treatment of primary autonomous GH-secreting pituitary adenoma
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, Acromegaly= transsphenoid surgery
Stereoactic radiation- effective when rapid control of GH levels is not
essential, not surgical candidate, or persisting hyperfunction despite
resection
Chemo with temozolomide considered for uncontrolled
Somatostatin analogs (octreotide, octreotide acetate, and lanreotide) -->
normalize IGF-1 levels and lower GH levels
• Pegvisomant → supplement somatostatin analogs; effective drug that
induces tissue insensitivity to GH (blocks GH receptor) Dopaminergic
agonists (carbergoline) → if tumor is secreting prolactin
GOAL: normalize GH and IGF-1 serum levels (age range), restoring normal
pituitary function, relieving or preventing complications from tumor
expansion
What is the target tissue and action of Somatostatin?
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Anterior pituitary
Inhibits release of growth hormone(GH) and TSH
How are lipid-soluble hormones transported?
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Lipid-soluble hormones diffuse freely across the cell and nuclear
membrane and bind with cytosolic or nuclear receptors. (can also bind
with receptors in or on the plasma membrane)
,what is the role of PTH?
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increase serum calcium and decrease serum phosphate
What is the target organ and function of LH?
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In women:
granulosa cells
Ovulation, progesterone production
In men:
Leydig cells
Testicular growth, testosterone production
What do Alpha cells secrete?
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Glucagon
where is calcitonin produced?
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, produced by parafollicular cells in the thyroid
SIADH
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high levels of ADH in the absence of normal physiologic stimuli for its
release
What do Beta cells secrete?
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insulin and amylin
Patho of DI
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inability of the kidney to increase permeability to water which leads to
excretion of large volumes of dilute urine and an increase in plasma
osmolality
what causes ADH to be secreted?
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