Chapter 29: Pharm of Reproduction Flashcards Preview

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Flashcards in Chapter 29: Pharm of Reproduction Deck (37)
1

What is the mechanism of action of finasteride?

5 alpha reductase inhibitor, therefore blocking conversion of testosterone to DHT

2

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)

3

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

4

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

5

What drugs could you give to improve symptoms of decreased urine flow?

STERIDES

6

Mechanism of action of anastrozole and letrozole?

aromatase inhibitor - COMPETITIVE
(aromatase convertes androgens to estrogens)

7

How do exemestane and formestane differ in MOA from anastrazole and letrozole?

stanes are irreversible

8

What drugs would you use to treat estrogen dependent tumors?

Aromatase inhibitors (Gunner Al Zole and Ef Stanes are irreversible)

9

Severe estrogen repression greatly increases the risk for what..?

osteoporotic fractures

10

What is the MOA of tamoxifen?

estrogen receptor agonist in BONE
estrogen receptor antagonist in TISSUE

11

Major risk of tamoxifen? How do you combat this?

endometrium neoplasm ...
limit administration to less than 5 years

12

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

13

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

14

Clomiphene concern?

potential increase in size of ovaries (hypertrophy and cysts)

15

What is the major complete estrogen receptor antagonist? MOA is competitive inhibition of estrogen receptor. Used for metastatic breast cancer in postmenopausal women.

Fulvestrant

Full Vested Auntie - this crazy lady is post menopausal and full vested because of breast cancer...
MUST INHIBIT THAT ESTROGEN SHITS

16

What drug, used to treat metastatic prostate cancer and BPH, is most effective when coupled with castration? What is it's MOA?

Flutamide

Androgen receptor antagonist - blocks DHT and testosterone acitvity

Flute is high pitched so when you lose testosterone craps you get high voice

17

What androgen receptor antagonist is indicated for treatment of hirsutism, acne, hypertension? What is its specific MOA?

Spironolactone

aldosterone receptor antagonist with activity at androgen receptor

Captain Jack Spiro has a lot of facial hair - think hirsutism

18

What drug would you use for abortion through day 63 of pregnancy?

Mifepristone

19

Levonorgestrel use?

Progestin

Morning after pill

1.5 mg 120 hrs

20

Why is estrogen always co-administered with a progestin in women with a uterus?

Unopposed estrogen increases the risk of endometrial cancer

21

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

22

MOA of estrogen-progestin combos?

Suppress GnRH,LH, FSH and follicular development --> inhibits ovulation

23

Adverse effects of estrogen-progestin contraception?

arterial/venous thromboembolism, pulmonary embolism, cerebral thrombosis

gallbladder disease

24

Norgestrel

Progestin

25

Ethinyl estradiol

Estrogen

26

Mestranol

Estrogen

27

Norethindrone

Progestin

28

Triphasic oral formulations of estrogen-progestin contraceptives has higher or lower amounts of progestin each month?

LOWER

29

What would you use as contraceptive in patients for whom estrogen use is contraindicated?

Progestin-only contraceptive

30

Progestin-only contraceptive MOA?

Alter frequency of GnRH pulsing and decrease anterior pituitary responsiveness to GnRH

31

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

32

Treatment of choice for hypogonadism?

Androgen hormone replacement

Testosterone enanthate/testosterone cypionate

33

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!

34

What could potentially be used as a male contraceptive? Is there an oral form?

testosterone enanthate

no oral form because of first pass hepatic metabolism

35

Testosterone hormone replacement is available in a topical gel formulation...what is a risk of this?

Potential transfer to female partner...BAD THING

36

What hormone replacement therapy can cause acne or gynecomastia

testosterone

37

Androgen replacement therapy should not be taken lightly and could be abused by athletes. What is some criteria to avoid this abuse?

only offer to men with consistent signs of hypogonadism and low plasma testosterone