Estrogens, Progestrins, And Androgens Flashcards Preview

Med School Year 2 Flash Cards > Estrogens, Progestrins, And Androgens > Flashcards

Flashcards in Estrogens, Progestrins, And Androgens Deck (55):
1

What is the main estrogen made by the ovary?

Estradiol

2

What 2 estrogens are made by conversion from androgens in the liver and adrenal glands?

Estrone and estriol

3

Which estrogen is high is high in pregnancy?

Estriol

4

Where is estrogen made in the male?

Made by Sertoli cells in the testis

5

What is the enzyme used to convert testosterone to estrogen in the testis?

Aromatase

6

What are the physiological effects of estrogen?

1. Development of sex organs and secondary sex characteristics
2. Closure of the epiphyseal plates
3. Stimulate ductal development in breast
4. Pigmentation in the skin
5. Increase binding globulins
6. Increase HDL, decrease LDL
7. Reduce bone resorption
8. Enhance coaguability
9. Libido, mood

7

Where is progesterone produced in the female?

By the corpus luteum
During pregnancy: placenta

8

What are the physiological effects of progesterone?

1. Matures endometrium
2. Development of secretory apparatus of the breast
3. Increases body temp
4. Depressants effects, sedatives

9

How does progesterone or its metabolites make inhibitory effects?

Hits GABBA A receptor

10

How much testosterone is freely circulating?

2%

11

What are the effects of testosterone?

1. Growth of pubic hair, axillary hair, beard
2. Growth of larynx, thickening of vocal chordsSebum secretion
3. Decrease binding globulin
4. Stimulate EPO secretion
5. Anabolic effects

12

What is oxymetholone?

17-alkyl deriv of testosterone

13

What oxymetholone used to treat?

Bone marrow hypoplasia, myelofibrosis

14

What are 17-alkyl derivatives associated with?

Hyperbilirubinemia, increased hepatic enzymes, cholestatic hepatitis,

15

What is the bioavailability of estradiol?

10%

16

What may alter the efficacy of oral estrogens?

Broad spectrum antibiotics that alter intestinal flora

17

What drugs might estrogens alter the metabolism of?

Drugs metabolized by glucoronidases. Like acetaminophen

18

What is the MOA of oral contraceptives?

Exert negative feedback on the hypothalamus and pituitary --
1. Reduce GnRH
2. Reduce FSH secretion - incomplete follicular development
3. Reduce LH secretion - no ovulation

19

How do OCs affect sperm and endometrium?

It thickens the cervical mucous to reduce sperm.
It alters the endometrial structure makes the uterus unreceptive for implantation

20

What is the most commonly used estrogen in OCs?

Ethinyl estradiol

21

What are th most commonly used progesterones?

Norethindrone
Levonorgestrel
Norgestimate
Desogestrel

22

What is the potency of the progesterones used?

1. Desogestrel
2. Norgestrel
3. Norgestimate, norethindrone

23

Which progesterone has an increased risk of thromboembolism?

Desogestrel

24

Which estrogen has androgenicity that is similar to spironolactone?

Drospirenone in Yasmin

25

What are the advantages of triphasic OCs?

Less spotting, breakthrough bleeding and amenorrhea

26

Who do we use progestin only on?

Women at risk for certain estrogen-dependent cancers or who don't tolerate the estrogen portion in OCs or who are breast feeding

27

What is the disadvantage of using progestin only?

It is not as effective at inhibiting ovulation

28

What is injectable progestin for?

For long term contraception

29

Who is injectable progestin not good for?

Women who want to get pregnant soon after treatment

30

What are the disadvantages of implantable progestin?

Need for surgical implantation and removal
Irregular bleeding

31

What can lower the efficacy of OCs?

Phenytoin
Rifampin
Antibiotics

32

What are the side effects of estrogen?

TE - increases clotting factors and decreases antithrombin III
Increase risk of MI
HTN
Nausea - heightened sense of smell
Edema
Headache or worsens migraines - converts tryptophan to nicotinic acid
Cancer of breast, cervix, liver

33

What are the side effects of progestin?

Increased appetite - increase in the amount of insulin
Weight gain
Depression
Increased bp
Increase acne and CV disease

34

What are the contraindications to OCs?

Pregnancy
Women with history of estrogen-dependent neoplasm or breast cancer
TE disorders
Liver disease
Smokers

35

What is plan b?

It is a high dose of levonorgestrel

36

What is RU486?

Mifepristone - has a luteolytic effect, usually combined with a prostaglandin which may trigger uterine contraction

37

What is DES?

May interfere with timing of uterine maturation

38

What are the post coital contraceptives?

Plan B
Mifepristone
DES

39

What is hormone replacement used for?

Reducing menopause symptoms
Reducing osteoporosis
Treating primary hypogonadism (ovarian failure, hypopituitarism)

40

What is the treatment for menopause?

Low dose estrogen and a progestin

41

What are the HRTs for menopause?

Conjugated equine estrogen
Metroxy-progesterone acetate (provera)
Estradiol
Prempro (CEE + MPA)

42

What are progestins given for in menopause?

For reducing endometrial and uterine cancer

43

What are the benefits of HRT?

Reduces heart attacks and strokes
Reduces hot flashes
Decreases bone loss

44

What are the problems with HRT?

Poor compliance because of bleeding and fear of cancer.
Hypogonadism

45

What are the side effects with estrogen in HRT.

Hyper pigmentation
Increased migraines
Breast tenderness
Nausea
Bleeding
Cancer

46

What are the contraindications to HRT?

Hx of estrogen dependent cancers
TE
Liver disease
Smoking

47

What are the advantages of transdermal estradiol?

Reduced conversion of estradiol to estrone
Little risk for TE
No effect of SHBG

48

What is the disadvantage of transdermal estradiol?

May not cause increase in HDL or lower LDL

49

What is can androgen therapy be used for?

Hypogonadal men
Reverse atrophy following trauma, surgery, disease
Anemia
Osteoporosis

50

What are the side effects of androgen therapy?

Masculinizing effects or gynecomastia
Hirsutism
Acne
Hepatic dysfunction
Azospermia
Abuse

51

What are the contraindications to androgens?

Hx of prostate or breast cancer
Pregnant women

52

What are the disorders or androgen excess?

Hirsutism
Acne
Amenorrhea
Gynecomastia
Prostatic hyperplasia - urinary retention
PCOS
Cushing's

53

What drugs can be used for hirsutism?

OCs
AR antagonist - spironolactone, flutamide
DHT synthesis inhibitors - finasterides, dutasteride
GnRh analogs
Eflornithine cream - ornithine decarbox inhibitor

54

What is clomiphene?

A partial estrogen agonist - reduces negative feedback so increases gonadotropins and estrogens

55

What is Faslodex?

Pure anti- estrogen