Gonadotropin, GnRH and GnRH Analogs

Schriefer 2/3/11

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Gonadotropin, GnRH and GnRH Analogs by Mind Map: Gonadotropin, GnRH and GnRH Analogs

1. Luteinizing H

1.1. MOA

1.1.1. Female:

1.1.1.1. Stimulates ovulation

1.1.1.2. Luteinization of follicle

1.1.1.2.1. Synthesis and secretion of progesterone and estrogen from corpus luteum

1.1.2. Male

1.1.2.1. Teste: Stimulates secretion of androgens from interstitial Leydig cells

1.2. Names

1.2.1. Menotropins

1.2.1.1. combo of LH and FSH

1.2.2. Chorionic Gn

1.2.3. rh-lutropin alpha

1.3. Admin

1.3.1. IM (peptide H)

1.4. Use

1.4.1. Stimultes ovulation

1.4.1.1. Used in assisted pregnancy procedures

1.4.2. Increases fertility in men

1.4.2.1. Use testosterone to develop 2nd sexual characteristics

1.4.3. Kits used to predict time of ovulation

1.5. SE

1.5.1. Induction of multiple pregnancies (OHS)

1.5.1.1. OHS can also cause ascites, shock, pulm edema, etc

2. FSH

2.1. Name

2.1.1. rh-FSH

2.1.2. Follitropin

2.1.3. Urinary FSH

2.1.4. Urofollitropin

2.2. MOA

2.2.1. Activates Gs

2.2.2. Ovary: promote follicle development

2.2.3. Testis: Stimulate testicular growth and maintain seminiferous tubule

2.3. Use

2.3.1. Promote ovulation

2.4. SE

2.4.1. OHS

2.4.1.1. multiple pregnancies

3. Chorionic Gn (hCG)

3.1. Not a pituitary H

3.1.1. synthesized by syncytiotrophoblasts in placenta

3.1.1.1. Similar structure and action as LH

3.2. Names

3.2.1. rh-HCG

3.2.2. choriogonadotropin alpha

3.3. MOA

3.3.1. Stimulate and sustain fn of corpus luteum

3.4. Use

3.4.1. induction of ovulation

3.4.2. descent of testes in cryptochidism

3.4.3. detection of pregnancy (used in preg tests)

3.4.4. re-start testosterone synthesis after using anabolic steroids

4. GnRH

4.1. Natural Gn

4.1.1. Gonadarelin

4.1.1.1. Only used diagnostically today

4.2. Long-acting analogs

4.2.1. Leuprolide

4.2.2. Nafareline

4.3. Admin

4.3.1. Leuprolide - intranasal spray

4.3.2. Nafareline - injection

4.4. MOA

4.4.1. Long-term effect: Decreased production of GnRH

4.4.1.1. Decreased estrodiol and testosterone release

4.4.2. Short term will see a "flair" in GnRH, LH, and FSH levels

4.4.2.1. Can be painful

4.4.2.1.1. If can't tolerate, use GnRH antagonist instead

4.5. Use

4.5.1. Tx of PMS

4.5.2. Endomestriosis

4.5.3. Prostate cancer

4.5.4. Central precocious puberty

4.5.5. Experimental use as male controceptive

5. GnRH antagonists

5.1. Names

5.1.1. Ganorelix

5.1.2. Centrorelix

5.1.3. Degarelix

5.1.4. Abarelix

5.2. Use

5.2.1. G&C: Inhibits premature LH spike prior to harvesting eggs for IVF

5.2.2. D&A: Tx for advanced prostate cancer

5.2.3. Alternate to GnRH analogs

5.2.3.1. Doesn't have the initial GnRH surge, just blocks receptor

5.3. SE

5.3.1. Sever allergic rxn