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PITUITARY GLAND DRUGS: ANTERIOR LOBE (ADRENOCORTICOTROPIC…
PITUITARY GLAND DRUGS:
ANTERIOR LOBE
ADRENOCORTICOTROPIC HORMONE (ACTH):
(TETRACOSACTRIN)
(Synacthen, Synacthen Depot)
Mechanism of Actions:
Synthetic polypeptide with properties similar to those of ACTH stimulating the synthesis of glucocorticoids, mineralocorticoids and to a lesser extent, androgens.
Indications:
Diagnostic investigation of adrenocortical insufficiency.
Exacerbation of multiple sclerosis (MS)
Hypsarrhythmia and/or infantile spasm.
Nursing Considerations:
Contraindications:
TB involving the lungs
Herpes simplex infection of the eye
Hypothyroidism
Diabetes
Crushing’s syndrome
Low amount of calcium and potassium in the blood
Mental disorder with loss normal personality
Myasthenia Gravis
Hypertension
Chronic heat failure
Diverticulitis
Side Effects:
Hypersensitivity reactions eg. Nausea and vomiting,dizziness, urticaria, flushing, malaise, dyspnoea and angio-edema
Long term use may result in corticosteroids-like adverse effects eg. Osteoporosis, muscle weakness, bone fractures, peptic ulcer, abdominal distention, hyperpigmentation, thin fragile skin.
(Prolonged therapy) glaucoma, cataracts
Injection site reaction and antibody formation
Storage Conditions:
Store the peptide at -20°C
Route of Administration:
Intramuscular (ampoules 250microgram/mL, ampoule depot 1mg/mL)
GROWTH HORMONE:
(SOMATOTROPIC HORMONES)
(SOMATOTROPIN (SOMATROPHIN) (Genotropin,Genotropin GoQuick, Genotropin MiniQuick,Humotrope, Norditropin, Nutropin Aq Cortridge solution for injection)
Nursing Considerations:
Storage Conditions:
Most other growth hormones must be refrigerated at all times, but not Norditropin FlexPro pens. Store them in the refrigerator at first, but after the first time you use FlexPro [or NordiFlex], [they/it] can be kept at room temperature (up to 77°F) if you’ll be using them within 21 days. (If you need to keep a pen for up to 4 weeks, store it in the fridge.) This may allow for greater flexibility without having to preplan refrigeration for pens during overnight visits, vacation even last-minute trips.
Side Effects:
(Rare) Myositis, benign intracranial hypertension, Type2 DM
(Rare) lipoatrophy(sc), antibody formation
(Turner’s syndrome) otitis media, ear disorder,hypothyrodism, peripheral edema
Site, mild and transient edema.
(Children) scoliosis, slipped epiphysis of hip, mild transient urticaria at the injection
(Adults, uncommon) headache, muscle weakness, glycosuria
(Adults, common) paraesthesia, muscle stiffness, peripheral edema,arthraigia
(injection site) pain, redness, swelling
Contraindications:
Hyperglycaemia
Visible water retention
Lung failure causing loss of breath
Abnormal result for glucose tolerance testing
Middle ear infection
Hypertension
Decreased function of the adrenal gland
Untreated deficient secretion of pituitary hormones
Retinal changes of eye in a patient with diabetes mellitus.
Untreated decreased levels of thyroid hormone
Brain tumours
Route of Administration:
Orally (cartridge solutions)
Intramuscular (vials)
Subcutaneous (prefilled pen)
Indications:
Growth disturbance in children with chronic renal insufficiency/ weight loss than 25th percentile
Paediatrics patients with prader-Wis syndrome (to treat short stature and improve body composition).
Adults with severe deficiency of GH
Growth disturbance associated with Turner’s Syndrome.
Decreased or failed secretion pituitary gland GH, resulting in short stature.
Mechanism of Action:
Human GH is normally secreted at night during sleep, promoting growth through action of insulin-like growth factors (IGF). Human GH promotes skeletal visceral and lipid metabolism. Human GH increases retention of sodium, potassium and phosphorus.
GONADOTROPHIC HORMONES:
(CHORIONIC GONADOTROPHIN(hCG))
Mechanism of Action:
Action is identical to that of pituitary LH although it also has some action on FSH. Stimulates interstitial testicular cells to produce testosterone (males) and progesterone and oestrogen (females)
Indications:
Males) hypogonadotropic hypogonadism, cryptochism (not caused by obstruction) delayed puberty (because of insufficient gonadotrophic pituitary function).
(Females) improve function of the corpus luteum; sterility, inducing ovulation.
Nursing Considerations:
Contraindications:
Males with known/suspected androgen-dependent tumours
Prostate gland/ testes cancer.
Visible water retention
Pregnancy
Side Effects:
(Males ,high dose) salt and water retention.
(Males, rare) gynaecomastia
(Injection site) pain, redness, swelling, itching
Storage Route:
All vials should be stored in carefully sealed plastic containers or satchels. When refrigerated, the mixed and unmixed vials must be kept separate from food and beverages to avoid any cross contamination risk.
Route of Administration:
Intramuscular (ampoules 1500IU,50000IU)
PROLACTIN SUPPRESSION:
(QUINAGOLIDE HYDROCHLORIDE (Noprolac))
Mechanism of Action:
Selective dopamine D2-receptor agonist that only inhibits prolactin (not other pituitary hormones). Prolonged duration of action, allowing once daily administration.
Indications:
Hyperprolactinaemia (idiopathic, prolactin secreting pituitary micro adenoma or macroedenoma induced)
Nursing Considerations:
Side Effects:
Nausea, vomiting, anorexia, abdominal pain, diarrhoea, constipation
Headache, dizziness, fatigue, insomnia
Hypotension
Muscle weakness
Nasal congestion
(rare) acute psychosis, somnolence, compulsive behaviours i.e pathological gambling, increased libido
Contraindications:
Mental illness
Parkinson’s disease
Hypersensitivity.
Liver or kidney impairment
Storage Conditions:
Keep your medicine in the original container until it is time to take it. Store it in a cool dry place. Do not store it or any other medicine in the bathroom or near a sink. Do not leave it in the car or on window sills.
Route of Administration:
Orally ( 25 microgram,50 microgram, 75 microgram tablets)