Hypothalamic / Pituitary Drugs

Somatropin

• Growth hormone (GH) mimetic
• Mechanism
  • agonist at GH receptors
  • increases production of insulin growth factor-1 (IGF-1)
• Clinical use
  • GH deficiency
  • increase adult height for children with conditions associated with short stature 
    • Turner syndrome
  • wasting in HIV infection
  • short bowel syndrome
• Toxicity
  • scoliosis
  • edema
  • gynecomastia
• increased CYP450 activity

Octreotide

• Somatostatin mimetic
• Mechanism
  • agonist at somatostatin receptors
• Clinical use
  • acromegaly
  • carcinoid
  • gastrinoma
  • glucagonoma
  • acute esophageal variceal bleed
• Toxicity
  • GI upset
  • gallstones
• bradycardia

Oxytocin

• Mechanism
  • agonist at oxytocin receptor
• Clinical use
  • stimulation of labor
  • uterine contractions
  • control of uterine hemorrhage after delivery
  • stimulate milk letdown
• Toxicity
  • fetal distress 
  • abruptio placentae 
• uterine rupture

Desmopressin

• ADH (vasopressin) mimetic
• Mechanism
  • agonist at vasopressin V₂ receptors
• Clinical use
  • central (pituitary) diabetes insipidus
  • hemophilia A (factor VIII deficiency)
    • increases availability of factor VIII
  • von Willebrand disease
    • increases release of von Willebrand factor from endothelial cells
• Toxicity
  • GI upset
  • headache
  • hyponatremia
  • allergic reaction