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Pituitary Disorders (Prolactinoma (1st line: D2 agonist (↓ PRL secretion…
Pituitary Disorders
Prolactinoma
1st line: D2 agonist
↓ PRL secretion and ↓ tumour size
Bromocroptine, Cabergoline
2nd line: Trans-sphenoidal excision
If visual or pressure symptoms don’t response to
medical Rx
Cranial DI
Desmopressin
IV
Nasal spray
Avoid dilutional hyponatraemia by daily polyuria
episode
Hypopituitarism
ACTH: hydrocortisone
GH: rh-GH
FSH / LH
Testosterone
OCP
TSH: T4
Acromegaly
1st line: trans-sphenoidal excision
2nd line: somatostatinanalogues – octreotide
90% respond
IGF1 normalised in 60%
3rd line: GH antagonist – pegvisomant
4th line: radiotherapy