repro drugs Flashcards

1
Q

GnRH analog w agonist properties when used in pulsatile fashion

A

leuoprolide

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

GnRH antagonist when used in continousu fashion

A

leuoproilde

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

use of leuprolide

A

uterine fibroids, endometriosis, precocious puberty, prostate cancer, infertility

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

other GnRH analgos

A

nafarelin, goserilin, histerilin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

estrogen drugs include

A

ethinyl estradiol, DES, mestranol

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

use of estrogen drugs

A

hypogonaidsm or ovarian failure, menstrual abnomralities, hormone replacement therapy in postmenopausal women; use in men w androgen dependent prostate cancer

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

SE of estroge ndrugs

A

increase risk of endometrial cancer (when given w/o progestoerone)
bleeding in postmenopausal women
clear cell adenocarcinoma of vagina in females exposed to DES in utero; increase risk of thrombi

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Contraindciatiosn in estrogen drugs

A

ER+ breast cancer, history of DVT’s

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Selective estrogen receptor modulators

A

clomiphene, tamoxifen, raloxifene

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Clomiphene is an antagnoist at estrogen receptors in

A

hypothalamus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

prevents normal feedback inhibition and increase release of LH and FSH from pituitary, which stimulates ovulation

A

clomphene

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

treat infertility due to anovulation (PCOS)

A

clomiphene

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

SE hot flashes, ovarian enlargement, multiple simulatenous pregnancies, visual disturbances

A

clomiphene

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

tamoxifen is an antagnoist at the

A

breast

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

tamoxifen is an agonist at the

A

bone, uterus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Increases risk of thromboembolic events and endometrial cancer

A

used to treat and prevent recurrence of ER/PR + breast cancer

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

raloxifene is antagnoist at

A

breast, uterus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

raloxifene is agonist at the

A

bone

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

increase risk of thrombooembolic evenrts but no increased risk of endometrial cancer

A

raloxifene

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

which estrogen receptor modulater is used to treat osteoporosis

A

raloxifene

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

aromatase inhibitors

A

anastrozole, letrozole, exemestane

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

inhibit periperhal conversion of androgen to estrogen

A

aromatase inihbitor

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

clinical use of aromatase inihbiot

A

ER+ breast cancer in postmenopausal women

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

Hormone replacement therapy is used for

A

relief or prevention of menopausal symptoms (hot flashes, vaginal atrophy), osteoporosis (increase estrogen, decrease osteoclast activity)

25
Q

unopposed estrogen replacement therpay increases risk of what cancer

A

endometrial
(thus progesterone / progestin is added)
also possible increased CV risk

26
Q

progestins drugs

A

levonorgestrel, medroxyprogesterone, etonogestrel, norethindrone, megestrol, and many others when combined w estrogen

27
Q

binds progesterone receptors; decreases growth and increases vascularization of endometrium, thicken cervical mucus

A

progestin

28
Q

thickens cervical mucus

A

progestin

29
Q

use of progestin

A

contraception, endometrial cancer, abnoraml uterine bleeding

30
Q

describe progestin challenge:

A

presence of withdrawal bleeding excludes anatomic defects (asherman syndrome) and chronic anovulation without estorgen

31
Q

antiprogestins include

A

mifepristone, ulipristal

32
Q

mechanism of antiprogestin

A

competitive inhibitors of progestins at progesterone receptors

33
Q

use of antiprogestin

A

termination of pregnancy

34
Q

mifepristone + misoprostol does what

A

terminates pregnancy

35
Q

emergency contraception

A

ulipristal

36
Q

Contraindications of OCP

A

smokers > 35 yrs old (increased risk of CV events), pt’s w increase risk of CV disease (including history of VTE, coronary artery disease, stroke), migraine (esp w aura), breast cancer

37
Q

mechanism of copper intrauterine device

A

produces local inflammatory reaction toxic to sperm and ova, prevents fertilization and implantation; hormone free

38
Q

most effective emergency contraception

A

copper intrauterine device (long acting reversible contraception

39
Q

B2 agonists that relax the uterus; used to decrease contraction frequency in women during labor

A

terbutaline, ritodrine

40
Q

tertbutaline is linked to increased risk of neonatal

A

intraventricular hemorraghe, hypoglycemia, hyperkalemia, hyocalcemia, ileus

41
Q

danazol mechanism

A

synthetic androgen that acts as a partial agonist at androgen receptors

42
Q

use of danazol

A

endometriosis, hereditary angioedema

43
Q

SE of danazol

A

weight gain, edema, acne, hirsuitsm masculinization

decrease HDL levels; hepatotxcity, psuedotumor cerebri

44
Q

testosterone receptor agnoists that treats prostate cancer; can cause gynecomastia

A

bicalutamide

45
Q

testosterone does what to LDL and HDl

A

increase LDL and decrese HDL

46
Q

direct arteriorlar vasodilator used for androgenetic alopecia; severe refractory hypertension

A

minoxidil

47
Q

Antiandrogens include

A

finasteride, flutamide, ketoconazole

48
Q

used for BPH and male pattern baldness

A

finasteride (increase risk of gynecomastia)

49
Q

nonsteroidal competitive inhibitor at androgen receptors; used for prostate carcinoma

A

flutamide

50
Q

inhibits steroid synthesis, inhiibts 17,20 desmolase/17 a hydroxylase)

A

ketoconazole

51
Q

inhibits steroid binding, 17,20 desmolase/17ahydroxylase

A

spironolactone

52
Q

used in pCOS to reduce androgenic symptoms; both can cause gynecomastia and amenorrhea

A

ketoconazole and spironolacton

53
Q

a1 antagonist used to treat BPH by inhibitng smooth muscle contraction

A

tamsulosin

54
Q

tamsulosin is selective for which receptors

A

a1a/D receptors (foudn on prostate) vs. vascular a1B receptors

55
Q

PDE5 inhibitors include

A

sildenafil, vardenafil, tadalafil

56
Q

mechanism of pde5inhibiotrs

A

inhibit pde5: increase cGMP; prolonged smooth muscle realxaiton in resposne to NO; increase blood flow in corpus cavernosum of penis; decrease pulmonary vasc reisiatnce

57
Q

Pde5 inhibiotrs use

A

ED, pul htn, BPH (tadalafil only)

58
Q

SE of pde5 inhibitors

A

headache, flushing, dyspepsia, cyanopia (blue tinted vision); risk of life-threateing htn in patients taking nitrates