Hypothalamic and Pituitary Hormones

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Endocrine: Hypothalamic and Pituitary Hormones

Learning Objectives:The medical student should know and be able to discuss:

Overview
  • hormonal structural features that influence pharmacokinetic behavior
peptide steroid amine
  • differences between regulation of anterior vs. posterior pituitary hormonal release
  • the uses of the hormones and their analogs including:
    • replacement therapy for hormone deficiency
    • therapeutics to elicit effects not associated with physiologic blood levels
    • diagnostic tools to assess hypo- or hyperfunctional endocrine states.
  • major disease states associated with dysfunction of the secretion of the hormones
  • toxicities associated with exogenous administration of the hormones

Hormones of the Anterior Pituitary Gland 

Primary Hypothalamic, Anterior Pituitary and Target Gland Hormones

Hypothalamic

Pituitary

Target Organ

Target Organ Hormone

GHRH (+)
Somatostatin (-)

GH (+)

Liver

Somatomedins

CRH (+)

ACTH (+)

Adrenal Cortex

glucocorticoids
mineralocorticoids
androgens

TRH (+)

TSH (+)

Thyroid

T3
T4

GnRH/LHRH (+)

FSH (+)
LH (+)

Gonads

estrogen
progesterone
testosterone

Dopamine (-)

Prolactin (+)

Lymphocytes
Breast

Lymphokines

(+), stimulant; (-), inhibitor

Table adapted from Fitzgerald, P.A. and Klonoff, D.C., Section VII. Endocring Drugs: Hypothalamic & Pituitary Hormones in Basic and Clinical Pharmacology, (Katzung, B. G., ed) Appleton-Lange, 1998, p. 604.

Hormone Systems and Clinical Pharmacology

GHRH (Growth Hormone-Releasing Hormone, a.k.a sermorelin)

  • GHRH

  • somatostatin (growth hormone-inhibiting hormone)

  • octeotride (somatostatin analog)

  • GH (somatotropin)

CRH (Corticotropin-Releasing Hormone)

  • CRH
  • ACTH (adrenocorticotropic hormone)

TRH (Thyroid-Releasing Hormone; protirelin)

  • TRH
  • TSH (thyroid stimulating hormone)

GnRH (Gonadotropin-Releasing Hormone
LHRH, Luteinizing Hormone-Releasing Hormone)

  • GnRH Analogues

  • leuprolide

  • goserelin

NOTE: Human chorionic gonadotropin has no known effects on appetite, or on mobilization or distribution of body fat, contrary to some beliefs

Dopamine (PIF, Prolactin Inhibitory Factor)

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Hormones of the Posterior Pituitary Gland

  • vasopressin (AVP)
  • desmopressin (DDAVP)
  • Contraindications

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