1. Dopamine agonists

* Effecting orally
* Usually started first
* Most successful for tumors secreting both GH and prolactin
* Safe during pregnancy

2. Somatostatin analogs

Eg: octreotide, lanreotide

* Given by s.c route
* Injected once monthly
* Safe during pregnancy
* Expensive

3. GH receptor antagonist

Eg: pegvisomant

* Given by daily s.c injections
* Safe during pregnancy
* Cause visual field defects
* Extremely expensive

4. Tamoxifen

* In SERM
* Do not decrease GH level but reduces IGF 1 levels
* Used for persistent acromegaly in men and women who had breast cancer

A) Bleeding esophageal varices
B) Secretory diarrhea
C) Infective diarrhea
D) Acromegaly

Ans: C