Pharm MD7 cont'd

Question 1

Leuprolide

Answer 1

• GnRH agonist (pulsatile), antagonist (continuous)
• antagonistic action on GnRH receptors of pituitary-> decr gonadotropins and testosterone/estrogens used in tx of precocious puberty
• prevents early closure of epiphyses (incr final adult height), and combats psychosocial issues assoc. w/ precocious puberty

Question 2

Testosterone Replacement Therapy

Answer 2

• indicated in Klinefelter’s syndrome (and other causes of hypogonadism in males)
• improves virillization (not infertility in Klinefelter’s), libido, prevents osteoporosis
• may exacerbate gynecomastia
• can be started in puberty and d/c in conditions like constitutional growth delay when natural puberty takes over