Pituitary and Adrenocortical Hormones

The pituitary gland lies deep within the cranial vault, connected to the brain by the infundibular stalk (a downward extension of the floor of the third ventricle) and protected by an indentation of the sphenoid bone called the sella turcica (see Fig. 50-1). The pituitary gland, a small, gray rounded structure, has two parts  

This section of the chapter discusses FSH, LH, GH, and ACTH. FSH and LH are called gonadotropins because they influence the gonads (the organs of reproduction). GH, also called somatotropin, contributes to the growth of the body during childhood, especially the growth of muscles and bones. ACTH is produced by the anterior pituitary and stimulates the adrenal cortex to secrete the corticosteroids. The anterior pituitary hormone, TSH, is discussed in Chapter 51. Prolactin, which is also secreted by the anterior pituitary, stimulates the production of breast milk in the postpartum patient Additional functions of prolactin are not well understood. Prolactin is the only anterior pituitary hormone that is not used medically. 

The gonadotropins (FSH and LH) influence the secretion of sex hormones, development of secondary sex characteristics, and the reproductive cycle in both men and 

Clomiphene (Clomid) is a synthetic nonsteroidal compound that binds to estrogen receptors, decreasing the amount of available estrogen receptors and causing the anterior pituitary to increase secretion of FSH and LH. It is used to induce ovulation in anovulatory (nonovulating) women. 

Chorionic gonadotropin (HCG) is extracted from human placentas. The actions of HCG are identical to those of the pituitary LH. The hormone is used to induce ovulation in anovulatory women. This drug is also used for the treatment of prepubertal cryptorchism (failure of the testes to descend into the scrotum) and in men to treat selected cases of hypogonadotropic hypogonadism. 

The adverse reactions associated with the menotropins include ovarian enlai ment, hemoperitoneum (blood in the peritoneal cavity), abdominal discomfort, and febrile reactions. Urofollitropin administration may result in mild to moderate ovarian enlargement, abdominal discomfort, nausea, vomiting, breast tenderness, and irritation at the injection sitei Multiple births and birdi defects have been reported with the use of both menotropins and urofollitropin. 

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Discuss general actions, uses, adverse reactions, contraindications, precautions, and interactions of the pituitary and adrenocortical hormones. 

Discuss important preadministration and ongoing assessment activities the nurse should perform on a patient taking the pituitary and adrenocortical hormones. 

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