Somatropin

Sarah Al-Gethami

Pharm II

Growth hormone is a peptide hormone secreted by the pituitary gland that stimulates growth and cell reproduction. It is produced by recombinant DNA technology and is prescribed for a variety of reasons.

Functions:

Stimulate linear and skeletal growth. Increases number and size of skeletal muscle cells. Increases RBC mass and internal organ size. Increases cellular protein synthesis.

Reduces body fat stores

Promotes lipid mobilization.

Uses:

In Children:
Treatment

of growth failure.

Treatment

of short stature.

Uses:

In Adults:

A growth hormone deficiency . HIV+ adults with cachexia . Adults with short bowel syndrome.

Dosage:

For adults:

Hormone Replacement Therapy : 0.004 mg/kg/day - 0.016 mg/kg/day AIDS Wasting or Cachexia:
More 45 35

than 55 kg: 6 mg daily.

to 55 kg: 5 mg daily. to 45 kg: 4 mg daily.

less

than 35 kg, 0.1 mg/kg

Dosage
In

pediatrics:

For the treatment of idiopathic short stature:

0.024

to 0.034 mg/kg 6 to 7 times/wk.

Administration:

It

is administered SC and At bed time .

Nordilet

It

is a disposable multidose injection prefilled pen .

How to use the pen:

Step

1:
the solution .
Pull off the cap .
Check the solution .

Check

Step 2 :

Attach the needle.

Always Keep

use a new disposable needle . of the inner needle cap .

the outer needle cap ..

Dispose

 Step

3:

Check the flow.

Hold the pen with needle with the needle stillthe pointing pointing push upwards . upwards the button on the bottom .. Tap the cartridge with your finger a A drop of the solution should appear few times to make sure that the .bubbles collect at the top. If a drop doesnt appear after 6 air shots DO NOT use the pen ..

 Step

4:
the dose :

Dial

Put

the cap back on the pen ..

sure that the dosage indicator is back at 0 .

Make

Step 4 :

Dial the dose :

Turn
The

the dial in the direction shown to set the dose you want.
scale on the pen cap shows the number of clicks.

Every
The

time you make a full turn , 5 clicks will me set on the push button.
scale will show (5, 10, 15, 20 or 25 ) clicks .

Example :

How to select 8 clicks ..

Turn the pen cap one full turn so that 0 is next to the dosage indicator again .. you have now selected 5 clicks and 5 will appear on the push button scale .. Now continue turning the pen cap scale until 3 is next to the dosage indicator . Add the 3 from the cap scale and 5 from the dose scale and you have selected 8 clicks ..

How to check the dose set:

Add the number on the pen cap to the highest number shown on the push button scale .. If you have set a wrong dose, simply turn the pen cap forwards or backwards until the right number of clicks is set .. The maximum dose you can set is 29 clicks . If you try to set the dose at higher than 29 clicks, growth hormone will leak out of the needle and the dose will be wrong .

Step 5 :

Inject the solution:

Vary

the area that you inject so that you dont harm your skin . the needle into your skin vertically .. the dose by pressing the push button all the way in .. the injection keep the needle under the skin for at least 6 seconds and then withdraw it . the push button fully depressed until you remove it from the skin.

Insert

Deliver After

Keep

 Step

6:
the needle:
the outer needle cap .. And remove the

Remove

Replace

needle .

Always
If

use a new needle immediately after each injection ..

you do not remove it straight away air may fill into the cartridge , which may cause a wrong dose next time .

Quick tool

1st step:

check if dose is correct: 0.034 x wt.

2nd step:

calculated need for the 30 day period dose x 30

3rd step:

calculate number of syringes: need for 30 day / 5mg

4th step:

check number of clicks on label: 1 syringe = 75 clicks

Contraindications:

Hypersensitivity to growth hormone. Growth promotion in pediatric patients with closed epiphyses.

evidence of active malignancy.

active proliferative or severe nonproliferative diabetic retinopathy.

Adverse Reactions:

In Children:
Arthralgia. Edema Injection

site reaction.

Leg pain. pain.

Headache Hypothyroidism.

Muscle

Psoriasis

exacerbation.

Adverse Reactions:

In Adults:
Arthralgia. Myalgia. Peripheral

Edema.
Flu-like

edema.

syndrome.

Paresthesia. Skeletal

Headache.

pain.