Medication

Drug treatment of the pituitary gland diseases is conducted only after a complete endocrinological examination, with subsequent correction of hormonal levels.

For insufficient production of pituitary hormones (hypopituitarism), adequate doses of hormone replacement therapy are selected, both for the pituitary gland itself and for the peripheral endocrine glands.

In case of excessive production of pituitary hormones, drugs are used that affect the various links of the pathological mechanism of hyperproduction. Currently, quite effective drugs in the treatment of pituitary adenomas are:

  • dopamine agonists (often used in the treatment of pituitary adenoma – prolactinoma)
  • somatostatin analogs (often used in the treatment of pituitary adenoma – somatotropinoma)
  • derivatives of aminoglutethimide, ketoconazole, ortho-para-diphenyl-dichloro-ethane – used for Cushing’s disease to disrupt the synthesis of steroids in the adrenal glands (used only as a temporary measure). May cause adrenal insufficiency.
  • thyreostats (often used in the treatment of pituitary adenoma – thyrotropinoma) – for preoperative reduction of thyrotoxicosis.

Resistance to drug therapy may occur in the absence of appropriate receptors in the tumor.

Possible side effects:

  • dopamine agonists: nausea, vomiting, weakness, dizziness, headache, irritability, orthostatic hypotension, drowsiness, confusion, dyskinesia, psychomotor agitation, hallucinations, muscle cramps, dry mouth, paleness of the skin, fingers and toes.
  • somatostatin analogs: anorexia, nausea, vomiting, spastic abdominal pain, feeling of bloating, excessive gas formation, loose stool, diarrhea, steatorrhea, formation of gallstones, impaired glucose tolerance, persistent hyperglycemia.
  • derivatives of aminoglutethimide, ketoconazole, and ortho-para-diphenyl-dichloro-ethane: confused consciousness, lethargy, nausea, vomiting, diarrhea, skin rash, fever, leukopenia, agranulocytosis, thrombocytopenia, pancytopenia, alveolitis.
  • thyreostatics: skin rash, abnormal pigmentation of the skin, leukopenia, agranulocytosis, dyspeptic phenomena, abnormal liver function, cholestatic jaundice, headache, polyneuritis, arthralgia, fever, generalized lymphadenopathy.