04. Anterior Pituitary Hormones (Hypothalamus & Pituitary) III

  Anterior Pituitary Hormones -Pharmacological use     FSH LH ...

 

Anterior Pituitary Hormones-Pharmacological use

 

 

FSH

LH

Stimulates oogenesis & spermatogenesis Prepare from urine post menopausal women Lack, due to pituitary GnRH↓ lead to  infertility

Secret by placenta & taken from urine of pregnant mother Lack due to pituitary ↓GNRH,lead to Infertility(both sexes) Use to treat Crypto-orchidism [unsdesend testes] Precipitate puberty in males when delayed In hypogonatropic hypogonadism (↓Testosterone due to ↓Gonadotropin → 2nd ry sexual characteristics) HCG has similar  action to LH         In female (+ )→Progesterone         Male (+ )→ Testosterone

ACTH

1. From ant.pit
2. Synthetics are available -non allergic/dis advantage IM injection pain
3. Similar to steroids
4. Use in, diagnosis
5. Therapy- myochronic epilepsy , Rh^D arthritis

GH  ( separate lecture ) ( click here )

Posterior Pituitary Hormones

 

 

• They are produced in the hypothalamus, and carried by axo-plasmic flow
  1. ADH (Vasopressin)
  2. Oxytosin

ADH

• Mainly acts on V₂ receptors in CD and insert Aquaporin II water channels to P cells
• Regulates blood pressure
• Decrease hemorrhages
• Increase glycogenolysis in liver
• Increase ACTH secretion from anterior pituitary

 

Factors affecting ADH secretion

 

Increase ADH secretion	Decrease ADH secretion
Elevated plasma osmotic pressure Decreased ECF volume Pain, emotion, stress exercise Nausea, vomiting Standing AT II	Decreased plasma osmotic pressure Increased ECF volume Alcohol

 

Complications

ADH excess	ADH insufficient
SIADH Water retention Stimulate Aldosteron secretion Loss of salt in urine	Poly urea(DI) Cranial DI Problem at brain level, Lack of ADH Nephrogenic DI ADH level is normal, but insensitive to kidney

 

 

 

ADH Preparations

1.ADH(Vasopressin) For cranial DI

2.Lypressin

3.Desmopressin(DDAVP) No vasoconstriction,Longer duration of action,can give SC,orally & intra-nasally

• DDAVP is better than ADH

Use for ,

1) Cranial DI

2) Haemophilic-factor 7

3) Nocturnal enuresis in children

4) Bleeding –Oesophegeal varices

5) Vasoconstrictor in local anesthesia

 

Side effect

 

Coronary vessels –angina

Abdominal vessels –Cramps

 

Oxitosin (Syntosinon)

 

 

↑Uterine contraction

 

Use for

• Induce labour ,when uterine contraction is not adequate
• Combine with ergometrine (syntometrine )→to be use in PPH(post partum hemorrhage)

 

Pituitary  insufficiency causes

1. Adrenal gland hypotrophy
2. Reduced FSH & LH
3. Reduced ACTH (absent of stress induced Aldosteron secretion)
4. Stress sensitive
5. Reduced growth
6. Reduced thyroid function
7. Reduced ADH
8. Hypoglycemia
• Isolated GH deficiency is rare in adults

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