS
fever, heartburn
vertigo
cramps
uterine cramps
nasal irritation/congestion
REPORT: severe headaches, sweating, chest pain, tremors, heart irregularities, unexplained weight gain, blood in stool, seizure activity
13.
vasopression: ( = ADH)
(C)
Diabetes insipidus
Hypotensive emergencies
GI bleeding
Pulseless cardiac arrest
Septic shock (continuous IV)
CAUTION: seizure disorders, asthma, CV disease, renal disease
Infiltration can cause necrosis
Septic shock: continuous IV