BLOCK 3 PMY 302 - DRUGS to KNOW
Desmopressin MOA - activates V2 receptors in the kidney's collecting ducts, reabsorbing water
into plasma and concentrating the urine (prevents water from leaving the body)
Octreotide Acetate and Lanreotide Therapeutic effects - suppresses GH hypersecretions, reduces
pituitary adenoma overgrowth, and normalizing levels of GH and IGF-1
Somatropin Drug Class - Synthetic recombinant human growth hormone
Somatropin/Somatrem dosing - Daily dosing dependent and adjusted to individual clinical
response and IGF-1 levels
Somatropin/Somatrem pharmacokinetics - Following SC injection, 80% of the drug will be
systemically available
Somatropin/somatrem results and monitoring - Response to GH therapy is measured every 3-6
months by height and bone age determinations
Somatropin/Somatrem Therapeutic use - Childhood Dwarfism/Growth hormone deficiency
disorders
Somatrem Drug class - Analog of GH; synthetic recombinant human growth hormone with Extra
amino acid noted in protein makeup
Somatrem MOA - Similar to somatropin
Octreotide Acetate and Lanreotide drug class - synthetic analogs of somatostatin
,Octreotide Acetate and Lanreotide MOA - acts identical to somatostatin to directly inhibit GH
release from the anterior pituitary which effectively decreases circulating GH and IGF-1 levels
Octreotide Acetate and Lanreotide Dosing - Long-acting depots allow for once-a-month IM dosing
due to gradual release formula (10-20 mg/4 weeks) T ½: 1-2 hours
Octreotide acetate/Lanreotide/Pegvisomant Use - Acromegaly/Gigantism Tx
Somatropin MOA - Identical in action and abilities like endogenous secreted GH (stimulating
proliferation of bone growth plates and increased linear bone growth, promotion of protein synthesis
throughout the body)
Pegvisomant Drug class - GH receptor antagonist
Pegvisomant MOA - Blocks actions of GH and reduces the levels of circulating IGF-1
Pegvisomant Dosing - daily SubQ injections; increases dose until serum IGF-1 levels are
maintained to be within the age-appropriate/normal range (usually within 12 months, pt. Will have
normal or next to normal levels of IGF-1)
Pegvisomant drug structure - Extremely similar protein structure to GH but acts as a receptor
antagonist
Bromocriptine/Cabergoline drug class - Dopamine Receptor Agonists
Bromocriptine/Cabergoline MOA - Decreases prolactin production and secretions by prolactin-
secreting pituitary tumors; mimics the actions of dopamine and causes inhibition of prolactin secretion
Bromocriptine/Cabergoline Pharmacokinetics - Orally Active and effective use in 80-85% of cases
Bromocriptine/Cabergoline Therapeutic effects - Reduces tumor size, suppresses galactorrhea and
restores normal ovulatory menstrual cycles
,Bromocriptine special consideration - Longer track record of safety in use and cheaper to produce
(DOC/more commonly used)
Cabergoline special consideration - Has higher reported affinity for D2 receptors
Desmopressin Drug Class - DDAVP/Vasopressin synthetic analog
Desmopressin compared to ADH - Longer noted serum T ½ compared to ADH (DDAVP t ½ = 75
min) (ADH t ½ = >10 min)
Desmopressin Structure - Almost identical to ADH except for D-Amino acid in chemical chain
sequence (ADH has L-Amino Acid) *NOTE: Has a greater selectivity for V2 receptors compared to typical
ADH*
Desmopressin Pharmacokinetics - Extremely potent drug; Tablet (0.1-0.2 mg) or nasal spray
(0.01mg)
Desmopressin Outcomes of DI - Excessive urine production controlled with 0.1mg/3x daily
Desmopressin Outcomes of Nocturnal Enuresis - 4 months of Tx (0.2-0.4mg/daily) will decrease
average wet nights from 10/week to 6-7/2 weeks
Pitocin Drug class - Synthetic Oxytocin
Pitocin MOA - Stimulates uterine contractions during labor to strength (typically used in
induction/emergency scenarios if birth is taking an extremely long time)
Pitocin Pharmacokinetics - Given IV at low doses; used in OB/GYN practice
, Hydrocortisone Drug class - glucocorticoid replacement therapy
Hydrocortisone MOA - mimics actions of cortisol (increasing gluconeogenesis, protein, and lipid
catabolism and body resistance response to stress)
Hydrocortisone Use - replacement therapies for both adrenal insufficiencies and anti-
inflammatory/immunosuppressive treatments (Glucocorticoid of choice in replacement tx since adverse
effects are minimized)
Hydrocortisone Pharmacokinetics - Short-acting drug ( t ½ 80 min that requires 2-3 doses/daily);
The highest dose is an admin in the morning and smaller doses are given in the evening to mimic natural
cortisol blood levels // Short-acting preps are preferred because they can be adjusted readily to reduce
adverse effects and Extra doses can be given for bodily stresses (infections, fever, injury)
Fludrocortisone Drug class - mineralocorticoid replacement therapy
Fludrocortisone MOA - mimics actions of aldosterone (salt retention and elimination of K+; raises
BP)
Fludrocortisone Use - Provides mineralocorticoid activity in replacement therapies for adrenal
insufficiencies
Fludrocortisone Pharmacokinetics - T ½ 18-36 hours (long-lasting) daily dose; dosing is tailored to
manage BP and fluid balances
Prednisone drug class - glucocorticoid replacement therapy
Prednisone MOA - mimics actions of cortisol (increasing gluconeogenesis, protein, and lipid
catabolism, and body resistance response to stress) and has high anti-inflammatory properties; low
doses and short term use is important to prevent HPA axis suppression
Desmopressin MOA - activates V2 receptors in the kidney's collecting ducts, reabsorbing water
into plasma and concentrating the urine (prevents water from leaving the body)
Octreotide Acetate and Lanreotide Therapeutic effects - suppresses GH hypersecretions, reduces
pituitary adenoma overgrowth, and normalizing levels of GH and IGF-1
Somatropin Drug Class - Synthetic recombinant human growth hormone
Somatropin/Somatrem dosing - Daily dosing dependent and adjusted to individual clinical
response and IGF-1 levels
Somatropin/Somatrem pharmacokinetics - Following SC injection, 80% of the drug will be
systemically available
Somatropin/somatrem results and monitoring - Response to GH therapy is measured every 3-6
months by height and bone age determinations
Somatropin/Somatrem Therapeutic use - Childhood Dwarfism/Growth hormone deficiency
disorders
Somatrem Drug class - Analog of GH; synthetic recombinant human growth hormone with Extra
amino acid noted in protein makeup
Somatrem MOA - Similar to somatropin
Octreotide Acetate and Lanreotide drug class - synthetic analogs of somatostatin
,Octreotide Acetate and Lanreotide MOA - acts identical to somatostatin to directly inhibit GH
release from the anterior pituitary which effectively decreases circulating GH and IGF-1 levels
Octreotide Acetate and Lanreotide Dosing - Long-acting depots allow for once-a-month IM dosing
due to gradual release formula (10-20 mg/4 weeks) T ½: 1-2 hours
Octreotide acetate/Lanreotide/Pegvisomant Use - Acromegaly/Gigantism Tx
Somatropin MOA - Identical in action and abilities like endogenous secreted GH (stimulating
proliferation of bone growth plates and increased linear bone growth, promotion of protein synthesis
throughout the body)
Pegvisomant Drug class - GH receptor antagonist
Pegvisomant MOA - Blocks actions of GH and reduces the levels of circulating IGF-1
Pegvisomant Dosing - daily SubQ injections; increases dose until serum IGF-1 levels are
maintained to be within the age-appropriate/normal range (usually within 12 months, pt. Will have
normal or next to normal levels of IGF-1)
Pegvisomant drug structure - Extremely similar protein structure to GH but acts as a receptor
antagonist
Bromocriptine/Cabergoline drug class - Dopamine Receptor Agonists
Bromocriptine/Cabergoline MOA - Decreases prolactin production and secretions by prolactin-
secreting pituitary tumors; mimics the actions of dopamine and causes inhibition of prolactin secretion
Bromocriptine/Cabergoline Pharmacokinetics - Orally Active and effective use in 80-85% of cases
Bromocriptine/Cabergoline Therapeutic effects - Reduces tumor size, suppresses galactorrhea and
restores normal ovulatory menstrual cycles
,Bromocriptine special consideration - Longer track record of safety in use and cheaper to produce
(DOC/more commonly used)
Cabergoline special consideration - Has higher reported affinity for D2 receptors
Desmopressin Drug Class - DDAVP/Vasopressin synthetic analog
Desmopressin compared to ADH - Longer noted serum T ½ compared to ADH (DDAVP t ½ = 75
min) (ADH t ½ = >10 min)
Desmopressin Structure - Almost identical to ADH except for D-Amino acid in chemical chain
sequence (ADH has L-Amino Acid) *NOTE: Has a greater selectivity for V2 receptors compared to typical
ADH*
Desmopressin Pharmacokinetics - Extremely potent drug; Tablet (0.1-0.2 mg) or nasal spray
(0.01mg)
Desmopressin Outcomes of DI - Excessive urine production controlled with 0.1mg/3x daily
Desmopressin Outcomes of Nocturnal Enuresis - 4 months of Tx (0.2-0.4mg/daily) will decrease
average wet nights from 10/week to 6-7/2 weeks
Pitocin Drug class - Synthetic Oxytocin
Pitocin MOA - Stimulates uterine contractions during labor to strength (typically used in
induction/emergency scenarios if birth is taking an extremely long time)
Pitocin Pharmacokinetics - Given IV at low doses; used in OB/GYN practice
, Hydrocortisone Drug class - glucocorticoid replacement therapy
Hydrocortisone MOA - mimics actions of cortisol (increasing gluconeogenesis, protein, and lipid
catabolism and body resistance response to stress)
Hydrocortisone Use - replacement therapies for both adrenal insufficiencies and anti-
inflammatory/immunosuppressive treatments (Glucocorticoid of choice in replacement tx since adverse
effects are minimized)
Hydrocortisone Pharmacokinetics - Short-acting drug ( t ½ 80 min that requires 2-3 doses/daily);
The highest dose is an admin in the morning and smaller doses are given in the evening to mimic natural
cortisol blood levels // Short-acting preps are preferred because they can be adjusted readily to reduce
adverse effects and Extra doses can be given for bodily stresses (infections, fever, injury)
Fludrocortisone Drug class - mineralocorticoid replacement therapy
Fludrocortisone MOA - mimics actions of aldosterone (salt retention and elimination of K+; raises
BP)
Fludrocortisone Use - Provides mineralocorticoid activity in replacement therapies for adrenal
insufficiencies
Fludrocortisone Pharmacokinetics - T ½ 18-36 hours (long-lasting) daily dose; dosing is tailored to
manage BP and fluid balances
Prednisone drug class - glucocorticoid replacement therapy
Prednisone MOA - mimics actions of cortisol (increasing gluconeogenesis, protein, and lipid
catabolism, and body resistance response to stress) and has high anti-inflammatory properties; low
doses and short term use is important to prevent HPA axis suppression
