Pharm - Repro (FA, not in sketchy) Flashcards
(25 cards)
goserelin
MOA: GnRH analog
- continuous admin = transiently agonists, then antagonists
use: uterine fibroids. endometriosis, precocious puberty, prostate CA, infertility, breast cancer
leuprolide
MOA: GnRH analog
- continuous admin = transiently agonists, then antagonists
use: uterine fibroids. endometriosis, precocious puberty, prostate CA, infertility, breast cancer
Degarelix
MOA: GnRH antagonist, no start-up flare
use: prostate cancer
AE: hot flashes, liver toxicity
DES
MOA: binds estrogen r
use: hypOgonadism or ovarian failure, menstrual abnormalities (combined OCPs), hormone replacement therapy
AE: inc risk endometrial cancer if given w/o progesterone, bleeding, clear cell adenoCA of vagina in females exposed to DES in utero, inc risk thrombi
contraindications: ER + breast cancer, DVT hx, tobacco use >35 y/o
mestranol
MOA: binds estrogen r
use: hypOgonadism or ovarian failure, menstrual abnormalities (combined OCPs), hormone replacement therapy
AE: inc risk endometrial cancer if given w/o progesterone, bleeding, clear cell adenoCA of vagina in females exposed to DES in utero, inc risk thrombi
contraindications: ER + breast cancer, DVT hx, tobacco use >35 y/o
clomiphene
MOA: SERM, antagonist of estrogen r in hypothalamus; prevents normal fb inhibition and inc release of LH and inc FSH from pituitary to stimulate ovulation
use: infertility due to anovulation
AE: hot flashes, must simultaneous preg, ovarian enlargement, visual disturbances
tamoxifen
MOA: SERM, antagonist at breast, agonist at bone/uterus
use: tx/prevent recurrence of ER/PR + breast cancer
AE: inc risk of thromboembolic events (espec w/ smoking) and endometrial cancer
anastrozole
MOA: aromatase inhibitor, inhibits peripheral conversion of androgens to estrogen
use: ER + breast cancer in post-menopausal women
levonorgestrel
MOA: progestin, binds progesterone r, dec growth and inc vasculariz of endometrium, thickens cervical mucus
use: contraception, endometrial cancer, abnormal uterine bleeding
medroxyprogesterone
MOA: progestin, binds progesterone r, dec growth and inc vasculariz of endometrium, thickens cervical mucus
use: contraception, endometrial cancer, abnormal uterine bleeding
etonogestrel
MOA: progestin, binds progesterone r, dec growth and inc vasculariz of endometrium, thickens cervical mucus
use: contraception, endometrial cancer, abnormal uterine bleeding
norethindrone
MOA: progestin, binds progesterone r, dec growth and inc vasculariz of endometrium, thickens cervical mucus
use: contraception, endometrial cancer, abnormal uterine bleeding
megestrol
MOA: progestin, binds progesterone r, dec growth and inc vasculariz of endometrium, thickens cervical mucus
use: contraception, endometrial cancer, abnormal uterine bleeding
mifepriston
MOA: antiprogestin, competitive inhibitor at progesterone r
use: termination of pregnancy (with misoprostol)
ulipristal
MOA: antiprogestin, competitive inhibitor at progesterone r
use: termination of pregnancy (with misoprostol)
combined contraception
progestins and ethinyl estradiol
MOA: inhib LH/FSH –> no estrogen surge –> no LH surge –> no ovulation
progestins also thicken cervical mucus and inhibit endometrial proliferation (less suitable envio for implantation)
AE: breakthrough menstrual bleeding, breast tenderness, VTE, hepatic adenomas
contraindications: smokers > 35 y/o, pt w/ inc risk CVD, migrane (esp w/ aura), breast cancer, liver disease
tocolytics
terbutaline
nifedipine
indomethacin
danazol
MOA: synthetic androgen, acts as partial agonist at androgen r
use: endometriosis, hereditary angioedema
AE: weight gain, edema, acne, hirsutism, masculinization, dec HDL levels, hepatotoxicity, idiopathic intracranial HTN
testosterone/methytestosterone AE
dec intratesticular testosterone in male by inhibiting release of LH (via neg fb), premature closure of epiphyseal plates, inc LDL, dec HDL
finasteride
MOA: 5a-reductase inhibitor (dec conversion of testosterone to DHT)
use: BPH, male-pattern baldness
AE: gynecomastia and sexual dysfunction
flutamide
MOA: nonsteroidal competitive inhibitor at androgen r
use: prostate CA
bicalutamide
MOA: nonsteroidal competitive inhibitor at androgen r
use: prostate CA
apalutamide
MOA: nonsteroidal competitive inhibitor at androgen r
use: prostate CA
enzalutamide
MOA: nonsteroidal competitive inhibitor at androgen r
use: prostate CA
