Successfully reported this slideshow.
We use your LinkedIn profile and activity data to personalize ads and to show you more relevant ads. You can change your ad preferences anytime.
Anterior pitutary hormones <br />
Hormone<br />Secretory products of endocrine glands released directly into circulation in small amounts and transported to...
Types of cell-to-cell signaling<br />Endocrine Hormones: travel via bloodstream to target cells<br />Neurocrine hormones: ...
Classification of hormones <br /><ul><li>Depending upon chemical nature
Amines or amino acid derivatives
Catecholamines, thyroid hormones
Proteins & polypeptides
Posterior pitutary hormones: oxytocin, vasopressin
Insulin , glucagon, PTH, other anterior pitutary hormones
Steroid hormones
Glucocorticoids, mineralocorticoids, sex steroids, Vit D
Depending on Mechanism of action
Group I  & Group II hormones </li></li></ul><li>Depending on MOA<br /><ul><li>Group I: bind to intracellular receptors
Group II: Involve second messenger
A: cyclic AMP: ACTH, ADH, CRH, FSH, LH,TSH, PTH
B: cyclic GMP: Atrial natriuretic factor, NO
C: calcium/PI:  AcH, catecholamines 1,  gastrin, oxytocin, TRH, GnRH
D:kinases/phosphatase: erythropoetin, GH, insulin, IGF, NGF, prolactin </li></li></ul><li>Regulation of hormone secretion ...
Negative feed back
Long loop feed back
Short loop feed back
Ultra short loop feed back
Positive feed back
Neural control
Chronotrophic control </li></li></ul><li>Negative feed back control <br /><br />Hypothalamus<br />Long loop <br /><br />...
Negative feedback effects of cortisol<br />
Feedback control of insulin by glucose concentrations<br />
Neural control <br /><ul><li>Evokes or supresses hormone secretion in response to external & internal stimuli
External stimuli: visual, auditory, olfactory
Internal stimuli: pain, emotion, fright
Examples of neural control
Oxytocin : fills milk ducts in response to suckling
Aldosterone: augments circulatory volume in response to upright posture
Release of melatonin: in response to darkness</li></li></ul><li>Chronotropic control<br /><ul><li>Endogenous neuronal rhyt...
Diurnal rhythms, circadian rhythms (growth hormone and cortisol), Sleep-wake cycle; seasonal rhythm</li></li></ul><li>Epis...
An episode of release longer than an hour, but less than 24 hours: ultradian
If the periodicity is approximately 24 hours, the rhythm is referred to as circadian
usually referred to as diurnal because the increase in secretory activity happens at a defined period of the day. </li></l...
Circadian Clock<br />
Physiological importance of pulsatile hormone release <br /><ul><li>Demonstrated by GnRH infusion
If given once hourly, gonadotropin secretion and gonadal function are maintained normally
A slower frequency won’t maintain gonad function
Faster, or continuous infusion inhibits gonadotropin secretion and blocks gonadal steroid production</li></li></ul><li>Fun...
Role of hypothalamus <br />Highest relay centre <br />Integrates endocrine & ANS and ensures the smooth coordination by th...
Anterior pitutary hormones <br />
Pitutary gland <br />
Anterior pitutary hormones <br />Acidophils: <br />Somatotrophes: Growth hormone<br />Lactotrophes: Prolactin<br />Basophi...
Growth hormone <br />191 amino acid <br />22000 molecular weight <br />Physiological Functions:<br />Growth of organs <br ...
Regulation of secretion <br />GHRH & GHIH secreted by hypothalamus <br />GH Release stimulated  by <br />Dopamine<br />5 H...
Provocative stimuli for GH<br />Arginine<br />Glucagon <br />L-Dopa<br />Insulin <br />Clonidine<br />
Syndromes associated with GH <br />Deficiency of GH <br />Dwarfism <br />Increased CVS Mortality <br />Excess GH<br />Giga...
Dwarfism <br />Shortness of stature <br />Growth retardation in all parts of body proportionately <br />Normal mental acti...
Gigantism <br />Abnormal height <br />Large hands and feet<br />Coarse facial features <br />Bilateral gynaecomastia<br />...
Acromegaly<br />Acromegalic face:<br /> thick lips, macroglossia, prominent eye brows<br />Broad thick nose, thickened ski...
Treatment of GH Deficiency <br />Cadaveric pitutary growth hormone <br />Human recombinant preparations <br />Somatotropin...
Somatropin<br />Growth hormone preparation whose sequence matches native growth hormone <br />
Somatrem<br />Derivative of growth hormone with additional methionine at amino terminus <br />Somatropin and somatrem have...
Encapsulated somatropin<br />Injected IM once or twice per month <br />
Sermorelin acetate <br />A synthetic form of Human GHRH <br />Peptide of 29 Aminoacids corresponds to first 29 AA of Human...
Uses of Growth hormone <br />Replacement therapy <br />20-40 microgram/ kg  Subcutaneously daily <br />Turners syndrome <b...
Adverse effects<br />↑ ICT with papilloedema<br />Visual changes<br />Headache, nausea<br />Leukemia <br />↑ incidence of ...
Agents used in GH excess<br />Somatostatin<br />Somatostatin analogs <br />Octreotide<br />Lanreotide<br />Vapreotide<br /...
Somatostatin<br />GHIH<br />Non specific<br />TSH, insulin, gastrin<br />Half life = 1-3 min<br />Rebound increase in GH a...
Octreotide<br />More specific for Growth hormone <br />Less chances of hyperglycemia <br />Uses<br />Carcinoid syndrome <b...
Sandostatin<br />Slow releasing form <br />20-40 mg IM 4 weekly <br />Adverse effects of somatostatin analogs <br />Abdomi...
Upcoming SlideShare
Loading in …5
×

Anterior pitutary hormones

11,912 views

Published on

Physiology and pharmacology of anterior pitutary hormones

Published in: Health & Medicine, Technology
  • Login to see the comments

Anterior pitutary hormones

  1. 1. Anterior pitutary hormones <br />
  2. 2. Hormone<br />Secretory products of endocrine glands released directly into circulation in small amounts and transported to specific target cells or organs where they exert physiological, morphological or biochemical responses <br />
  3. 3. Types of cell-to-cell signaling<br />Endocrine Hormones: travel via bloodstream to target cells<br />Neurocrine hormones: released from nerve terminals<br />Paracrine hormones: act on adjacent cells <br />Autocrine hormones: Released and act on the cell that secreted them. <br />Intracrine Hormones: act within the cell that produces them. <br />
  4. 4. Classification of hormones <br /><ul><li>Depending upon chemical nature
  5. 5. Amines or amino acid derivatives
  6. 6. Catecholamines, thyroid hormones
  7. 7. Proteins & polypeptides
  8. 8. Posterior pitutary hormones: oxytocin, vasopressin
  9. 9. Insulin , glucagon, PTH, other anterior pitutary hormones
  10. 10. Steroid hormones
  11. 11. Glucocorticoids, mineralocorticoids, sex steroids, Vit D
  12. 12. Depending on Mechanism of action
  13. 13. Group I & Group II hormones </li></li></ul><li>Depending on MOA<br /><ul><li>Group I: bind to intracellular receptors
  14. 14. Group II: Involve second messenger
  15. 15. A: cyclic AMP: ACTH, ADH, CRH, FSH, LH,TSH, PTH
  16. 16. B: cyclic GMP: Atrial natriuretic factor, NO
  17. 17. C: calcium/PI: AcH, catecholamines 1, gastrin, oxytocin, TRH, GnRH
  18. 18. D:kinases/phosphatase: erythropoetin, GH, insulin, IGF, NGF, prolactin </li></li></ul><li>Regulation of hormone secretion <br /><ul><li>Feed back control
  19. 19. Negative feed back
  20. 20. Long loop feed back
  21. 21. Short loop feed back
  22. 22. Ultra short loop feed back
  23. 23. Positive feed back
  24. 24. Neural control
  25. 25. Chronotrophic control </li></li></ul><li>Negative feed back control <br /><br />Hypothalamus<br />Long loop <br /><br />Ultra Short loop <br />Hypophysiotrophic hormone <br /><br />Anterior pitutary<br />Pitutarytrophic hormone <br />Short loop <br />Target gland <br />Target gland hormone <br />
  26. 26. Negative feedback effects of cortisol<br />
  27. 27. Feedback control of insulin by glucose concentrations<br />
  28. 28. Neural control <br /><ul><li>Evokes or supresses hormone secretion in response to external & internal stimuli
  29. 29. External stimuli: visual, auditory, olfactory
  30. 30. Internal stimuli: pain, emotion, fright
  31. 31. Examples of neural control
  32. 32. Oxytocin : fills milk ducts in response to suckling
  33. 33. Aldosterone: augments circulatory volume in response to upright posture
  34. 34. Release of melatonin: in response to darkness</li></li></ul><li>Chronotropic control<br /><ul><li>Endogenous neuronal rhythmicity
  35. 35. Diurnal rhythms, circadian rhythms (growth hormone and cortisol), Sleep-wake cycle; seasonal rhythm</li></li></ul><li>Episodic secretion of hormones<br /><ul><li>frequency of about one hour—circhoral
  36. 36. An episode of release longer than an hour, but less than 24 hours: ultradian
  37. 37. If the periodicity is approximately 24 hours, the rhythm is referred to as circadian
  38. 38. usually referred to as diurnal because the increase in secretory activity happens at a defined period of the day. </li></li></ul><li>Circadian (chronotropic) control<br />
  39. 39. Circadian Clock<br />
  40. 40. Physiological importance of pulsatile hormone release <br /><ul><li>Demonstrated by GnRH infusion
  41. 41. If given once hourly, gonadotropin secretion and gonadal function are maintained normally
  42. 42. A slower frequency won’t maintain gonad function
  43. 43. Faster, or continuous infusion inhibits gonadotropin secretion and blocks gonadal steroid production</li></li></ul><li>Functions of the hormones <br />Growth & differentiation <br />Maintenance of homeostasis <br />Reproduction<br />Regulation of biochemical reactions <br />
  44. 44. Role of hypothalamus <br />Highest relay centre <br />Integrates endocrine & ANS and ensures the smooth coordination by the cerebral cortex <br />Hypothalamic regulatory hormones <br />Releasing hormones <br />TRH, GnRH, GHRH,CRH, MSH-RF, Prolactin Releasing factor <br />Releasing inhibitory hormones <br />GH-RIH, MSH-RIF, PIF <br />
  45. 45. Anterior pitutary hormones <br />
  46. 46. Pitutary gland <br />
  47. 47. Anterior pitutary hormones <br />Acidophils: <br />Somatotrophes: Growth hormone<br />Lactotrophes: Prolactin<br />Basophils:<br />Gonadotrophes: FSH & LH<br />Thyrotropes: TSH<br />Corticolipotrohes: ACTH <br />
  48. 48. Growth hormone <br />191 amino acid <br />22000 molecular weight <br />Physiological Functions:<br />Growth of organs <br />Positive nitrogen balance <br />Direct and indirect actions <br />
  49. 49. Regulation of secretion <br />GHRH & GHIH secreted by hypothalamus <br />GH Release stimulated by <br />Dopamine<br />5 HT <br />α2 Agonist <br />GH Release inhibited by <br />IGF-1<br />Free Fatty Acids<br />Beta Agonist <br />GH itself <br />Amplitude of secretory pulses is maximal at night <br />
  50. 50. Provocative stimuli for GH<br />Arginine<br />Glucagon <br />L-Dopa<br />Insulin <br />Clonidine<br />
  51. 51. Syndromes associated with GH <br />Deficiency of GH <br />Dwarfism <br />Increased CVS Mortality <br />Excess GH<br />Gigantism <br />Acromegaly<br />
  52. 52. Dwarfism <br />Shortness of stature <br />Growth retardation in all parts of body proportionately <br />Normal mental activity <br />Immature faces <br />Delicate extremities <br />Sexual maturity does not occur if associated with gonadotropin deficiency <br />
  53. 53. Gigantism <br />Abnormal height <br />Large hands and feet<br />Coarse facial features <br />Bilateral gynaecomastia<br />Loss of libido <br />Hyperglycemia <br />
  54. 54. Acromegaly<br />Acromegalic face:<br /> thick lips, macroglossia, prominent eye brows<br />Broad thick nose, thickened skin <br />Prognathism<br />Protrusion of lower jaw<br />Spade like hands, thick wide fingers, large feet<br />Kyphosis<br />Organomegaly<br />
  55. 55. Treatment of GH Deficiency <br />Cadaveric pitutary growth hormone <br />Human recombinant preparations <br />Somatotropin<br />Somatotrem<br />Encapsulated somatotropin<br />Sermorelin acetate <br />
  56. 56. Somatropin<br />Growth hormone preparation whose sequence matches native growth hormone <br />
  57. 57. Somatrem<br />Derivative of growth hormone with additional methionine at amino terminus <br />Somatropin and somatrem have similar biological action and potencies <br />Half life = 20 minutes but biological action lasts 9-17 hrs <br />Once daily administration is sufficient <br />
  58. 58. Encapsulated somatropin<br />Injected IM once or twice per month <br />
  59. 59. Sermorelin acetate <br />A synthetic form of Human GHRH <br />Peptide of 29 Aminoacids corresponds to first 29 AA of Human GHRH <br />Has full biological activity <br />Well tolerated , Less expensive <br />But less effective will not work in defects of anterior pitutary<br />
  60. 60. Uses of Growth hormone <br />Replacement therapy <br />20-40 microgram/ kg Subcutaneously daily <br />Turners syndrome <br />50 microgram/kg <br />Aids associated wasting <br />3-4 microgram / kg <br />
  61. 61. Adverse effects<br />↑ ICT with papilloedema<br />Visual changes<br />Headache, nausea<br />Leukemia <br />↑ incidence of type 2 DM<br />Adults:<br /> Edema, carpal tunnel syndrome, arthralgia, myalgia<br />
  62. 62. Agents used in GH excess<br />Somatostatin<br />Somatostatin analogs <br />Octreotide<br />Lanreotide<br />Vapreotide<br />Sandostatin<br />Dopamine receptor agonists: bromocriptine<br />GH antagonist: Pegvisomant<br />
  63. 63. Somatostatin<br />GHIH<br />Non specific<br />TSH, insulin, gastrin<br />Half life = 1-3 min<br />Rebound increase in GH after its discontinuation <br />Not preferred <br />
  64. 64. Octreotide<br />More specific for Growth hormone <br />Less chances of hyperglycemia <br />Uses<br />Carcinoid syndrome <br />VIP secreting tumors <br />Gastrinoma<br />Secretorydiarhoea: AIDS, DM<br />IBS , Esophageal Varices , insulinoma<br />Dose: 50 -200 µg TDS subcutaneously <br />
  65. 65. Sandostatin<br />Slow releasing form <br />20-40 mg IM 4 weekly <br />Adverse effects of somatostatin analogs <br />Abdominal pain <br />Steathorrea<br />GB stone <br />Vit B12 deficiency <br />
  66. 66. Prolactin<br />198 Amino acid peptide hormone <br />Synthesis and secretion starts in fetal pitutary<br />↓ Secretion of prolactin by <br />Hypothalamic regulation (D2<br />↑ secretion of prolactin by <br />Stress, exertion, hypoglycemia<br />TRH, VIP, prolactin releasing peptide <br />
  67. 67. Regulation of prolactin<br />
  68. 68. Mechanism of action <br />
  69. 69. Physiological effects <br />Growth & development of breast <br />Growth and development of ductal and lobular epithelium <br />Induce lactation after birth of baby <br />Increased prolactin levels supress normal menstrual cycle <br />
  70. 70. Hyperprolactinemia<br />Females: <br />Galactorrhea and amenorrhoea<br />Infertility <br />Males:<br />Loss of libido <br />Infertility <br />Drugs causing hyperprolactinemia<br />Chlorpromazine, haloperidol, metoclopramide<br />Reserpine , alpha methyl dopa<br />
  71. 71. Treatment of hyperprolactinemia<br />Dopaminergic agonists <br />Bromocriptine<br />Cabergoline<br />Pergolide<br />Quinagolide<br />
  72. 72. Bromocriptine<br />Uses <br />Hyperprolactinemia<br />Acromegaly<br />Parkinsonism <br />Hepatic coma <br />Supression of lactation <br />
  73. 73. Bromocriptine<br />Pharmacokinetics<br />Only 1/3rd absorbed orally <br />First pass metabolism present <br />Half life = 3 hours <br />Dose: <br />Start 1.25 mg HS <br />After 1 week 1.25 mg can be added in morning <br />Can be increased to 5 mg BD <br />
  74. 74. Bromocriptine<br />Adverse effects<br />Nausea , vomiting <br />Postural hypotension <br />Nasal decongestion<br />Digital vasospasm <br />CNS effects: hallucinations, night mares, insomnia <br />
  75. 75. Pergolide<br />Ergot derivative <br />Cheapest Dopamine agonist <br />Dose= 0.025 mg increased to 0.25 mg gradually <br />
  76. 76. Cabergoline<br />Ergot derivative with longer hlaf life <br />T ½ = 65 hours <br />Higher affinity and selectivity to D2 receptors<br />More effective less toxic <br />Dose= 0.25 mg twice weekly <br />
  77. 77. Quinagolide<br />Non ergot D2 agonist <br />T ½ = 22 hours dose= 0.1 -0.5 mg /day <br />
  78. 78. Gonadotropins (FSH & LH)<br />Hypothalamus releases GnRH in pulses 1-2 hrly<br />GnRh regulates FSH & LH <br />Feed back inhibition of LH>FSH<br />Estrogen & Progesterone inhibit both FSH & LH <br />Inhibin inhibits only FSH <br />Dopamine Inhibits only LH <br />
  79. 79. Physiological functions <br />FSH<br />Females:<br />Gametogenesis<br />Follicular development <br />Estrogen and progesterone production <br />Imp role in Menstrual cycle <br />Males<br />Stimulation & maintainence of spermatogenesis <br />LH <br />Females<br />Ovulation <br />Corpus luteumMaintainence<br />Estrogen & progesterone production <br />Imp role in menstrual cycle<br />Males:<br />Testesterone & androgen biosynthesis <br />
  80. 80. Disturbances of gonadotropin secretion <br />Excess<br />Precocious puberty <br />Deficiency <br />Amenorrhoea, infertility<br />oligospermia<br />
  81. 81. Preparations of gonadotropins<br />Menotropin: FSH + LH<br />Obtained from urine of postmenopausal women<br />Urofollitropin: Pure FSH <br />Preferred in PCOD <br />HCG<br />Obtained From Urine Of Pregnant Females<br />DNA recombinant FSH <br />
  82. 82. Uses of gonadotropins<br />Infertility in females <br />When clomiphene fails <br />Menotropin for 10 days then HCG 10000 IU, IM<br />Infertility in males <br />HCG 1000-2500 IU, IM 3 times in a week <br />Then menotropin after 3-4 months <br />Cryptorchism<br />To aid Invitro fertilization<br />Regress AIDS related Kaposis Sarcoma <br />
  83. 83. Adverse effects <br />Ovarian hyperstimulation, multiple pregnancies <br />Polycystic ovarian disease <br />Pain in lower abdomen <br />Edema, headache, depression<br />Allergic reactions <br />
  84. 84. GnRH & GnRH analogs <br />
  85. 85. Gonadorelin<br />Synthetic GnRH<br />T ½ = 4-6 min <br />Used for testing pitutarygonadal axis in male or female hypogonadism<br />Pulsatile administration IV every 90 min <br />Infertility, cryptorchism. & delayed puberty <br />
  86. 86. GnRH agonists <br />Goserelin<br />Buserilin<br />Leuprolide<br />Naferiline<br />Triptoreline<br />
  87. 87. GnRH agonists <br />Longer acting 6-12 hours <br />Initial increase in LH & FSH <br />But after 1-2 weeks cause desensitization and decrease FSH & LH secretion <br />Decrease estrogen and testesterone<br />They cause pharmacological oopherectomy and orchiectomy<br />
  88. 88. Uses of GnRH analogs <br />Precocious puberty <br />Prostatic carcinoma <br />Breast cancer <br />Contraception: under investigation <br />
  89. 89. Adverse effects <br />Hot flushes <br />Loss of libido <br />Vaginal dryness <br />Osteoporosis <br />Emotional liability<br />
  90. 90. GnRH antagonists Cetrorelix , Granirelix<br />Competitive antagonists <br />Advantage<br />No initial increase in gonadotropins<br />Do not cause histamine release <br />Used in endometriosis 3 mg Cetrorelix SC weekly for 2 months<br />Uterine Fibroids: cetrorelix twice weekly for 1 month before surgery <br />
  91. 91. Thyroid stimulating hormone <br />Stimulates T3 & T4 secretion<br />Induces hyperplasia and hypertrophy of thyroid <br />Promotes oxidation of trapped iodide <br />
  92. 92. ACTH<br />Stimulate cortisol synthesis from adrenal cortex<br />Corticotropin Regulating Hormone (CRH): secreted by hypothalamus regulates it.<br />USES<br />Diagnosis of pitutary –adrenal axis disorders <br />Like corticosteroids but unpredictable action <br />

×