26.2 Growth Hormones and Suppressants
2 min read•june 18, 2024
therapy is a game-changer for those with growth disorders. It uses recombinant human growth hormone to stimulate growth, cell reproduction, and more. This treatment can help kids reach normal height and improve adults' quality of life.
Nurses play a crucial role in managing growth hormone therapy. They monitor patients' growth, administer injections, and watch for side effects. Patient education is key, covering proper injection techniques, lifestyle tips, and the importance of sticking to the treatment plan.
Growth Hormone Therapy
Key characteristics and actions of growth hormone drugs
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- Recombinant human growth hormone () treats growth hormone deficiency and other disorders binds to growth hormone receptors stimulating growth, cell reproduction, , , and glucose production
- most commonly prescribed form of rhGH administered via subcutaneous injection with dosage individualized based on patient response and levels
- Growth hormone therapy normalizes height and achieves normal adult stature in children with growth disorders (, , Noonan syndrome, idiopathic short stature)
- In adults, growth hormone therapy treats adult-onset growth hormone deficiency improving body composition, bone density, cardiovascular risk factors, and quality of life
Indications, side effects, and contraindications
- Indications: growth hormone deficiency, Turner syndrome, Prader-Willi syndrome, Noonan syndrome, idiopathic short stature, adult-onset growth hormone deficiency
- Common side effects: headache, muscle pain, joint pain, , ,
- Rare but serious side effects: benign (pseudotumor cerebri), slipped capital femoral epiphysis, scoliosis progression
- Contraindications: active malignancy, acute critical illness, severe obesity, severe respiratory impairment, active proliferative or severe non-proliferative diabetic retinopathy, hypersensitivity to the drug or its components
Nursing considerations
- Assess patient's growth and development (height, weight, body proportions)
- Monitor IGF-1 levels adjusting dosage to maintain levels within normal range for age and sex
- Administer growth hormone via subcutaneous injection rotating injection sites to prevent lipoatrophy
- Educate patients and caregivers on proper injection technique and medication storage
- Monitor for side effects (headache, edema, joint pain) and signs of benign intracranial hypertension (headache, vision changes, nausea)
- Monitor blood glucose levels assessing for insulin resistance
- Collaborate with multidisciplinary team (endocrinologists) to ensure optimal patient care
Patient education points
- Emphasize adherence to prescribed dosage and administration schedule
- Teach proper injection technique and site rotation using a new needle for each injection and allowing refrigerated medication to reach room temperature before injecting
- Instruct patients to report side effects to healthcare provider
- Encourage regular follow-up visits to monitor growth, development, and treatment response
- Discuss maintaining a healthy lifestyle (balanced diet, regular exercise)
- Inform patients that growth hormone therapy is a long-term commitment and results may not be immediately apparent
- Advise patients to inform all healthcare providers about their growth hormone therapy as it may interact with other medications or affect surgical procedures
- Provide emotional support and resources for coping with psychological aspects of growth disorders and treatment
Key Terms to Review (60)
Acromegaly: Acromegaly is a hormonal disorder that results from excess growth hormone (GH) in the body, typically caused by a pituitary adenoma. It leads to abnormal enlargement of bones and tissues, particularly noticeable in the hands, feet, and face.
Acromegaly: Acromegaly is a rare hormonal disorder caused by the overproduction of growth hormone (GH) by the pituitary gland, leading to the abnormal growth of various body tissues and organs, particularly the hands, feet, and facial features.
Agonist: An agonist is a substance that binds to a receptor and activates it to produce a biological response. Agonists can be drugs or endogenous compounds like hormones.
Anabolism: Anabolism is the metabolic pathway that involves the synthesis of complex molecules from simpler ones, requiring the input of energy. It is the constructive phase of metabolism, in contrast to catabolism, which is the destructive phase. Anabolism is a crucial process for growth, repair, and maintenance of the body's tissues and structures.
Angioedema: Angioedema is a rapid swelling of the dermis, subcutaneous tissue, mucosa, and submucosal tissues. It can be life-threatening if it affects the airway and often occurs as an adverse reaction to certain medications.
Anterior Pituitary: The anterior pituitary, also known as the adenohypophysis, is the front lobe of the pituitary gland. It is a critical endocrine gland responsible for the production and secretion of several essential hormones that regulate important physiological processes in the body, including growth, metabolism, and stress response.
Arthralgia: Arthralgia refers to pain in one or more joints, without visible signs of inflammation. It is a common symptom associated with various medical conditions, including those related to growth hormone regulation.
Bioavailability: Bioavailability refers to the degree and rate at which a drug or other substance is absorbed and becomes available at the site of action in the body. It is a crucial pharmacokinetic property that determines the effectiveness and safety of a medication.
Bromocriptine mesylate: Bromocriptine mesylate is a dopamine agonist used primarily to treat Parkinson’s disease and prolactinomas. It works by stimulating dopamine receptors, which helps to reduce symptoms of these conditions.
Carpal Tunnel Syndrome: Carpal tunnel syndrome is a condition caused by compression of the median nerve as it passes through the carpal tunnel in the wrist, leading to numbness, tingling, and weakness in the hand and fingers. This condition is particularly relevant in the context of growth hormones and suppressants, as it can be a side effect of certain treatments.
Catabolism: Catabolism is the metabolic process by which complex molecules are broken down into simpler ones, releasing energy in the process. It is the opposite of anabolism, which involves the synthesis of complex molecules from simpler ones. Catabolism is a crucial component of the overall metabolic activities in the body, particularly in the context of growth hormones, androgens, and anabolic steroids.
Edema: Edema is the abnormal accumulation of fluid in the body's tissues, leading to swelling. This term is particularly relevant in the context of fluid balance, cardiovascular function, kidney and hormonal regulation, and the use of various medications.
Endocrine System: The endocrine system is a complex network of glands and hormones that regulate and coordinate many of the body's functions, including growth, metabolism, sexual function, and mood. It plays a crucial role in maintaining homeostasis and ensuring the proper functioning of various physiological processes.
Fundoscopic Examinations: Fundoscopic examinations, also known as ophthalmoscopy, are a diagnostic procedure used to visually inspect the back of the eye, including the optic nerve and retina. This examination is crucial in the assessment and management of various conditions related to growth hormones and their suppressants.
Genotropin: Genotropin is a brand name for the synthetic human growth hormone somatropin, which is used to treat growth hormone deficiency in children and adults. It is a recombinant DNA-derived human growth hormone that helps promote growth and development by stimulating the production of insulin-like growth factor-1 (IGF-1).
Gigantism: Gigantism is a rare condition characterized by excessive growth and abnormal enlargement of the body, primarily due to overproduction of growth hormone during childhood before the growth plates have closed. This results in an individual growing significantly taller than the average height for their age and sex.
Glucose Intolerance: Glucose intolerance is a condition in which the body has difficulty regulating blood glucose levels, leading to impaired glucose metabolism. This term is particularly relevant in the context of diuretics and growth hormone treatments, as these can impact glucose homeostasis.
Growth Hormone: Growth hormone (GH) is a peptide hormone produced by the pituitary gland that stimulates growth, cell reproduction and regeneration in humans and other animals. It plays a crucial role in regulating various metabolic processes and is essential for normal growth and development throughout life.
Growth Hormone Receptor: The growth hormone receptor is a protein found on the surface of cells that binds to growth hormone, a critical hormone responsible for regulating growth, development, and various metabolic processes in the body. This receptor plays a central role in mediating the effects of growth hormone on target tissues.
Growth hormone receptor antagonists: Growth hormone receptor antagonists are drugs that block the action of growth hormone by binding to its receptors without activating them. This prevents excessive growth hormone activity, which can be useful in treating conditions like acromegaly.
Growth Hormone Stimulation Test: The growth hormone stimulation test is a diagnostic procedure used to evaluate the body's ability to produce and release growth hormone (GH) in response to specific stimuli. This test is primarily employed in the assessment of growth hormone disorders, such as growth hormone deficiency or excess.
Growth hormone suppressants: Growth hormone suppressants are medications that inhibit the secretion or action of growth hormone (GH) in the body. They are often used to treat conditions like acromegaly and gigantism, where there is excessive GH production.
Half-life: Half-life is the time required for the concentration of a drug in the bloodstream to reduce by half. It helps determine dosing intervals and duration of drug effects.
Half-Life: Half-life is a fundamental concept in pharmacology that describes the time it takes for the concentration or amount of a drug in the body to be reduced by half. It is a crucial factor in understanding the pharmacokinetics and pharmacodynamics of drugs, as well as their dosing and administration.
Homeostasis: Homeostasis is the process by which the body maintains a stable and balanced internal environment, despite changes in external conditions. It is a fundamental principle that allows the body to function optimally and adapt to various stressors.
Humatrope: Humatrope is a brand name for a synthetic human growth hormone (hGH) medication used to treat growth hormone deficiency in both children and adults. It is a recombinant DNA-derived somatropin that helps promote normal growth and development by stimulating the production of insulin-like growth factor-1 (IGF-1).
Hypopituitarism: Hypopituitarism is a condition characterized by the underproduction of one or more hormones by the pituitary gland, a small endocrine gland located at the base of the brain. This hormonal deficiency can lead to a variety of health issues, including growth and development problems, reproductive difficulties, and metabolic disturbances.
Hypothalamus: The hypothalamus is a crucial part of the brain that regulates various physiological processes, including hunger, thirst, sleep, and hormone release. It plays a pivotal role in maintaining homeostasis by controlling the endocrine system through its interaction with the pituitary gland.
Hypothalamus: The hypothalamus is a small, but crucial, region of the brain that plays a vital role in maintaining homeostasis, regulating hormone production, and coordinating the body's responses to various stimuli. As a key component of the endocrine system, the hypothalamus serves as the link between the nervous system and the endocrine system, allowing for the integration of physiological and behavioral processes.
Hypothyroidism: Hypothyroidism is a condition in which the thyroid gland produces an insufficient amount of thyroid hormones, leading to a slowing of various metabolic processes in the body. This term is relevant across multiple topics, including osmolality, vitamins and minerals, mood stabilizers, potassium channel blockers, growth hormones, thyroid and parathyroid functions, thyroid and antithyroid drugs, and weight management.
IGF-1: IGF-1, or Insulin-like Growth Factor 1, is a hormone that plays a crucial role in growth and development. It is produced primarily by the liver in response to growth hormone (GH) stimulation and acts on target tissues to promote cell growth, differentiation, and survival.
Insulin Resistance: Insulin resistance is a condition in which the body's cells become less responsive to the hormone insulin, leading to impaired glucose metabolism and an increased risk of developing type 2 diabetes. This term is crucial in understanding the pathophysiology and management of various endocrine and metabolic disorders.
Insulin-Like Growth Factor 1: Insulin-like growth factor 1 (IGF-1) is a hormone that is structurally and functionally similar to insulin. It plays a crucial role in regulating growth, cell proliferation, and metabolism in the body. IGF-1 is primarily produced by the liver in response to growth hormone (GH) secretion, and it acts on target tissues to promote cell growth and differentiation.
Intracranial Hypertension: Intracranial hypertension is a condition characterized by an abnormal increase in the pressure within the skull, which can lead to various neurological complications. It is a critical factor to consider in the context of growth hormones and their suppressants.
Lanreotide acetate: Lanreotide acetate is a synthetic analog of somatostatin, used primarily to treat acromegaly by reducing growth hormone levels. It is administered via deep subcutaneous injection.
Lipohypertrophy: Lipohypertrophy is a condition characterized by the abnormal enlargement or overgrowth of fat tissue, often occurring as a side effect of repeated insulin injections in individuals with diabetes. This condition is particularly relevant in the context of growth hormones and their suppressants, as it can impact the effectiveness and administration of these treatments.
Lipolysis: Lipolysis is the process of breaking down fat (triglycerides) stored in adipose tissue into free fatty acids and glycerol. This metabolic pathway is crucial for the release and utilization of stored energy, and it is closely linked to the regulation of growth hormones, glucocorticoids, and weight management strategies.
Negative Feedback Loop: A negative feedback loop is a regulatory mechanism in biological systems where the output of a process acts to reduce or inhibit further changes in that output. This process helps maintain homeostasis and balance within the body's physiological systems.
Neuroendocrine system: The neuroendocrine system is a complex network of interactions between the nervous system and the endocrine glands, primarily involving the hypothalamus and pituitary gland. It regulates various physiological processes such as stress response, growth, and metabolism.
Norditropin: Norditropin is a brand name for a synthetic human growth hormone (somatropin) used to treat growth hormone deficiency in both children and adults. It is a recombinant DNA-derived human growth hormone that helps promote growth and development by stimulating the production of insulin-like growth factor-1 (IGF-1) in the liver and other tissues.
Octreotide acetate: Octreotide acetate is a synthetic analog of somatostatin, used to inhibit the secretion of certain hormones and peptides. It is commonly employed in treating conditions like acromegaly and severe diarrhea associated with certain tumors.
Papilledema: Papilledema is the swelling of the optic nerve head, or optic disc, due to increased intracranial pressure. It is a critical sign that can indicate the presence of an underlying neurological condition requiring immediate medical attention.
Parlodel: Parlodel, also known as bromocriptine, is a dopamine agonist used to treat Parkinson's disease and certain pituitary tumors. It works by stimulating dopamine receptors in the brain.
Pediatric: Pediatric refers to the branch of medicine that involves the medical care of infants, children, and adolescents. It encompasses a range of practices including pharmacology, immunizations, and treatments for various disorders.
Pegvisomant: Pegvisomant is a growth hormone receptor antagonist used to treat acromegaly, a condition characterized by excessive growth hormone (GH) production. It works by blocking the effects of GH, thereby reducing insulin-like growth factor 1 (IGF-1) levels.
Prader-Willi syndrome: Prader-Willi syndrome is a genetic disorder characterized by hypothalamic dysfunction, leading to growth hormone deficiencies and other metabolic issues. It often presents with symptoms like insatiable appetite, obesity, and developmental delays.
Protein Synthesis: Protein synthesis is the process by which cells create new proteins. It involves the transcription of genetic information from DNA to RNA, and the subsequent translation of that RNA into functional protein molecules. This process is essential for growth, repair, and the proper functioning of cells, tissues, and organs throughout the body.
Receptor Binding: Receptor binding is the process by which a molecule, such as a drug or hormone, binds to a specific receptor on the surface or within a cell, triggering a physiological response. This interaction between the ligand and the receptor is a fundamental mechanism underlying the effects of various pharmacological agents and endogenous signaling molecules.
RhGH: rhGH, or recombinant human growth hormone, is a synthetic version of the natural human growth hormone produced by the pituitary gland. It is used to treat various medical conditions related to growth hormone deficiencies, such as growth failure in children and adults, and to promote muscle growth and fat loss.
Saizen: Saizen is a brand name for the synthetic human growth hormone somatropin, which is used to treat growth hormone deficiency in both children and adults. It is an injectable medication that helps stimulate the production and release of natural growth hormones in the body.
Sandostatin: Sandostatin is a synthetic version of somatostatin, a hormone that inhibits the release of several other hormones. It is used to treat severe diarrhea and flushing caused by certain types of cancer and to manage acromegaly.
Small for Gestational Age: Small for gestational age (SGA) refers to a newborn whose birth weight or length is below the 10th percentile for their gestational age, meaning they are smaller than expected based on the average size of babies at that stage of pregnancy. This condition is often associated with growth hormones and suppressants, as they can impact fetal development and growth during pregnancy.
Somatostatin: Somatostatin is a peptide hormone that acts as a growth hormone-inhibiting hormone, suppressing the secretion of growth hormone, thyroid-stimulating hormone, and several other hormones. It plays a crucial role in regulating the endocrine system and maintaining homeostasis within the body.
Somatostatin analogs: Somatostatin analogs are synthetic versions of the natural hormone somatostatin, used to inhibit the release of growth hormone and other hormones. They are commonly prescribed for conditions like acromegaly, neuroendocrine tumors, and severe diarrhea.
Somatostatin Analogs: Somatostatin analogs are a class of synthetic compounds that mimic the effects of the naturally occurring hormone somatostatin. Somatostatin is a peptide hormone that inhibits the secretion of various hormones, including growth hormone, insulin, and glucagon, making somatostatin analogs valuable for the management of conditions related to excessive hormone production.
Somatotropin: Somatotropin, also known as growth hormone (GH), is a peptide hormone produced and secreted by the anterior pituitary gland. It plays a crucial role in regulating growth, development, and various metabolic processes within the body.
Somatropin: Somatropin is a synthetic form of human growth hormone (hGH), a polypeptide hormone produced by the pituitary gland that plays a crucial role in growth, cell regeneration, and metabolism. As a pharmaceutical agent, somatropin is used to treat various conditions related to growth hormone deficiency.
Somatuline: Somatuline is a brand name for lanreotide, a synthetic version of somatostatin used to treat acromegaly and symptoms caused by neuroendocrine tumors. It works by inhibiting the release of several hormones including growth hormone.
Somavert: Somavert is a brand name for pegvisomant, a growth hormone receptor antagonist used to treat acromegaly by reducing the effects of excess growth hormone. It works by blocking growth hormone receptors, thereby decreasing the production of insulin-like growth factor-1 (IGF-1).
Turner Syndrome: Turner syndrome is a chromosomal disorder that affects females, characterized by the partial or complete absence of one of the X chromosomes. This genetic condition leads to a variety of physical and developmental challenges, with implications for growth and hormone regulation.