Pharmacology

Question 1

What is the treatment of ovarian germ cells cancer?

Answer 1

BEP (BEC) cocktail

1. Bleomycin (antibiotic that inhibits DNA synthesis)
2. Etoposide (inhibits DNA synthesis)
3. Cisplatin (heavy metal complex alkylating agent that inhibits DNA replication)

Question 2

What is the treatment for ER - breast cancer?

Answer 2

• Topoisomerase inhibitor
• Taxane
• Alkylating agent
• Trastuzumab: targets antigen with monoclonal antibody

Question 3

When is hormone replacement therapy indicated to prevent CVD?

Answer 3

• < 60
• < 10 years of menopause
• NOT IN WOMEN WITH ESTABLISHED ARTHEROSCLEROSIS

Question 4

What is the treatment of testis cancer?

Answer 4

BEP (BEC) cocktail

1. Bleomycin (antibiotic that inhibits DNA synthesis)
2. Etoposide (inhibits DNA synthesis)
3. Cisplatin (heavy metal complex alkylating agent that inhibits DNA replication)

Question 5

How does the OCP work?

Answer 5

• MANY SITES OF ACTION –> no LH surge –> no ovulation
• Side effects: no developing follicle, thinner endometrial lining –> no implantation

Question 6

Name 2 approved selective estrogen-receptor modulators used for osteoporosis?

Answer 6

1. Raloxifene
2. Bazedoxifene

They are both agonists to bone & lipids and antagonists to breast & endometrium cancer

Question 7

What is the treatment for ER + breast cancer?

Answer 7

• Aromatase inhibitors
• Anti-estrogens: tamoxifen

Question 8

What is the treatment of epithelial ovarian cancer?

Answer 8

1. Platinum compound (Cisplatin)
2. Taxane (Taxol; acts by stabilization of cellular microtubules)

Question 9

What is a common side effect of progesterone contraceptive methods?

Answer 9

Breakthrough bleeding (between menses)

Question 10

With what can you treat menopausal vaginal dryness?

Answer 10

With a low dose of local estrogen

Question 11

Which drugs can interact with contraceptive medication?

Answer 11

1. Induction of P450s
2. Entero-hepatic circulation
3. Drugs binding to plasma proteins

Question 12

What is the absolute contraindication when you prescribre Vasdenafil (Levitra)?

Answer 12

NITROGLYCERINE

Question 13

What is the ONLY medication approved for treatment of nausea and vomiting during pregnancy?

Answer 13

Diclectin

Question 14

What are the contra-indications for IUD?

Answer 14

• Tubal pregnancy
• Severe pain
• Allergy to copper
• STI
• Precancerous lesions
• Pregnancy
• Anemia
• Abnormal uterine bleeding
• Past hx of progestin receptor-positive breast cancer
• Endometrial/uterine cancer

Question 15

Name 2 drugs that suppress gonadotropin release and induce hypogonadism?

Answer 15

Agonists – Luprolide - causes an initial hormone surge Antagonist – Degarelix - no hormone surge

Question 16

What are the principles for drug used in hormone-dependant cancers?

Answer 16

1. Effective singly
2. Additive / synergistic
3. Have non-cumulative toxicities
4. Given in maximum tolerated doses

Question 17

What drug can you give for castration resistant prostate cancer?

Answer 17

• Enzalutamide: a pure AR antagonist that directly binds to the receptor
• Abiraterone: selectively and irreversibly inhibits the CYP17A1

Question 18

What are the contra-indications to OCP?

Answer 18

• Smoking + 35 y/o
• Breast cancer
• Blood clots
• Liver disease
• Kidney disease
• Pregnancy
• Unexplained uterine bleeding

Question 19

What is the treatment for ER + and HER-2 + breast cancer?

Answer 19

Combined treatments

Question 20

What is the treatment of prostate cancer?

Answer 20

1. Prostate removal
2. Castration
3. Diethylstiilbestrol
4. Androgen Receptor Antagonist
5. GnRH antagonist
6. GhRH agonist
7. 5a-reducatse inhibitors

Question 21

What are the types of PDE5 Inhibitors?

Answer 21

1. Sildenafil (Viagra): peaks in 1 hour
2. Tadalafil (Cialis): peaks in 2 hours
3. Vasdenafil (Levitra): peaks in 45 minutes