Question
A 50-year-old patient presents with a recurrence of a pituitary tumor that is overproducing growth hormone (GH). Which medication is the most appropriate for treatment?
| A. |
Bromocriptine |
| B. |
Octreotide |
| C. |
Pegvisomant |
| D. |
Goserelin |
Show Answer
|
Correct Answer » C Explanation |
 |
- A growth hormone (GH)-secreting pituitary adenoma in an adult causes acromegaly.
- The pharmacological options for acromegaly include somatostatin analogues such as octreotide and GH receptor antagonists such as pegvisomant.
- The provided study material specifically identifies pegvisomant as a GH receptor antagonist indicated for the treatment of acromegaly.
- The high-yield drug table likewise lists pegvisomant as the specific drug for acromegaly.
Why Pegvisomant is correct:
- Pegvisomant is a growth hormone receptor antagonist.
- It blocks GH action at peripheral GH receptors, thereby reducing downstream insulin-like growth factor-1 (IGF-1) effects.
- It is therefore particularly useful for controlling the biochemical effects of excess GH in acromegaly.
Why the other options are less appropriate
A. Bromocriptine — Incorrect
- Bromocriptine is a dopamine D2 receptor agonist.
- Its major indication is hyperprolactinemia.
- It can also be used in acromegaly, but the supplied material notes that it is less effective than octreotide.
- Therefore, it is not the best answer when pegvisomant is available.
B. Octreotide — Incorrect
- Octreotide is a somatostatin analogue that inhibits GH secretion.
- It is an important treatment for acromegaly and is specifically described in the supplied material as being used for acromegaly.
- However, the question is testing the characteristic drug pegvisomant, the GH receptor antagonist specifically indicated for acromegaly.
D. Goserelin — Incorrect
- Goserelin is a gonadotropin-releasing hormone (GnRH) analogue.
- Continuous administration suppresses luteinizing hormone (LH) and follicle-stimulating hormone (FSH).
- It is used in conditions such as prostate cancer, endometriosis, uterine fibroids, and precocious puberty—not for GH excess.
