female reproductive

Question 1

how to administer GnRH for it to act as an agonist vs antagonist

Answer 1

agonist- pulsatile

antagonist- continuous

Question 2

clinical use of pulsatile GnRH analog

Answer 2

infertility

Question 3

clinical uses of continuous GnRH analogs (5)

Answer 3

hormone dependent tumors 
central precocious puberty
uterine fibroids
endometriosis maintenance 
PCOS

Question 4

prototypic GnRH analog

Answer 4

leuprolide

Question 5

specific indication of ganirelix

Answer 5

GnRH receptor antagonist to suppress premature LH surge in women undergoing ovarian hyperstimulation

Question 6

aromatase inhibitors MOA

Answer 6

prevent conversion of testosterone –> estrogen in ovary, prevent conversion of androstenedione –> estrone in adipose

Question 7

2 competitive inhibitors

2 covalent binders

Answer 7

competitive- anastrozole, letrozole

covalent- exemastane, formestane

Question 8

adverse effect of amortizes inhibitors

Answer 8

osteoporosis

Question 9

indication for aromatase inhibitors

Answer 9

treatment of metastatic ER+ breast cancer in postmenopausal women

Question 10

agonist/antagonist of tamoxifen

Answer 10

agonist- endometrium

antagonist- breast

Question 11

agonist/antagonist of raloxifene

Answer 11

agonist- bone

antagonist- breast, endometrium

Question 12

agonist/antagonist of clomiphene

Answer 12

agonist- ovaries

antagonist- hypothalamus, ant pituitary

Question 13

use limiting SE of tamoxifen

Answer 13

endometrial cancer

Question 14

ADRs of clomiphene (4)

Answer 14

multiple gestation, visual disturbance, hot flashes, ovarian enlargement

Question 15

androgen receptor antagonist indicated for use in men with prostate CA/BPH

Answer 15

flutamide

Question 16

androgen receptor antagonist indicated for use in women with PCOS/hirsutism

Answer 16

spironolactone

Question 17

3 SEs of androgen receptor antagonists

Answer 17

decreased libido
gynecomastia
amenorrhea

Question 18

danazol MOA

Answer 18

partial agonist of androgen receptors

Question 19

use of danazol

Answer 19

endometriosis

Question 20

MOA of mifepristone

Answer 20

progesterone receptor antagonist

Question 21

use of mifepristone

Answer 21

inductions of abortion

Question 22

what med is given with mifepristone? why?

Answer 22

misoprostol, to stimulate uterine contractions

Question 23

5 toxicities of HRT

Answer 23

endometrial cancer, postmenopausal bleeding, thromboembolism, HTN, gallbladder disease

Question 24

5 mechanisms of OCPs

Answer 24

suppress follicle development, inhibit ovulation, alter tubal peristalsis, decrease endometrial receptivity, decrease cervical mucus secretions

Question 25

2 medications that decrease the effectiveness of estrogens

Answer 25

penicillin, tetracyclines

Question 26

estrogens can inhibit the metabolism of (3)

Answer 26

cyclosporine, antidepressants, glucocorticoids

Question 27

estrogen may antagonize the effects of-

Answer 27

warfarin

Question 28

SE of POPs

Answer 28

androgenic

Question 29

MOA of emergency contraception

Answer 29

blocks LH surge, produces endometrial changes that are not conducive to implantation