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repro drugs Flashcards

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1
Q

GnRH analog w agonist properties when used in pulsatile fashion

A

leuoprolide

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2
Q

GnRH antagonist when used in continousu fashion

A

leuoproilde

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3
Q

use of leuprolide

A

uterine fibroids, endometriosis, precocious puberty, prostate cancer, infertility

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4
Q

other GnRH analgos

A

nafarelin, goserilin, histerilin

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5
Q

estrogen drugs include

A

ethinyl estradiol, DES, mestranol

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6
Q

use of estrogen drugs

A

hypogonaidsm or ovarian failure, menstrual abnomralities, hormone replacement therapy in postmenopausal women; use in men w androgen dependent prostate cancer

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7
Q

SE of estroge ndrugs

A

increase risk of endometrial cancer (when given w/o progestoerone)
bleeding in postmenopausal women
clear cell adenocarcinoma of vagina in females exposed to DES in utero; increase risk of thrombi

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8
Q

Contraindciatiosn in estrogen drugs

A

ER+ breast cancer, history of DVT’s

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9
Q

Selective estrogen receptor modulators

A

clomiphene, tamoxifen, raloxifene

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10
Q

Clomiphene is an antagnoist at estrogen receptors in

A

hypothalamus

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11
Q

prevents normal feedback inhibition and increase release of LH and FSH from pituitary, which stimulates ovulation

A

clomphene

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12
Q

treat infertility due to anovulation (PCOS)

A

clomiphene

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13
Q

SE hot flashes, ovarian enlargement, multiple simulatenous pregnancies, visual disturbances

A

clomiphene

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14
Q

tamoxifen is an antagnoist at the

A

breast

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15
Q

tamoxifen is an agonist at the

A

bone, uterus

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16
Q

Increases risk of thromboembolic events and endometrial cancer

A

used to treat and prevent recurrence of ER/PR + breast cancer

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17
Q

raloxifene is antagnoist at

A

breast, uterus

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18
Q

raloxifene is agonist at the

A

bone

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19
Q

increase risk of thrombooembolic evenrts but no increased risk of endometrial cancer

A

raloxifene

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20
Q

which estrogen receptor modulater is used to treat osteoporosis

A

raloxifene

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21
Q

aromatase inhibitors

A

anastrozole, letrozole, exemestane

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22
Q

inhibit periperhal conversion of androgen to estrogen

A

aromatase inihbitor

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23
Q

clinical use of aromatase inihbiot

A

ER+ breast cancer in postmenopausal women

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24
Q

Hormone replacement therapy is used for

Study These Flashcards
A

relief or prevention of menopausal symptoms (hot flashes, vaginal atrophy), osteoporosis (increase estrogen, decrease osteoclast activity)

25
unopposed estrogen replacement therpay increases risk of what cancer
endometrial (thus progesterone / progestin is added) also possible increased CV risk
26
progestins drugs
levonorgestrel, medroxyprogesterone, etonogestrel, norethindrone, megestrol, and many others when combined w estrogen
27
binds progesterone receptors; decreases growth and increases vascularization of endometrium, thicken cervical mucus
progestin
28
thickens cervical mucus
progestin
29
use of progestin
contraception, endometrial cancer, abnoraml uterine bleeding
30
describe progestin challenge:
presence of withdrawal bleeding excludes anatomic defects (asherman syndrome) and chronic anovulation without estorgen
31
antiprogestins include
mifepristone, ulipristal
32
mechanism of antiprogestin
competitive inhibitors of progestins at progesterone receptors
33
use of antiprogestin
termination of pregnancy
34
mifepristone + misoprostol does what
terminates pregnancy
35
emergency contraception
ulipristal
36
Contraindications of OCP
smokers > 35 yrs old (increased risk of CV events), pt's w increase risk of CV disease (including history of VTE, coronary artery disease, stroke), migraine (esp w aura), breast cancer
37
mechanism of copper intrauterine device
produces local inflammatory reaction toxic to sperm and ova, prevents fertilization and implantation; hormone free
38
most effective emergency contraception
copper intrauterine device (long acting reversible contraception
39
B2 agonists that relax the uterus; used to decrease contraction frequency in women during labor
terbutaline, ritodrine
40
tertbutaline is linked to increased risk of neonatal
intraventricular hemorraghe, hypoglycemia, hyperkalemia, hyocalcemia, ileus
41
danazol mechanism
synthetic androgen that acts as a partial agonist at androgen receptors
42
use of danazol
endometriosis, hereditary angioedema
43
SE of danazol
weight gain, edema, acne, hirsuitsm masculinization | decrease HDL levels; hepatotxcity, psuedotumor cerebri
44
testosterone receptor agnoists that treats prostate cancer; can cause gynecomastia
bicalutamide
45
testosterone does what to LDL and HDl
increase LDL and decrese HDL
46
direct arteriorlar vasodilator used for androgenetic alopecia; severe refractory hypertension
minoxidil
47
Antiandrogens include
finasteride, flutamide, ketoconazole
48
used for BPH and male pattern baldness
finasteride (increase risk of gynecomastia)
49
nonsteroidal competitive inhibitor at androgen receptors; used for prostate carcinoma
flutamide
50
inhibits steroid synthesis, inhiibts 17,20 desmolase/17 a hydroxylase)
ketoconazole
51
inhibits steroid binding, 17,20 desmolase/17ahydroxylase
spironolactone
52
used in pCOS to reduce androgenic symptoms; both can cause gynecomastia and amenorrhea
ketoconazole and spironolacton
53
a1 antagonist used to treat BPH by inhibitng smooth muscle contraction
tamsulosin
54
tamsulosin is selective for which receptors
a1a/D receptors (foudn on prostate) vs. vascular a1B receptors
55
PDE5 inhibitors include
sildenafil, vardenafil, tadalafil
56
mechanism of pde5inhibiotrs
inhibit pde5: increase cGMP; prolonged smooth muscle realxaiton in resposne to NO; increase blood flow in corpus cavernosum of penis; decrease pulmonary vasc reisiatnce
57
Pde5 inhibiotrs use
ED, pul htn, BPH (tadalafil only)
58
SE of pde5 inhibitors
headache, flushing, dyspepsia, cyanopia (blue tinted vision); risk of life-threateing htn in patients taking nitrates

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