A) Treatment of GH deficiency

Explanation: Growth Hormone/Somatropin (recombinant) is used for the treatment of GH deficiency, growth failure in children, and GH replacement in adults with confirmed deficiency, addressing various conditions related to growth and hormone deficiency.

D) Treatment of thyroid cancer

Explanation: Recombinant TSH is utilized in the treatment of thyroid cancer, particularly administered just before a tracer dose of radioiodine to stimulate the uptake of radioiodine, aiding in the management of this specific type of cancer.

A) Releasing or inhibiting hormones produced by the hypothalamus

Explanation: Anterior pituitary hormones are regulated by releasing or inhibiting hormones produced by the hypothalamus, which includes various hormones such as GHRH, somatostatin, dopamine, CRH, TRH, and GnRH.

D) Hypothalamus and posterior pituitary

Explanation: Vasopressin (ADH) and oxytocin are synthesized in the hypothalamus and then transported to the posterior pituitary, where they are stored before being released into circulation. This process highlights the role of the hypothalamus and posterior pituitary in the production and release of these hormones.

C) Oxytocin and vasopressin

Explanation: The posterior pituitary gland releases oxytocin and vasopressin, which are important hormones involved in various physiological processes such as uterine contractions, lactation, and water balance regulation.

C) Renal collecting duct system

Explanation: The V2 receptor of vasopressin is predominantly located in the principal cells of the renal collecting duct system, where it primarily mediates the antidiuretic effect by regulating water reabsorption in the kidneys.

B) Increase in osmolality

Explanation: The principal physiological stimulus for the release of vasopressin is an increase in osmolality, which triggers the body's response to maintain water balance.

B) The hypothalamus controls the pituitary gland

Explanation: The hypothalamus exerts control over the pituitary gland, influencing its hormone production and release, showcasing the interconnected nature of these two components within the endocrine system.

B) Relaxation

Explanation: Oxytocin causes marked but transient relaxation of vascular smooth muscles when given in large doses, leading to a temporary fall in blood pressure. This effect is notable in the context of its therapeutic applications.

B) In the control of variceal bleeding in portal hypertension

Explanation: Desmopressin injection is used to boost factor VIII concentration in mild to moderate haemophilia, particularly in the control of variceal bleeding in portal hypertension.

B) Acromegaly

Explanation: Somatostatin Analogues like Octreotide are utilized for the treatment of acromegaly, a condition characterized by excessive growth hormone production, demonstrating their therapeutic application in managing specific hormonal disorders.

B) Treatment of acromegaly

Explanation: Pegvisomant is used in the treatment of acromegaly, a condition characterized by excessive growth hormone production, and functions as a growth hormone antagonist to address this hormonal imbalance.

D) Their structures are very similar

Explanation: Vasopressin (ADH) and oxytocin are noted for their very similar structures, indicating a close resemblance in their molecular composition. This similarity is significant in understanding their functions and interactions within the body.

A) By hypothalamic releasing hormone

Explanation: Contrary to many other hormones, the secretion of vasopressin is not regulated by hypothalamic releasing hormone, highlighting its unique regulatory mechanism.

D) Potent vasoconstriction

Explanation: Vasopressin exerts potent vasoconstriction throughout the circulation, leading to increased peripheral resistance and contributing to the regulation of blood pressure and blood flow in the cardiovascular system.

C) Low oxygen levels

Explanation: In addition to osmolality and hypovolaemia, factors such as pain, nausea, and hypoxia can also stimulate vasopressin secretion, indicating the diverse physiological triggers for this hormone.

A) Regulating metabolism

Explanation: Pituitary hormones play a vital role in regulating metabolism, demonstrating their significance in influencing various physiological processes such as growth, development, and energy utilization.

A) V1 receptor

Explanation: Most of the adverse effects of vasopressin are mediated through the V1 receptor on vascular or gastrointestinal smooth muscle, highlighting the significance of this receptor in the physiological response to vasopressin.

C) Marked facial pallor as a result of cutaneous vasoconstriction

Explanation: A large dose of vasopressin injection causes marked facial pallor as a result of cutaneous vasoconstriction, indicating the impact of vasopressin on the circulatory system and its potential adverse effects.

B) Such effects are less common and less severe with desmopressin

Explanation: The adverse effects of desmopressin are less common and less severe compared to vasopressin, highlighting a potential advantage of desmopressin in therapeutic applications.

B) Fluid retention and water intoxication

Explanation: All three drugs, vasopressin, desmopressin, and terlipressin, can cause fluid retention and water intoxication, emphasizing the need for careful monitoring and dosage control when using these medications.

D) Oedema, scarring, rhinitis, congestion, irritation, pruritus, and ulceration

Explanation: Intra nasal administration of vasopressin, desmopressin, and terlipressin can lead to local effects such as oedema, scarring, rhinitis, congestion, irritation, pruritus, and ulceration, highlighting the potential nasal-related adverse effects of these drugs.

E) Tropic hormones

Explanation: Anterior pituitary hormones are tropic hormones, which are hormones that have the ability to regulate the function of other endocrine glands.

C) Hypothalamus

Explanation: Vasopressin is synthesized in the hypothalamus and transported to the posterior pituitary in bound form, specifically bound to neurophysin, highlighting the unique process of its production and transportation.

C) Increases water permeability

Explanation: Vasopressin increases water permeability in the collecting duct, allowing for greater reabsorption of water and contributing to the regulation of water balance in the body.

B) Vasoconstrictor in the splanchnic circulation

Explanation: Terlipressin primarily acts as a vasoconstrictor in the splanchnic circulation, which is significant in its therapeutic application for conditions such as variceal bleeding.

C) Dopamine

Explanation: Hormones and neurotransmitters such as acetylcholine, histamine, dopamine, prostaglandin, and angiotensin II stimulate vasopressin secretion, highlighting the complex regulatory network involved in vasopressin release.

D) Von Willebrand factor

Explanation: Through V2 receptors, the substance increases circulating levels of Von Willebrand factor, which is involved in blood coagulation and clot formation.

B) Antidiuretic effect and hyponatraemia due to free water retention

Explanation: Large doses of oxytocin can produce an antidiuretic effect and hyponatraemia due to free water retention, highlighting its impact on water balance and the potential adverse effects associated with its use.

C) Ergometrine produces faster contractions superimposed on a tonic contraction

Explanation: Unlike oxytocin, ergometrine produces faster contractions superimposed on a tonic contraction, making it suitable for specific medical uses such as the treatment of postpartum hemorrhage.

C) Given during active management of the third stage of labor

Explanation: Ergometrine is administered during active management of the third stage of labor to prevent postpartum hemorrhage, highlighting its specific role in obstetric care.

A) Induction or augmentation of labour

Explanation: Oxytocin is used therapeutically to induce or augment labor, making it a crucial hormone in obstetrics and gynecology for facilitating childbirth.

B) Hypothalamus

Explanation: Oxytocin is synthesized in the hypothalamus, highlighting its origin within the brain and its role as a neurohypophysial hormone.

D) Abortion

Explanation: Oxytocin is utilized as a therapeutic agent in the context of abortion to induce contractions and facilitate the process, highlighting its role in obstetric and gynecological interventions.

C) Anterior and posterior

Explanation: The pituitary gland is composed of two lobes, the anterior and posterior lobes, each with distinct functions and hormone secretion.

C) Palliative treatment of hormone-responsive tumors (prostate and breast cancer)

Explanation: Leuprolide and Goserelin are GnRH analogues used in the palliative treatment of hormone-responsive tumors such as prostate and breast cancer, highlighting their role in managing these specific types of cancer.

A) Stimulates uterine contractions and milk ejection

Explanation: Oxytocin plays a crucial role in stimulating uterine contractions during childbirth and promoting milk ejection during breastfeeding, highlighting its significance in reproductive and lactation processes.

B) Control of variceal bleeding

Explanation: Terlipressin is a prodrug of vasopressin and is primarily used in the control of variceal bleeding, making it a crucial medication in managing this specific medical condition.

D) It may modulate the CNS autonomic system

Explanation: The substance may modulate the CNS autonomic system, potentially influencing functions such as heart rate, arterial blood pressure, respiratory rate, and sleep patterns.

D) Glucocorticoids

Explanation: Substances such as ethanol, phenytoin, low-dose morphine, glucocorticoids, fluphenazine, haloperidol, and promethazine inhibit vasopressin secretion, demonstrating the diverse range of factors that can modulate vasopressin release.

A) Contraction

Explanation: At higher concentrations, vasopressin contracts gastrointestinal smooth muscles via V1 receptors, indicating its role in regulating gastrointestinal motility and function.

C) Glycogenolysis in hepatocytes

Explanation: Vasopressin at higher concentrations triggers glycogenolysis in hepatocytes, contributing to the regulation of blood glucose levels and energy metabolism.

D) Nocturnal enuresis

Explanation: Desmopressin injection is used in the treatment of nocturnal enuresis, a condition characterized by involuntary urination during sleep.

C) Lithium

Explanation: Lithium can be used if the disease cannot be controlled by other measures or where tetracycline is contraindicated, emphasizing its potential role as an alternative medication in specific situations.

B) Uterine inertia

Explanation: Oxytocin is utilized in cases of uterine inertia to stimulate contractions and address the condition, demonstrating its therapeutic role in managing this obstetric complication.

C) Sensory stimuli from the cervix and vagina

Explanation: Oxytocin secretion is induced by sensory stimuli from the cervix and vagina, emphasizing the role of these stimuli in triggering the release of this hormone.

C) Growth hormone and prolactin

Explanation: The anterior pituitary hormones include growth hormone, ACTH, FSH, LH, TSH, and prolactin, each playing a crucial role in regulating various body functions.

A) Assisted reproduction

Explanation: GnRH antagonists such as Ganirelix and Cetrorelix are utilized in assisted reproduction, emphasizing their role in fertility treatments and in vitro fertilization procedures.

B) Vasoconstriction

Explanation: The V1 receptor of vasopressin is primarily responsible for mediating vasoconstriction, which is the constriction of blood vessels, leading to an increase in blood pressure and regulation of blood flow.

C) Regulating hormone production

Explanation: Hypothalamic and pituitary hormones primarily function to regulate the production and release of hormones throughout the body, playing a crucial role in maintaining hormonal balance and overall physiological function.

C) Contracts uterine muscle

Explanation: At higher concentrations, oxytocin contracts uterine muscle via oxytocin receptors, which is a crucial physiological response during childbirth and lactation.

A) Treatment of pituitary (cranial) diabetes insipidus

Explanation: Desmopressin injection is used in the treatment of pituitary (cranial) diabetes insipidus, a condition characterized by the inability to regulate water balance in the body.

B) By controlling hormone levels

Explanation: Hypothalamic and pituitary hormones contribute to homeostasis by controlling hormone levels, ensuring a balanced internal environment and optimal physiological function.

C) In the control of variceal bleeding in portal hypertension

Explanation: Vasopressin or terlipressin, a prodrug of vasopressin, is used in the control of variceal bleeding in portal hypertension due to its vasoconstrictor effect.

B) Demeclocycline

Explanation: Demeclocycline can be given to inhibit vasopressin, highlighting its specific role in targeting vasopressin and its potential therapeutic application in managing related conditions.

C) It causes contraction of myoepithelial cells

Explanation: Oxytocin causes contraction of myoepithelial cells which surround alveolar channels in the mammary gland, and therefore can be used to enhance milk ejection, such as through a nasal spray.

B) Chlopropamide

Explanation: Chlopropamide can potentiate small or residual amounts of circulating vasopressin, but it carries a risk of hypoglycemia, making it a potential option for patients intolerant to antidiuretic peptides.

C) Insignificant vasoconstrictor effect and longer duration of action

Explanation: Desmopressin has two advantages over vasopressin, including an insignificant vasoconstrictor effect and a longer duration of action, making it a preferred option for certain therapeutic applications.

C) Dopamine

Explanation: Dopamine is the hormone that inhibits prolactin secretion, highlighting its role in regulating anterior pituitary hormone function.

B) Reduction in size of prolactinomas

Explanation: Dopamine Agonists such as Bromocriptine and Cabergoline are primarily used for the reduction in size of prolactinomas, highlighting their therapeutic application in managing this specific type of pituitary tumor.

C) G protein-coupled receptors (GPCR)

Explanation: The cellular effects of vasopressin are mediated by G protein-coupled receptors (GPCR), specifically the V1 and V2 receptors, which play a crucial role in regulating vasoconstriction and antidiuretic effects, respectively.

C) It enhances memory and learned behavior

Explanation: The substance has some effects on memory and learned behavior, indicating a potential positive impact on cognitive functions.

C) ACTH

Explanation: The substance enhances the secretion of adrenocorticotropic hormone (ACTH), which plays a role in regulating the body's response to stress and other vital functions.

B) Heart failure, high blood pressure, asthma

Explanation: The medication should be used with caution in individuals with heart failure, high blood pressure, and asthma, as these conditions may require careful monitoring and management to avoid potential complications.

C) Vascular disease, chronic nephritis, skin conditions

Explanation: The medication is contraindicated in individuals with vascular disease, especially coronary artery disease, unless extreme caution is exercised, as well as in those with chronic nephritis. These conditions pose significant risks and may lead to adverse effects if the medication is used.

B) Suppresses it

Explanation: Oxytocin can suppress the action of ACTH, indicating its potential influence on the endocrine system and the hormonal regulation within the body.

D) Cardiac arrhythmias and reductions in cardiac output

Explanation: Vasopressin can cause cardiac arrhythmias and reductions in cardiac output, underscoring the potential cardiovascular impact of this hormone and its therapeutic implications.

A) Desmopressin

Explanation: Desmopressin is the drug of first choice for patients who cannot tolerate antidiuretic peptides due to side effects or allergic reactions, making it a primary treatment option in such cases.

C) Post partum haemorrhage

Explanation: Oxytocin is employed therapeutically to manage postpartum haemorrhage by promoting uterine contractions, aiding in the prevention and treatment of excessive bleeding after childbirth.

D) Carbamazepine

Explanation: Carbamazepine, which acts in a similar way to chlopropamide, can be used in cases where treatment for diabetes insipidus (DI) following head injury or surgery is required for a limited period, providing a temporary therapeutic option.

C) 5-12 minutes

Explanation: The half-life of the drug is 5-12 minutes, indicating the time it takes for the concentration of the drug in the body to reduce by half, which is crucial for understanding its pharmacokinetics.

C) Water intoxication and hyponatraemia

Explanation: High doses of the drug, combined with a large volume of fluid intake, can lead to water intoxication and hyponatraemia, underscoring the importance of monitoring fluid balance during its administration.

B) Vasopressin and oxytocin

Explanation: The posterior pituitary hormones include vasopressin and oxytocin, which are involved in the regulation of water balance, uterine contractions, and milk ejection during breastfeeding.

C) Regulating water balance

Explanation: Vasopressin, also known as antidiuretic hormone, primarily functions in regulating water balance by controlling the reabsorption of water in the kidneys, thereby influencing urine concentration and overall fluid balance in the body.

C) Increases Na+ and urea transport

Explanation: Vasopressin increases Na+ and urea transport, facilitating the reabsorption of these substances in the renal tubules and contributing to the regulation of electrolyte balance in the body.

D) They control the release of other hormones

Explanation: Hypothalamic and pituitary hormones play a key role in controlling the release of other hormones within the endocrine system, demonstrating their essential function in maintaining hormonal balance and overall physiological regulation.

B) Contracts uterine muscle

Explanation: At higher concentrations, vasopressin contracts uterine muscle via V1 receptors, demonstrating its role in uterine contraction and regulation of blood pressure.

C) Subcutaneously

Explanation: The medication for pharmacokinetics can be administered subcutaneously, which involves injecting the medication into the fatty tissue layer just below the skin. This route of administration allows for gradual absorption of the medication.

B) 20 min

Explanation: The half-life (T½) of the medication for pharmacokinetics is 20 minutes, indicating the time it takes for the concentration of the medication in the body to reduce by half. This information is crucial for determining dosing intervals and overall pharmacokinetic profile.

C) Liver and kidney

Explanation: The medication for pharmacokinetics is inactivated by peptidase in various tissues, particularly in the liver and kidney. This highlights the importance of considering the metabolic pathways and potential sites of inactivation when determining the dosage and administration of the medication.

B) It increases contraction frequency

Explanation: Oxytocin stimulates both the frequency and force of contraction in the uterus, with full relaxation in between, and this effect is highly dependent on the presence of estrogen, particularly in the pregnant uterus, which becomes more sensitive at term.

C) Inadequate secretion of vasopressin

Explanation: Diabetes insipidus (DI) is caused by an inadequate secretion of vasopressin, leading to impaired renal concentration of water. This can result from various factors such as head injury, tumors, haemorrhage, or may be idiopathic or familial.

C) Thiazide diuretics

Explanation: If polyuria is not satisfactorily controlled with chlopropamide, thiazide diuretics may be added to the treatment regimen, offering an alternative approach for managing the condition.

B) Increase in plasma osmolality

Explanation: Similar to vasopressin, the secretion of oxytocin is provoked by an increase in plasma osmolality, highlighting a common regulatory mechanism for these two hormones.

C) 10%

Explanation: The bioavailability of intranasal Desmopressin is 10%, which indicates the proportion of the drug that enters the systemic circulation when administered through the nasal route, influencing its effectiveness and dosage considerations.

A) Loop diuretics

Explanation: In addition to water restriction, the use of loop diuretics may be needed for management, indicating the potential need for this specific medication to address the condition.

A) Peripheral vasoconstriction and gangrene

Explanation: Large doses of vasopressin, desmopressin, and terlipressin rarely lead to peripheral vasoconstriction and gangrene, highlighting the potential adverse effects of these drugs when administered in high amounts.

C) Allergic reactions ranging from urticana to anaphylactic shock

Explanation: Allergic reactions, including urticana to anaphylactic shock, can occur with the administration of vasopressin, desmopressin, and terlipressin, underscoring the potential immunological responses associated with these drugs.

B) Inadequate response to vasopressin

Explanation: Nephrogenic diabetes insipidus (DI) is caused by an insufficient renal response to vasopressin, leading to impaired renal concentration of water. This condition can be a result of various factors affecting the kidneys' ability to respond to vasopressin.

C) It is an alkaloid from a fungus

Explanation: Ergometrine is characterized as an alkaloid derived from a fungus that infects grain, distinguishing it from hormones and other compounds. This unique origin contributes to its pharmacological properties.

D) Ethanol

Explanation: The secretion of oxytocin is suppressed by ethanol, indicating the inhibitory effect of alcohol on the release of this hormone.

D) Removed largely by kidney and liver

Explanation: The drug is primarily eliminated from the body through the kidney and liver, highlighting the organs responsible for its clearance and emphasizing its pharmacokinetic profile.

B) Head injury, tumours, haemorrhage, or infarction

Explanation: Cranial diabetes insipidus (DI) can be caused by head injury, tumours, haemorrhage, or infarction, among other factors. These conditions can lead to an inadequate secretion of vasopressin, resulting in impaired renal concentration of water.

D) 75 minutes

Explanation: The half-life (T½) of Desmopressin is 75 minutes, indicating the time it takes for the concentration of the drug in the body to reduce by half, which is an important pharmacokinetic parameter to consider in its therapeutic use.

C) It stimulates the uterus constantly

Explanation: Ergometrine is known to stimulate the uterus at all times, with increased sensitivity during late pregnancy. This continuous uterine stimulation is a key aspect of its pharmacological action and clinical use.

C) Syntocinon

Explanation: Synthetic oxytocin is referred to as 'syntocinon', distinguishing it from other related hormones and emphasizing its pure form for therapeutic use.

C) Dopamine receptors

Explanation: Ergometrine is an α-adrenoceptor and dopamine agonist, indicating its specific interaction with dopamine receptors. This pharmacological action is essential to understand its therapeutic effects and potential side effects.

C) Hyponatremia

Explanation: SIADH is characterized by hyponatremia, which is a low concentration of sodium in the blood, often accompanied by impaired water excretion and hypo-osmolality due to inappropriate secretion of ADH.

C) Lethargy, anorexia, nausea, vomiting, muscle cramps, convulsion, coma, and even death

Explanation: Clinical manifestations of SIADH include lethargy, anorexia, nausea, vomiting, muscle cramps, convulsion, coma, and even death, highlighting the severity of the condition.

E) Intranasal preparations are used to enhance milk ejection

Explanation: Intranasal preparations of oxytocin are employed therapeutically to enhance milk ejection, making it a valuable intervention in lactation and postpartum care.

B) Every 10 minutes

Explanation: The dose of oxytocin may be increased every 10 minutes until contractions occur, indicating the need for close monitoring and adjustment of the infusion rate.

B) 3-5 milliunits/min

Explanation: Oxytocin is administered intravenously at a rate of 1-3 milliunits/min and must be closely monitored, with the possibility of increasing the dose every 10 minutes until contractions occur, followed by intervals of at least 20 minutes.

C) Malignancies, pulmonary disease, and CNS disease/injuries

Explanation: SIADH can be caused by malignancies such as oat cell lung cancer, pulmonary disease, CNS disease or injuries like head injury, infection, and trauma, as well as general surgery and certain drugs.

D) 20 minutes

Explanation: After contractions occur, the dose of oxytocin should be increased at intervals of at least 20 minutes, emphasizing the need for careful and controlled administration.

D) Syntometriene

Explanation: A mixture of oxytocin and ergometrin is available under the name Syntometriene, which is noted to have several advantages, indicating its potential therapeutic benefits.

E) Buccal mucosa

Explanation: The drug is readily absorbed from the buccal mucosa, allowing for the use of buccal lozenges as a route of administration, which can impact its pharmacokinetics and therapeutic applications.