Hormonal Drugs

Question 1

Spironolactone (Aldactone)

Answer 1

-Antiandrogen: blocks dihydrotestosterone (DHT) from binding to receptor
Category C
Treats: hirsutism, hormonal acne (especially in PCOS), androgenetic alopecia
SE: ↑ K+ level, gynecomastia, breast tenderness (most common) and menstrual irregularity
Acne- takes 3 cycles to work
-start 50 mg daily and increase to 200 mg daily max
-caution fam hx breast CA
-Not with K sparing diuretics, Ace, Li
-Can use with OCPs, increased r/o HyK
-Preg C-feminization male feturs

Question 2

Finasteride
(Proscar) (Propecia)

Answer 2

-Inhibits 5α-reductase (converts testosterone to DHT)
Category X
Treats: androgenetic alopecia
SE: ↓ libido, erectile dysfunction, teratogen

Question 3

Oral contraceptive pill
(OCP)

Answer 3

Block both ovarian and adrenal androgen production; used in hormonal acne
Low androgenic progestins: norethindrone, levonorgestrel, desogestrel, norgestimate
Ortho Tri-Cyclen:
Estrostep:
Yaz:

Question 4

Minoxidil
(Rogaine)

Answer 4

-VasoD of hair follicles, improves blood flow to hair
2 topical formulations: 2% and 5% Treats: alopecia
-oral LDOM 1.25/2.5 mg PO daily
SE: contact dermatitis, rarely HA or chest pain/ palpitaitons, pedal/hand edema