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For instructor materials including Power Points, Answers to Clinical Encounter Questions, please contact userservices@mhprofessional.com.
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Content Update
September 12, 2024
Long-Acting Growth Hormone Products for the Treatment of Growth Hormone Deficiency: Recombinant growth hormone (GH) therapy has been the main pharmacologic treatment for GH deficiency in children and adults. Recent advancements in the treatment of GH deficiency have introduced long-acting growth hormone (LAGH) products, which have the potential to enhance adherence and clinical outcomes. Traditional daily recombinant GH therapy is effective but often burdensome, contributing to poor adherence to the daily subcutaneous or intramuscular injections. New LAGH formulations—lonapegsomatropin (Skytrofa), somatrogon-ghla (NGENLA), and somapacitan-beco (Sogroya)—offer reduced injection frequencies (weekly) while maintaining stable GH levels. These innovations may provide a more convenient treatment option that improves quality of life. Healthcare providers should consider baseline adherence patterns, long-term safety data, and patient preferences when incorporating LAGH products into clinical practice.
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Content Update
May 09, 2022
Pediatric Growth Deficiency 2021 FDA Novel Drugs Lonapegsomatropin-tcgd (Skytrofa®) and vosoritide (Voxzogo®) were recently approved by the United States Food and Drug Administration (FDA) for growth deficiency. Lonapegsomatropin-tcgd offers pediatric patients with growth hormone deficiencies favorable dosing frequency options, while Vosoritide is the first drug approved specifically for achondroplasia, the most common form of skeletal dysplasia. Cost, efficacy, and safety for both medications will be discussed in this update.
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LEARNING OBJECTIVES
Upon completion of the chapter, the reader will be able to:
List the mediators and primary effects of pituitary hormones.
Identify clinical features of patients with acromegaly.
Discuss the role of surgery and radiation therapy for patients with acromegaly.
Select appropriate pharmacotherapy for patients with acromegaly based on patient-specific factors.
Identify clinical features of children and adults with growth hormone (GH) deficiency and select appropriate pharmacotherapy for these patients.
Recommend monitoring parameters necessary to assess therapeutic outcomes and adverse effects in patients receiving GH therapy.
List common etiologies of hyperprolactinemia.
Identify clinical features of patients with hyperprolactinemia.
Select appropriate pharmacologic and nonpharmacologic treatments for patients with hyperprolactinemia based on patient-specific factors.
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PHYSIOLOGY OF THE PITUITARY GLAND
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The pituitary, referred to as the “master gland,” is a small endocrine gland located at the base of the brain and is responsible for the regulation of many other endocrine glands and body systems. Growth, development, metabolism, reproduction, and stress homeostasis are among the functions influenced by the pituitary. Functionally, the gland consists of two distinct sections: the anterior pituitary lobe and the posterior pituitary lobe. The pituitary receives neural and hormonal input from the inferior hypothalamus via blood vessels and neurons.
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The posterior pituitary is innervated by nervous stimulation from the hypothalamus, resulting in the release of specific hormones to exert direct tissue effects. The hypothalamus synthesizes two hormones, oxytocin and vasopressin. These hormones are stored and released from the posterior pituitary lobe. The anterior pituitary lobe is under the ...