Hormonas

• Hormonas hipotálamo hipofisarias

• GH
• Gonadotrofinas
• Esteroides sexuales
• PRL
• Regulación de liberación
• Efectos
• Hormonas neurohipofisarias
                                                                    
Growth hormone-releasing hormone (GHRH) (+) growth hormone
{somatotropin, GH)Liver insulin-like growth factors (IGF, somatomedins)

Somatotropin releasing-inhibiting hormone (SRIH, somatostatin)(-)

growth hormone {somatotropin, GH)Liver insulin-like
growth factors (IGF, somatomedins)
Corticotropin-releasing hormone (CRH) (+) adrenocorticotropin
(ACTH) Adrenal cortex glucocorticoids, mineralocorticoids,
androgens
Thyrotropin-releasing hormone (TRH) (+) thyroid-stimulating
hormone (TSH) thyroid thyroxine, triiodothyronine
Gonadotropin-releasing hormone (GnRH) (+) (follicle-stimulating hormone
{FSH}; luteinizing hormone {LH}) gonads estrogen, progesterone,
testosterone

Dopamine (-) prolactin breast

• GHRH, CRH, GnRH, TSH, ACTH,
FSH, LH, and Dopamine receptors
associated G protein-GTP
complexadenylyl cyclase activation
cAMP production  protein kinase
activation intracellular protein
phosphorylation  hormonal effects
• Dopamine receptor -- Gi protein coupling
(lactotroph receptor system)  
decreased adenylyl cyclase activity
decreased prolactin secretion
• Growth hormone: GTP complex
related to somatostatin receptors
potassium channels inhibit growth
hormone (GH) secretion
• Thyrotropin-releasing hormone: G
protein complexes related to thyrotrophs'
TRH receptors phosphoinositide-
specific phospholipase C cytoplasmic
free calcium stimulating TSH
secretion
Type of Agent Stimulation (+) Inhibition (-)

Hypothalamic factors GHRH somatotropin

-2 adrenergic receptor agonists (clonidine,

Biogenic amines  adrenergic agonists
norepinephrine
adrenergic receptor antagonists (e.g., -2 adrenergic receptor antagonists (e.g.,
 
propranolol) yohimbine)
5-HT (serotonin) receptor antagonists (e.g.,
  5-HT (serotonin) stimuli (e.g.,L-tryptophan)
cyproheptadine, methysergide)
Dopaminergic stimuli (e.g., L-DOPA, Dopaminergic antagonists (e.g.,
 
apomorphine, bromocriptine) chlorpromazine)
Hormones Decreased IGF-I Increased IGF-I

  Estrogen Progestins

Glucocorticoids (acutely, glucocorticoids

  Vasopressin
increase growth hormone release)

  Glucagon (cholinergic-mediated)  

  Hypoglycemia (-adrenergic mediated) Increased blood sugar

  Decreased free fatty acids Increased free fatty acids

  Amino acid (arginine; cholinergic-mediated)  

Others Exercise---adrenergic mediated Antimuscarinic agents (e.g., atropine)

  Stress---adrenergic mediated  

  Sleep --cholinergic-mediated  

Cholinergic-muscarinic stimulation (e.g.,

 
pyridostigmine)
Hipotalamo
Hipotalamo
Hipotalamo
• GnRH en pulsos EV o IM estimula
• GnRH continua inhibe
• GNRH sinteticas mas potentes y de larga
duracion
•  Leuprolida, nafarelin, buserelin, goserelin,
histrelin
• En forma continua down regulation
• GnRH Route of Administration: IV or
subcutaneous
• GnRH analogues Route of Administration:
subcutaneous, nasal spray, intramuscular
• GnRH half-life: 4 minutes
• GnRH analog half-life: three hours
• Sites of degradation: hypothalamus & pituitary
• Binding site: receptors on pituitary
gonadotropes
• pulsatile IV administration (frequency every 1-
4 hours) FSH & LH secretion stimulation
• continuous GnRH administration (or GnRH
analog depot formulation) inhibition of
gonadotropin release
INDICACIONES
• Evaluacion de pubertad tardia
• EXCITATORIO PULSATIL
Infertilidad:Hipogonadismo
hipogonadotrofico hipotalamico
• INHIBITORIO: Ca prostata,
endometrio, endometriosis,
poliquistosis ovarica, pubertad
precoz
EFECTOS ADVERSOS
• Cefalea, TGI, osteoporosis
 Estrogenos
ER

E
R
ADN

ARNm
Sintesis de proteínas
• Receptores progesterona
• Receptores de ocitocina
• otras
PROGESTERONA
AR

A
R
ADN

ARNm
Sintesis de proteínas
 Utero
• MIOMETRIO
• Proliferacion
glandular B2 AMPc
relajacion
• Secrecion
• ENDOMETRIO
Contraccion
OT IP3/DG
PG IP3/DG
Changes During the Fertility Cycle
 
 
 
 
 Glandula Mamaria
• Desarrollo de estroma • ESTROGENOS
• Deposito de lipidos
• Desarrollo de conductos
• DESARROLLO DE
ACINOS • PROGESTERONA

• Secrecion de leche • PROLACTINA

• Expulsion de leche • OCITOCINA

 Anticonceptivos
• Estrogenos solos pildora
post coito
• Gestagenos solos • Dificultan nidacion
• Combinados
• Simultaneos bajas • Inhiben
estrogenos gonadotrofinas
• Simultaneos altas • Mayor efectos
estrogenos adversos
Hipotalamo
 ANDROGENOS
AR

A
R
ADN

ARNm
Sintesis de proteínas
 Efectos adversos
• Deficit LH-FSH ICSH
• Masculinizacion de fetos femeninos
• Femenizacion de fetos masculinos
• Ca de vaginas femeninos
• Edema
• Estrogenos:Tromboembolismo, Ca mama,
endometrio
 Interacciones
• Inductores enzimaticos: DPH, FB CBZ,
RFP, Pirazolonas, Clorpromazina
• Absorcion intestinal: Ampicilina, CFC,
MTZ
• Flora bacteriana: ATB
• Disminuye efecto de ACO
• Disminuye BT hepatica Imipramina
• IH,IR
 Hormonas neurohipofisarias
• Nucleo supraoptico y • V2 absorcion TC y TD
paraventricular del de agua y sodio
Hipotalamo
• V1 presor
• ADH
• Tumores-vincristina, • VIII
vinblastina,CFM, AD3C, • Efectos: cefalea, SCA
CBZ contracciones uterinas
• - Etanol corticoides DPH
• Indicaciones DBT
• Analogo Desmopresina
insipida
 Metabolismo fosfocalcico
• Calcio
• Fosforo
• Fluor
• Paratohormona
• Vit D
• Calcitonina
• Bifosfonatos/Ipriflabona
Intestino Tubulo renal
• Calcio Calcio
• Fosforo
Fosforo
Aluminio
calcio

Efecto antirraquirtico
Hidroxiapatita Calcio
Fluoropatita
Hueso
 Absorcion de calcio
Aumenta Disminuye
• Tiazidas • Furosemida
• Calcitriol • Calcitonina
• AINES • GC
• Digitalicos
• AG
• T3T4
 Excrecion de Fosforo
Aumenta Disminuye (aumenta
• PTH reabsorcion)
• Acidosis metabolica • 1,25 di-OH vit D
• GC • Alcalosis respiratoria
-metabolica
• GH
 Vitamina D
Intestino RIÑON
1,25 DI-OH-D • 1,24,25 tri OH D
D • 1,25 Di OH-D
Acidos biliares • 25-OH –D
Metabolito mayor
Excrecion biliar vida media

• 24,25 DI –OH-D
• Metabolitos
incativos renales
Intestino Tubulo renal
• Calcio Calcio
• Fosforo
Fosforo
Aluminio
calcio

Efecto antirraquirtico
Hidroxiapatita Calcio
Fluoropatita
Hueso