Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

WH > Pharm > Flashcards

Pharm Flashcards

(85 cards)

Start Studying
1
Q

Names & Indications of estrogen

A

-estrols (Hexestrol & Diethylstibestrol)

Cancer therapy
HRT
Contraception

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What are we trying to alter in estrogen therapy?

A

The estrogen response-the creation of proteins

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Which pharmolocolgic agent is described as “flat and hydrophobic”?

A

Estrogen

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Which estrogen receptor gene has a more specialized role and why?

A

Estrogen Receptor Gene-B: dominates in the lung and has limited tissue expression.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

List the SERM corepressors

A

Raloxifene
Tamoxifen
Fulvestrant

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What are the indications for SERMs?

A

They inhibit the estrogenic effects of breast cancer while maintaining bone mass.

Used in cancer therapy, HRT, and contraception

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What are antihormones that inhibit activity by reducing P160 coactivator binding to estrogen receptor surfaces?

A

SERMs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Antagonists in breast, uterus, & CNS
Agonist in bone (bone sparing)
Unknown in liver

A

Raloxifeine - SERM

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Antagonist in breast & CNS
Partial antagonist in uterus & liver
Agonist in bone

A

Tamoxifen - SERM

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Largest “extra” structure of all anti-estrogens.

So large it degrades the protein

A

Fulvestrant - SERM

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Compounds that can have estrogenic activity by binding the ER, but made in plants

A

Phytoestrogens

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Give examples of phytoestrogens

A

Isoflavinoid: Soy beans, can relieve menopausal symptoms

Lignnas: High fiber foods

Coumestans: various beans. Alfalfa and clover sprouts are highest.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What are used as HRT?

A

Conjugated Estrogens (Premarin/Equine/Ethyinyl Estradiol)

Estradiols (Estrace and Estraderm)

Duavee

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

This addresses long-term issues of aging that result from loss of estrogen after menopause

A

HRT

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Relief of menopausal symptoms is clear, but longer term benefits harder to prove

A

HRT

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Oral Conjugated Estrogens

A

Premarin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Tablet/cream form of estrogen

A

Estrace

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Dermal patch form of estrogen

A

Estraderm

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

HRT that combines SERM + E2 for those worried about endometrial cancer

A

Duavee

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

What’s the rule in dosing regarding HRT?

A

Use low does that works for a few years (CV benefit is greater in younger women closer to 5-7years post-menopause)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

List the aromatase inhibitors

A

Anastorozole
Letrozole
Exemestane

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

In what population should aromatase inhibitors be used?

A

Only use in post menopausal women

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

MOA of aromatase inhibitors

A

Aromatase tissue is active in the breast, so we prevent androgens from turning into estrogens which cause growth of breast cancer

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

Describe the differences between the aromatase inhibitors

A

Anastorozole and Letrozole are competitive inhibitors (substrates) that bind to androgen.

Exemestane is a suicide substrate

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
List the bisphosphonates
Biphoshonates: - Alendronate (least potent) - Risendronate - Ibandronate - Zolendronic Acid (most potent)"
26
What's the first line treatment of osteoporosis?
bisphosphonates
27
MOA of bisphosphonates
Inhibit farnesyl pyrophosphate synthase --> osteoclasts apoptose --> bone breakdown decreases As osteoclasts die off, the messages they normally send to osteoblasts are reduced --> less osteoblast activity (which is why drug holidays are needed)
28
What drugs decrease vertebral and non-vertebral fx?
Bisphosphonates
29
Which drugs require a drug holiday and why?
Bisphosphonates - Needed to allow osteoblast activity to reset Monitor bone mineral density and turnover markers during holiday Re-initiate therapy if density declines or markers increase
30
AEs of bisphosphonates
Esophagitis (with oral forms) Avascular necrosis/osteonecrosis of jaw Atypical fragility fractures and delayed healing Contraindicated in eGFR <30-35%"
31
Which drug is approved for women receiving aromatase inhibitors and men receiving hormone ablation for prostate cancer
Denosumab
32
MOA of denosumab
Humanized monoclonal antibody to RANKL put out by osteoblasts Prevent formation of active osteoclasts and inhibit bone resorption Does not absorb into bone matrix Bone turnover is not suppressed after its cessation"
33
Things to keep in mind regarding denosumab
Shorter HL than Biphosphontes Stopping therapy can lead to high risk of multiple vertebral fractures Do NOT d/c without considering replacement with another anti-resorptive tx
34
AE of denosumab
Atypical fragility fractures AVN of jaw Increased risk of infections (cellulitis, endocarditis) Suppression of bone turnover (delayed fx healing)
35
Contraindications of denosumab
Current hypocalcemia Pregnancy Hypersensitivy
36
Indication of teriparatide
Moderate to severe osteoporosis (ex: from GC use)
37
MOA of teriparatide
It's a PTH analog. - Increases bone formation by the same mechanism as low levels of PTH. - Stimulates osteoclasts to release Ca2+ from bone and increase Ca2+ reabsorption from the gut and kidney. - Low levels are anabolic and stimulate collagen synthesis
38
Which osteoporosis drug is administered SC
Teriparatide
39
AEs of teriparatide
Mild hypercalcemia Nausea, HA, dizziness, muscle cramps Do NOT give >2yrs Do not use with bisphosphonates
40
Contraindications of teriparatide
Hypercalcemia Multiple myeloma, bone metastasis, skeletal tumor Children/teens with growing bones
41
In which tissue does Estrogen Receptor Gene A dominate?
Reproductive tissue and the liver
42
MOA of SERM coactivators
dimerize E2 --> less E2 affinity for DNA | --> increase transcription --> DNA relaxation
43
MOA of SERM corepressors
tighten up DNA and suppress gene expression
44
Which SERM is used for breast cancer treatment?
Tamoxifen
45
Which SERM is used for bone retention?
Raloxifene
46
Why does breast cancer best respond to this SERM drug?
Tamoxifen - due to its action on both the Estrogen-Receptor and Progesterone-Receptor
47
AE of Tamoxifen
- Increase in endometrial cancer in postmenopausal women - Thromboembolic events - Cataracts
48
AE of aromatase inhibitors
Osteoporosis
49
Indication of Trastuzumab
Breast cancer
50
MOA of Trastuzumab
-Acts on protein made by Her2/neu
51
AE of Trastuzumab
- Heart failure (cardiotoxicity) - Respiratory problems - Serious allergic rx
52
MOA of progestin
- Thins endometrium: can lead to atrophy - Thickens cervical mucus - Decreases tubal motility - Several generations with varying androgen effects and bioavailability
53
MOA of ethinyl estradiol
- Suppress ovulation: along with progestin, negative feedback to hypothalamus and pituitary to decreased FSH/LH production - Estrogen suppression of FSH stops folliculogenesis - Cycle control: stabilizes endometrium
54
Advantages of COC
- Rapid reversibility - **Decreased ovarian and endometrial cancer risk** - Improved acne and hirsutism - Improved dysmenorrhea and AUB - Reduced symptoms of endometriosis
55
Disadvantages of COC
- Increased hypercoagulability: VTE (greatest risk in 1st year of use) - MI, stroke: MINIMAL increased risks in adolescents/young adults
56
Contraindications of COC
- Smokers >35yo should discontinue OCPs | - Hx of heart disease, HTN, VTE, stroke, breast cancer, migraines with aura
57
Hormone in POP
Norethindrone (a progesterone)
58
POP indication
Use in women in whom estrogen-containing pills are contraindicated
59
Advantages of POP
- Safety: lower dose of hormone - greater safety than COC | - Few contraindications: estrogen-free
60
Disadvantages of POP
- Decreased efficacy compared to COC - Menstrual cycle disturbances!!! - Strict compliance necessary: use back up method of contraception (condom) for 2 days if >3hrs late taking pill. - Increased rates of functional ovarian cysts
61
Hormone(s) in the transdermal contraceptive patch
Estrogen and Progestin
62
Which contraceptives only contain progestin?
- POP - Depo - Implantables (Nexplanon, IUDs - except ParaGard) - Plan B - Levonorgestrel
63
Advantages of the transdermal contraceptive patch
- Increased compliance: 1 patch/week with 1 patch free week - Forgiving: 3 day error with decreased follicular size vs. pill - Does not cause weight gain - Good cycle control - Verifiable
64
Disadvantages of the transdermal contraceptive patch
- Possible increased risk of VTE (debatable) - Skin reactions: in up to 50% - Breast tenderness, headache, nausea - Less effective in those over 90 kg
65
Which hormones does the Nuvaring contain?
Ethinyl estradiol and etonogestrel
66
Advantages of the Nuvaring
- Inhibits ovulation for at least 35 days - Increased bioavailability through vaginal absorption, allows lower dose - Low, steady release of hormone - Does not cause weight gain - No effect on bone density
67
Disadvantages of the Nuvaring
- Risks similar to OCPs - **Headache: most common side effect** - **Vaginal symptoms: most common reason for discontinuation** - Leukorrhea - Foreign body sensation - Expulsion - Comfort with insertion/removal
68
Which hormones does the Depo injection contain?
Medroxyprogesterone acetate
69
MOA of the Depo
Inhibits ovulation: eliminates LH surge
70
Advantages of the Depo
* *-Estrogen-free** - Lasts 3 months - Effective in obesity - Decreased/absent menses - Minimal drug interactions - Can reduce frequency of grand mal seizures and pain associated with endometriosis
71
Disadvantages of the Depo
- Menstrual cycle disturbances * *-Weight gain** * *-Decreased bone density (BBW)** - Depression (conflicting data) - Delayed fertility, continued side effects after discontinuation - Frequent visits to health care provider
72
Which hormones does the Nexplanon contain
Etonogestrel | Progestin only
73
Advantages of the Nexplanon
- Highly effective - Lasts 3 years - Discreet - Decreased dysmenorrhea - Quick return to fertility
74
Which hormone do the hormonal IUDs contain?
Levonorgestrel | Progestin only
75
MOA of hormonal IUDs
Inhibits sperm capacitation and survival
76
Which IUD works up to 7 years?
Mirena & Lilleta
77
Which IUD works up to 5 years?
Kyleena
78
Which IUD works up to 3 years?
Skyla
79
Which IUDs lead to lighter and less frequent menses?
Mirena and Lilleta
80
What is the most effective emergency contraceptive?
Copper IUD | It must be inserted 5-7 days post unprotected sex
81
How long after sex can someone use Levonorgestrel as emergency contraception?
Ideally within 72hrs post-intercourse but can be effective up to 5 days (120hrs)
82
Which contraceptive is a progesterone blocker?
Ulipristal Acetate (Ella)
83
Other than the copper IUD, what is more effective in preventing pregnancy as an emergency contraceptive than Levonorgestrel Emergency Contraception?
Ulipristal Acetate (Ella)
84
How long after intercourse must Ulipristal Acetate (Ella) be taken as an emergency contraceptive?
Within 5 days
85
After using Ulipristal Acetate (Ella), how long should someone wait before starting hormonal contraception?
They can start hormonal contraception 5 days after using Ulipristal Acetate (Ella)

WH (1 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions