Analysis of the effect of drug treatment for pituitary adenoma

  Analysis of the effect of drug treatment for pituitary adenoma Pituitary adenoma is a common benign tumor with a general population incidence of 1 in 100,000, second only to glioblastoma and meningioma among intracranial tumors, accounting for about 10% of intracranial tumors. Pharmacological treatment of pituitary adenoma can also see a significant improvement in the therapeutic effect.  Bromocriptine: Bromocriptine is a semi-synthetic ergot alkaloid bromide, a dopamine agonist, which can excite the hypothalamus to secrete prolactin-releasing inhibitory factor and prevent the release of PRL, or stimulate dopamine receptors to effectively inhibit the secretion of PRL and partially inhibit the secretion of GH. The application of bromocriptine in the treatment of PRL adenoma can reduce PRL level, even to normal level; at the same time, it can reduce 60% of tumor volume, make patients have less headache, improve visual field, inhibit lactation, and restore gonadal function and fertility.  The disadvantage of bromocriptine is that after stopping the drug, the tumor will increase again, PRL will rise again and the symptoms will recur, so the efficacy of using bromocriptine alone to treat IPA is not ideal, but it can be used as one of the postoperative adjuvant treatment, especially for those who still have hyperprolactinemia after surgery.  By inhibiting the secretion and synthesis of GH, it can reduce the GH level to normal in 2/3 of patients with acromegaly; by inhibiting the growth of tumor, it can reduce the size of tumor, and it also has therapeutic effect on TSH-secreting adenoma and gonadotropinoma. The side effects of this drug are minor, mainly painful local injection, spasmodic abdominal pain, and a dual effect on glucose metabolism in GH patients.  Pre-operative use of octreotide can make the tumor softer and smaller, which helps surgical resection, and can also be used as post-operative adjuvant therapy to control the post-operative GH hypersecretion state. Cyproheptadine: Cyproheptadine is a 5-hydroxytryptamine antagonist, which can inhibit serotonin, stimulate CRH release and lower ACTH levels, and is suitable for the treatment of Cushing’s disease, and is also effective for Nelson syndrome.