Anterior pituitary drugs
Anterior pituitary drugs
The protein hormones produced in the anterior pituitary gland regulate growth, development, and sexual characteristics by stimulating the actions of other endocrine glands. Anterior pituitary drugs include:
- adrenocorticotropics, which include corticotropin, corticotropin repository, corticotropin zinc hydroxide, and cosyntropin
- somatrem and somatropin, growth hormones
- gonadotropics, which include chorionic gonadotropin and menotropins
- thyrotropics, which include thyroid-stimulating hormone, thyrotropin, and protirelin.
Pharmacokinetics
Anterior pituitary drugs aren’t given orally because they’re destroyed in the GI tract. Some of these hormones can be administered topically, but most require injection.
Absorption, distribution, and metabolism
Usually, natural hormones are absorbed, distributed, and metabolized rapidly. Some analogues, however, are absorbed and metabolized more slowly. Anterior pituitary hormone drugs are metabolized at the receptor site and in the liver and kidneys. The hormones are excreted primarily in urine.
Pharmacodynamics
Anterior pituitary drugs exert a profound effect on the body’s growth and development. The hypothalamus controls secretions of the pituitary gland. In turn, the pituitary gland secretes hormones that regulate secretions or functions of other glands.
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The concentration of hormones in the blood helps determine hormone production rate. Increased hormone levels inhibit hormone production; decreased levels raise production and secretion.
Pharmacotherapeutics
Anterior pituitary hormone drugs are used for diagnostic and therapeutic purposes:
- Corticotropin and cosyntropin are used diagnostically to differentiate between primary and secondary failure of the adrenal cortex.
- Corticotropin is also used to treat adrenal insufficiency.
- Somatrem is used to treat growth hormone deficiency.
Drug interactions
Anterior pituitary drugs interact with several types of drugs:
- Administering immunizations to a person receiving corticotropin increases the risk of neurologic complications and may reduce the antibody response.
- Corticotropin reduces salicylate levels.
- Enhanced potassium loss may occur when diuretics are taken with corticotropins.
- Barbiturates, phenytoin, and rifampin increase the metabolism of corticotropin, reducing its effects.
Estrogen effects
- Estrogen increases the effect of corticotropin.
- Taking estrogens, amphetamines, and lithium with cosyntropin can alter results of adrenal function tests.
- Concurrent use of amphetamines and androgens with somatrem may promote epiphyseal closure (closure of the cartilaginous bone growth plate).
- Concurrent use of somatrem and corticosteroids inhibits the growth-promoting action of somatrem.
Adverse reactions to anterior pituitary drugs
The major adverse reactions to pituitary drugs are hypersensitivity reactions.
Over the long haul
Long-term use of corticotropin can cause Cushing’s syndrome.
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