First Aid- Reproductive Flashcards Preview

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Flashcards in First Aid- Reproductive Deck (35):
1

-GnRH analog with agonist properties when used in pulsatile fashion

-antagonist properties when used in continuous fashion --> downregulates GnRH receptor in pituitary --> decreasesŽ  FSH/LH --> decreased estrogens and testosterone

Leuprolide

2

Tx when given continuously: metastatic prostate cancer (following androgen receptor blockade with flutamide), leiomyomas, endometriosis; uterine fibroids, precocious puberty

 

Tx when given pulsatile: infertility

 

 

Use of Leuprolide

3

Antiandrogen, n+v

toxicity of leuprolide

4

binds estrogen receptors

MOA of estrogens: ethinyl estradiol, DES (synthetic estrogen), mestranol

5

Use includes: Hypogonadism or ovarian failure, menstrual abnormalities, hormone replacement therapy in postmenopausal women; use in men with androgen-dependent prostate cancer. 

Use of estrogens: ethinyl estradiol, DES, mestranol

6

-increased risk of endometrial cancer, bleeding in postmenopausal women, clear cell adenocarcinoma of vagina in females exposed to DES in utero; increased risk of thrombi

-CI: ER+ breast cancer and history of DVTs

toxicity of estrogens: ethinyl estradiol, DES, mestranol

7

-Antagonist at estrogen receptors in hypothalamus. 

-Prevents normal feedback inhibition and
increases release of LH and FSH from pituitary, which stimulates ovulation. 

MOA of Clomiphene (selective ER modulator)

 

 

 

8

Used to tx infertility due to anovulation (e.g., PCOS) 

Clomiphene

9

Toxicity: May cause hot flashes, ovarian enlargement, multiple simultaneous pregnancies, visual disturbances 

Clomiphene

10

MOA: Antagonist at breast; agonist at bone and uterus

SE: increased risk of thromboembolic events and endometrial cancer

Tamoxifen (selective ER modulator)

11

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

Tamoxifen

12

Antagonist at breast, uterus; agonist at bone

MOA of Raloxifene (selective ER modulator)

-opposite of Tamoxifen

13

SE: increased risk of thromboembolic events but no increased risk of endometrial cancer (vs tamoxifen)

Raloxifene

14

Selective ER modulator primarily used to tx osteoporosis

Raloxifene

15

Aromatase inhibitors used in postmenopausal women with ER ⊕ breast cancer. 

anastrozole and exemestane

16

used to relieve or prevent menopausal symptoms (hot flashes, vaginal atrophy), osteoporosis (increase estrogen, decrease osteoclast activity)

hormone replacement therapy

 

Note: Unopposed estrogen replacement therapy  increases risk of endometrial cancer, so progesterone is added. Possible increased cardiovascular risk 

17

MOA: Bind progesterone receptors,  decrease growth and  increase vascularization of endometrium.

 

Use: oral contraceptives and to tx endometrial cancer and abnormal uterine bleeding

progestins

18

-Competitive inhibitor of progrestins at progesterone receptors

-used to terminate pregnancy

-administered with misoprostol (PGE1)

Mifepristone (RU-486)

19

Toxicity: Heavy bleeding, GI effects (nausea, vomiting, anorexia), abdominal pain. 

Mifepristone

20

β2-agonists that relax the uterus; used to  decrease contraction frequency in women during labor. 

terbutaline, ritodrine

21

MOA: Synthetic androgen that acts as partial agonist at androgen receptors. 

 

 

Danazol

22

Used to tx Endometriosis, hereditary angioedema.

danazol

23

Toxicity: Weight gain, edema, acne, hirsutism, masculinization, decreases HDL levels, hepatotoxicity. 

Danazol

24

Agonists at androgen receptors. 

testosterone, methyltestosterone

25

Treats hypogonadism and promotes development of 2° sex characteristics; stimulation of anabolism to promote recovery after burn or injury. 

Testosterone, methyltestosterone 

26

Toxicity: Causes masculinization in females;  decreases intratesticular testosterone in males by inhibiting release of LH (via negative feedback) Ž --> gonadal atrophy. Premature closure of epiphyseal plates. 

-increases LDL,  decreases HDL. 

Testosterone, methyltestosterone 

27

-5α-reductase inhibitor ( decreases conversion of testosterone to DHT).

-Useful in BPH and male-pattern baldness. 

Finasteride (anti-androgen)

28

-nonsteroidal competitive inhibitor at androgen receptors.

-Used for prostate carcinoma. 

Flutamide (anti-androgen)

29

-Inhibits steroid synthesis (inhibits 17,20-desmolase). 

-used to treat polycystic ovarian syndrome to reduce androgenic symptoms.

SE: gynecomastia and amenorrhea. 

ketoconazole

30

-Inhibits steroid binding, 17α-hydroxylase, and 17,20-desmolase. 

-used to treat polycystic ovarian syndrome to reduce androgenic symptoms.

-SE: gynecomastia and amenorrhea. 

Spironoloactone

31

α1-antagonist used to treat BPH by inhibiting smooth muscle contraction. Selective for α1A,D receptors (found on prostate) vs. vascular α1B receptors. 

Tamsulosin

32

-Inhibits PDE-5 --> increases cGMP, smooth muscle relaxation in corpus cavernosum,  increases blood flow, penile erection. 

-Used for erectile dysfunction

-Sildenafil, vardenafil, tadalafil 

 

Sildenafil, vardenafil, and tadalafil fill the penis. 

33

Toxicity: Headache, flushing, dyspepsia, cyanopsia (blue-tinted vision). Risk of life-threatening hypotension in patients taking nitrates 

Sildenafil, vardenafil, tadalafil 

 

-“Hot and sweaty,” but then Headache, Heartburn, Hypotension. 

34

Direct arteriolar vasodilator used for androgenetic alopecia and severe refractory htn

minoxidil

35

-inhibit LH/FSH and thus prevent estrogen surge --> no ovulation

-CI: smokers > 35 years old (increased risk of CV events), pts with history of thromboembolism and stroke or history of estrogen-dependent tumor. 

Oral contraception (synthetic progestins, estrogen) 

 

-note: progestins also cause thickening of cervical mucous --> decrease implantation of embryo