Growth hormonesUsed in the somafropin of dwarfism and growth failure, growth hormone hGH stimulates skeletal growth in pediatric patients with growth failure due to a lack of adequate secretion of endogenous GH. Skeletal growth somatropin genetic pharma accomplished at the epiphyseal plates at the ends of a growing bone. Growth and somatropin genetic pharma of epiphyseal plate cells are directly stimulated by GH and one of its mediators, IGF-I insulin-like growth factor. These signaling somatropin genetic pharma contribute to the GH-induced changes in enzymatic activity, transport function, and gene expression that ultimately culminate in changes in growth and phaarma. Although calcium excretion in the urine is increased, there is a slmatropin increase in calcium absorption from the intestine. Somatropin stimulates the synthesis of chondroitin sulfate and collagen, and increases the winstrol depot orally excretion of hydroxyproline.
DailyMed - HUMATROPE- somatropin
Its amino acid sequence and structure are identical to the dominant form of human pituitary growth hormone. Clinical studies in normal adults also demonstrated equivalent pharmacokinetics. Skeletal growth is accomplished at the epiphyseal plates at the ends of long bone.
Growth and metabolism of epiphyseal plate cells are directly stimulated by growth hormone and one of its mediators, insulin-like growth factor-I. Linear growth continues until the growth plates fuse at the end of puberty.
Protein Metabolism-Linear growth is facilitated in part by growth hormone-stimulated protein synthesis. This is reflected by increased cellular uptake of amino acids and nitrogen retention as demonstrated by a decline in urinary nitrogen excretion and blood urea nitrogen during growth hormone therapy.
Carbohydrate Metabolism-Growth hormone is a modulator of carbohydrate metabolism. Children with inadequate secretion of growth hormone sometimes experience fasting hypoglycemia that is improved by treatment with growth hormone. However, glucose levels remained in the normal range. Lipid Metabolism-Acute administration of human growth hormone to humans results in lipid mobilization. In growth hormone deficient patients, long-term growth hormone administration often decreases body fat.
The clinical significance of this is unknown. Mineral Metabolism-Growth hormone administration results in the retention of total body potassium, phosphorus, and sodium. Serum calcium levels appear to be unaffected. Distribution The mean volume of distribution of r-hGH given to healthy volunteers was estimated to be Metabolism The metabolic fate of somatropin involves classical protein catabolism in both the liver and kidneys.
In renal cells, at least a portion of the breakdown products is returned to the systemic circulation. The mean half-life of intravenous somatropin in normal males is 0. The longer half-life observed after subcutaneous or intramuscular administration is due to slow absorption from the injection site.
Excretion- The mean clearance of intravenously administered r-hGH in six normal male volunteers was Gender No gender studies have been performed in children.
In adults, the clearance of r-hGH in both men and women tends to be similar. Renal Insufficiency- Children and adults with chronic renal failure tend to have decreased clearance of r-hGH as compared to normals.
Hepatic Insufficiency- A reduction in r-hGH clearance has been noted in patients with hepatic dysfunction as compared with normal controls. Since, in rare instances, growth hormone deficiency may be an early sign of the presence of a brain tumor, the presence of such a tumor should be ruled out prior to initiation of treatment.
Available information suggests that the rate of tumor recurrence is not increased by growth hormone therapy. Growth hormone should not be initiated to treat patients with acute critical illness due to complications following open heart or abdominal surgery, multiple accidental trauma or to patients having acute respiratory failure. When Saizen is reconstituted in this manner, the reconstituted solution should be used immediately and any unused solution should be discarded.
The safety of continuing growth hormone treatment in patients receiving replacement doses for approved indications who concurrently develop these illnesses has not been established. Therefore, the potential benefit of treatment continuation with growth hormone in patients having acute critical illnesses should be weighed against the potential risk. Because human growth hormone may induce a state of insulin resistance, patients should be observed for evidence of glucose intolerance.
Human growth hormone should be used with caution in patients with diabetes mellitus or a family history of diabetes mellitus. Untreated hypothyroidism will jeopardize the response to growth hormone. Under these circumstances, epiphyseal maturation may progress rapidly. Patients with endocrine disorders, including growth hormone deficiency, may have an increased incidence of slipped capital femoral epiphysis.
Any child who develops a limp or complains of hip or knee pain during growth hormone therapy should be evaluated. Symptoms usually occurred within the first eight weeks of the initiation of growth hormone therapy. In all reported cases, IH-associated signs and symptoms resolved after temporary suspension or termination of therapy.
Funduscopic examination of patients is recommended at the initiation and periodically during the course of growth hormone therapy. When growth hormone is administered subcutaneously at the same site over a long period of time, lipodystrophy may result.
This can be avoided by rotating the injection site. As for any protein, local or systemic allergic reactions may occur. However, formal drug interaction studies have not been conducted.
Carcinogenesis, Mutagenesis, Impairment of Fertility: Reproduction studies have been performed in rats and rabbits at doses up to 31 and 62 times, respectively, the human child weekly dose based on body surface area.
There are, however, no adequate and well controlled studies in pregnant women. Because animal reproduction studies are not always predictive of human response, this drug should be used during pregnancy only if clearly needed. If home use is determined to be desirable by the physician, instructions on appropriate use should be given, including a review of the contents of the Patient Information Insert.
This information is intended to aid in the safe and effective administration of the medication. It is not a disclosure of all possible adverse or intended effects. If home use is prescribed, a puncture resistant container for the disposal of used syringes and needles should be recommended to the patient. As with all protein pharmaceuticals, a small percentage of patients may develop antibodies to the protein.
Despite the high binding capacity, these antibodies were not growth attenuating. The patient was subsequently shown to have a hGH-N gene defect. Thus, genetic analysis should be undertaken in any patient in whom anti-GH antibodies with high binding capacities occur.
No antibodies against proteins of the host cells were detected in the sera of patients treated up to five years. Any patient with well-documented growth hormone deficiency who fails to respond to therapy should be tested for antibodies to human growth hormone and for thyroid status. Leukemia has been reported in a small number of growth hormone deficient patients treated with growth hormone. It is uncertain whether this increased risk is related to the pathology of growth hormone deficiency itself, growth hormone therapy, or other associated treatments such as radiation therapy for intracranial tumors.
So far, epidemiological data fail to confirm the hypothesis of a relationship between growth hormone therapy and leukemia. For the treatment of growth hormone inadequacy, a dosage of 0. To prevent possible contamination, wipe the rubber vial stopper with an antiseptic solution before puncturing it with the needle. The syringes should be of small enough volume that the prescribed dose can be drawn from the vial with reasonable accuracy.
Expiration dates are stated on the labels. Clinical medicine is a group of medications and medical devices that study human diseases, methods of their diagnosis, treatment and prevention. Biological potency is determined by measuring the increase in body weight induced in hypophysectomized rats.
The reconstituted solution has a pH of 6. The quantitative composition per vial is: The pH is adjusted with sodium hydroxide or O-phosphoric acid. Action And Clinical Pharmacology: Tissue Growth Skeletal Growth: Race- No data are available. Indications And Clinical Uses: