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Flashcards in Repro Pharm Deck (24)
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1

Leuprolide

GnRH agonist (pulsatile) or GnRH antagonist (continuous)

Agonist: Infertility

Pulsatile: Prostate CA, Uterine fibroids, precocious puberty

2

Which form of testosterone can cause hepatotoxicity?

Danazol - also causes dec HDL, and inc LDL

3

What are some off-label uses for testosterone?

Male senescence

AIDS related muscle wasting

Blood dycrasias (hemolytic anemia)

4

What are testosterone drugs used to treat?

Endometriosis and hereditary angioedema - Danazol

Hypogonadism, develop 2˚ sex characteristics, burn recovery - Testosterone/Me-testosterone

5

Finasteride

5α-reductase inhibitor

BPH, male pattern baldness

6

Adverse Effects of Androgen Abuse

1. Dec. sperm production

2. Dec. testicular size

3. Erythrocytosis

4. Gynecomastia

7

What are the natural androgens? (3)

Androstenedione 

Testosterone

Dihydrotestosterone (DHT)

8

Flutamide

Non-steroidal AR blocker (competitive)

Used w/ Leuprolide for Metastatic Prostate Cancer

9

Which anti-androgen can cause hepatic failure?

Flutamide

10

What is the mechanism of action of Sildenafil, Vardenafil, and Tadalafil? What side effect do you need to be careful of?

PDE5 Inhibitor: ↑cGMP - relaxes smooth muscle

Nitrate vasodilator combo hypotension - caution w/ adrenergic R blockers

11

Alprostadil

PGE1 analog - injection/suppository ED

12

Where is testosterone metabolized?

Liver - high 1st pass effect

13

What do you use Estrogens to treat? (4)

Hypogonadism or ovarian failure

Menstural abnormalities (+ progestin)

Men w/ androgen-dependant prostate CA

14

Clomiphene

SERM: Antagonist of ER in hypothalamus - block feedback inhibition

↑LH and FSH

Ovulation

15

Tamoxifen

Antagonist of Breast ER

Agonist at Uterus and bone ER

Treat and prevent recurrence of ER⊕ Breast CA

16

Raloxifene

Agonist on bone ER

Antagonist at uterus ER

Osteoporosis

17

What is hormone replacement therapy used for? What must you not forget?

Relief or prevention of menopausal symptoms or osteoporosis

Add progesterone to avoid endometrial cancer

18

Anastrozole and Exemestane

Aromatase Inhibitors

Postmenopausal women w/ Breast CA

19

Mifepristone (RU-486)

Competitive inhibitor of progestins at PR

Termination of pregnancy + Misoprostol (PGE1)

20

Who are OCPs CI in?

Smokers > 35 yo

Hx of thromboembolism and stroke

Hx of estrogen-dependent tumor

21

Terbutaline

β2-agonist - relax uterus

↓contraction frequency during labor

22

What are ketoconazole and spironolactone used for?

PCOS - Prevent hirsutism

Ketoconazole: Inhibit steroid synthesis (17,20-desmolase)

Spironolactone: Inhibits steroid binding (17α-hydroxylase and 17, 20-desmolase)

23

Tamsulosin

α1-antagonist - BPH

Inhibits smooth muscle contraction

*α1A,D selective = prostate only*

24