Flashcards in Chapter 29: Pharm of Reproduction Deck (37)
What is the mechanism of action of finasteride?
5 alpha reductase inhibitor, therefore blocking conversion of testosterone to DHT
When would you use finasteride?
BPH because it slows the growth of prostate tissue and reduces the size (when you STERIDE on a bike it's uncomfortable on your prostate)
What is the major difference between finasteride and dutasteride?
F - type II and can be used for alopecia
D - type I and II and used for BPH
What is the major warning you should give your male patient who is married about finasteride and dutasteride?
Don't let your woman near that shit
HIDE YO KIDS HIDE YO WIFE
What drugs could you give to improve symptoms of decreased urine flow?
Mechanism of action of anastrozole and letrozole?
aromatase inhibitor - COMPETITIVE
(aromatase convertes androgens to estrogens)
How do exemestane and formestane differ in MOA from anastrazole and letrozole?
stanes are irreversible
What drugs would you use to treat estrogen dependent tumors?
Aromatase inhibitors (Gunner Al Zole and Ef Stanes are irreversible)
Severe estrogen repression greatly increases the risk for what..?
What is the MOA of tamoxifen?
estrogen receptor agonist in BONE
estrogen receptor antagonist in TISSUE
Major risk of tamoxifen? How do you combat this?
endometrium neoplasm ...
limit administration to less than 5 years
How do tamoxifen and raloxifene differ?
Raloxifene use to treat osteoporosis because its major capability was to increase estrogen receptor activity in bone...
tamoxifen is more to prevent breast cancer
What is the MOA of clomiphene?
antagonist in hypothalamus and ant. pituitary
agonist in ovaries
therefore will increase secretion of LH and FSH --> ovulation
Clome - clone - reproduction
potential increase in size of ovaries (hypertrophy and cysts)
What is the major complete estrogen receptor antagonist? MOA is competitive inhibition of estrogen receptor. Used for metastatic breast cancer in postmenopausal women.
Full Vested Auntie - this crazy lady is post menopausal and full vested because of breast cancer...
MUST INHIBIT THAT ESTROGEN SHITS
What drug, used to treat metastatic prostate cancer and BPH, is most effective when coupled with castration? What is it's MOA?
Androgen receptor antagonist - blocks DHT and testosterone acitvity
Flute is high pitched so when you lose testosterone craps you get high voice
What androgen receptor antagonist is indicated for treatment of hirsutism, acne, hypertension? What is its specific MOA?
aldosterone receptor antagonist with activity at androgen receptor
Captain Jack Spiro has a lot of facial hair - think hirsutism
What drug would you use for abortion through day 63 of pregnancy?
Morning after pill
1.5 mg 120 hrs
Why is estrogen always co-administered with a progestin in women with a uterus?
Unopposed estrogen increases the risk of endometrial cancer
What type of patient would you NOT give combination estrogen-progestin contraception?
DO NOT GIVE to women smokers over 35 because of serious cardio risks
MOA of estrogen-progestin combos?
Suppress GnRH,LH, FSH and follicular development --> inhibits ovulation
Adverse effects of estrogen-progestin contraception?
arterial/venous thromboembolism, pulmonary embolism, cerebral thrombosis
Triphasic oral formulations of estrogen-progestin contraceptives has higher or lower amounts of progestin each month?
What would you use as contraceptive in patients for whom estrogen use is contraindicated?
Progestin-only contraceptive MOA?
Alter frequency of GnRH pulsing and decrease anterior pituitary responsiveness to GnRH
What would you advise your patient to expect with respect to bleeding after prescribing her a progestin-only contraceptive?
breathrough spotting and irregular, light menstrual period during the first year of administration
Treatment of choice for hypogonadism?
Androgen hormone replacement
Testosterone enanthate/testosterone cypionate
You do NOT want to give androgen replacement therapy (i.e. testosterone) to which patients?
Men with prostate cancer
can INCREASE growth of the prostate...BAD!
What could potentially be used as a male contraceptive? Is there an oral form?
no oral form because of first pass hepatic metabolism
Testosterone hormone replacement is available in a topical gel formulation...what is a risk of this?
Potential transfer to female partner...BAD THING
What hormone replacement therapy can cause acne or gynecomastia