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The hormones produced by the hypothalamus and pituitary gland are key regulators of metabolism, growth, and reproduction. Preparations of these hormones, including recombinant forms and drugs that mimic or block their effects, are used in the treatment of a variety of endocrine disorders, including infertility.
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ANTERIOR PITUITARY HORMONES & THEIR HYPOTHALAMIC REGULATORS
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The hypothalamic and pituitary hormones and their antagonists are often grouped according to the anatomic site of release of the hormone that they mimic or block—the hypothalamus for gonadotropin-releasing hormone (GnRH); the anterior pituitary for growth hormone (GH), the 2 gonadotropins, luteinizing hormone (LH) and follicle-stimulating hormone (FSH), and prolactin; or the posterior pituitary for oxytocin and vasopressin (antidiuretic hormone [ADH]). This chapter focuses on the agents used commonly; refer to the full text Basic and Clinical Pharmacology for hormones that are either not used clinically or are used solely for specialized diagnostic testing (thyrotropin-releasing hormone [TRH], thyroid-stimulating hormone [TSH], corticotropin-releasing hormone [CRH], adrenocorticotropic hormone [ACTH], and growth hormone-releasing hormone [GHRH]). Hormones of the anterior pituitary are central links in the hypothalamic-pituitary endocrine system (or axis; Figure 37–1). All the anterior pituitary hormones are under the control of a hypothalamic hormone, and with the exception of prolactin, all mediate their ultimate effects by regulating the production by peripheral tissues of other hormones (Table 37–1). Four anterior pituitary hormones (TSH, LH, FSH, and ACTH) and their hypothalamic regulators are subject to feedback regulation by the hormones whose production they control. The complex systems that regulate hormones of the anterior pituitary provide multiple avenues of pharmacologic intervention.
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