Somatotropin
Somatotropin, commonly known as **growth hormone (GH)**, is a peptide hormone produced by the anterior pituitary gland. In veterinary medicine, recombinant bovine somatotropin (rbST) has historically been used to increase milk production in dairy cattle, while porcine somatotropin is utilized to improve feed efficiency and muscle growth in swine. In small animal medicine (dogs and cats), human recombinant somatotropin is occasionally used off-label to treat **pituitary dwarfism** (growth hormone deficiency). > **Clinical Pearl:** Due to species-specific differences in amino acid sequences, human GH can induce neutralizing antibody formation in dogs and cats, which may limit its long-term efficacy. Porcine GH is highly homologous to canine GH and is the preferred therapeutic option if it can be sourced.
กลไกการออกฤทธิ์: Somatotropin binds to specific cell surface receptors in target tissues (liver, bone, muscle, adipose). * **Direct effects:** Stimulates lipolysis and inhibits glucose uptake, leading to increased blood glucose levels (diabetogenic effect). * **Indirect effects:** Mediated primarily through the stimulation of **Insulin-like Growth Factor-1 (IGF-1)** production in the liver. **GH → Liver → IGF-1 release → Binds to IGF receptors → Promotes cellular proliferation, linear bone growth (at open epiphyseal plates), and protein synthesis.**
ขนาดยาตามชนิดสัตว์
- Growth hormone replacement · 0.3-0.7 IU/kg weekly divided into 3-5 doses · SC/IM · divided into 3-5 doses weekly · Continue for at least 6 weeks to evaluate response · IM injection is painful. Monitor IGF-1.
- Growth hormone replacement · 0.3-0.7 IU/kg weekly divided into 3-5 doses · SC/IM · divided into 3-5 doses weekly · Continue for at least 6 weeks to evaluate response · IM injection is painful. Monitor IGF-1.
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วิธีการให้ยา
ข้อห้ามใช้
- Closed epiphyseal plates (if seeking linear growth)
- Neoplasia (may stimulate tumor growth)
- Diabetes mellitus
- Hypersensitivity to the drug or formulation components
- Patients with closed epiphyses (unless treating specific adult-onset deficiencies)
- Known hypersensitivity
- Active neoplasia
อาการไม่พึงประสงค์
- Hyperglycemia
- Insulin resistance / Diabetes mellitus
- Acromegaly (with prolonged use)
- Antibody formation (when using human GH in pets)
- Injection site reactions
- Diabetogenic effect (hyperglycemia/diabetes mellitus)
- Local injection site reactions
- Antibody formation (reducing long-term efficacy)
อันตรกิริยาระหว่างยา
- Glucocorticoids · May antagonize the growth-promoting effects of somatotropin. · moderate
- Insulin · Somatotropin induces insulin resistance, potentially requiring significant adjustments in insulin dosage for diabetic patients. · major
การติดตาม
- Serum IGF-1 levels
- Blood glucose and urine glucose
- Thyroid panel (TSH/T4)
- Growth rate and body weight
- Physical signs of acromegaly
- Blood glucose
- Growth rate/body weight
- Injection site reactions
การได้รับยาเกินขนาด
Acute overdose is unlikely to cause severe clinical signs other than transient hypoglycemia followed by hyperglycemia. Chronic overdosage leads to **acromegaly** and **diabetes mellitus**.
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