Flashcards in Repro Pharm Deck (59):
Which drugs cause gynecomastia?
Some Drugs Cause Awkward Knockers:
What is leuprolide?
GnRH analog with agonist properties when used in pulsatile
Antagonist when given continuously
What is leuprolide used for?
Prostate cancer (continuous - use with flutamide)
Uterine fibroids (continue)
Precocious puberty (continuous)
What are the side effects of leuprolide?
What is testosterone used for?
Promotion of secondary sex characteristics
Stimulation of anabolism after burns or injury
What are the side effects of testosterone?
Masculinization in females
Inhibits LH in males so gonadal atrophy
Premature closure of epiphyseal plates
What is finasteride?
A five alpha reductase inhibitor
What is finasteride used for?
Male pattern baldness
benign prostatic hypertrophy
What is flutamide?
A nonsteroidal competitive inhibitor of androgens at the testosterone receptor
What is flutamide used for?
What are the side effects of finasteride?
What is the drawback of finasteride?
It takes 6 months for the full effect
What is saw palmetto?
A 5 alpha reductase inhibitor and androgen receptor blocker
What is the MOA of ketoconazole?
Inhibits steroid synthesis (17,20 desmolase - present in theca cells)
What is ketoconazole used for?
What are the side effects of spironolactone and ketoconazole?
What is the MOA of spironolactone?
Inhibits steroid binding
What are estrogens used for?
HRT in post meno women
And prostrate cancer
What are the side effects of estrogen therapies?
Increased risk of endometrial cancer
Bleeding in post meno
Clear cell adenocarcinoma of vagina in women exposed to DES
Increased risk of thrombi
What are the contraindications to using estrogen?
Hx of DVT
ER positive breast cancer
What are the selective estrogen receptor modulators?
What is clomiphene?
Partial agonist at estrogen receptors in hypothalamus
Prevents normal feedback inhibition
Increases LH and FSH from pituitary to stimulate ovulation.
What is clomiphene used for?
What are the side effects of clomiphene?
Multiple simultaneous pregnancies
What is tamoxifen?
Antagonist of estrogen receptors at breast tissue and partial agonist at endometrium
Used to treat ER positive breast cancer
What is raloxifene?
Agonist of estrogen receptors on bone --> decreases resorption of bone
What is HRT?
For relief and prevention of meno sx and osteoporosis (increase estrogen and decrease osteoclasts activity)
What is the risk of unopposed estrogen therapy?
Increased risk of endometrial cancer and CV risk
What is anastrozole/exemesrane?
Aromatase inhibitors used in post meno women with breast cancer
What are progestins used for?
Tx of endometrial cancer and abnormal uterine bleeding
Causes reduced growth and vascularization of endometrium
What is mifepristone?
An abortifacient - competitive inhibitor of progesterone receptors.
The anti-progestin effects cause release of endogenous prostaglandins and sensitize the myometrium to the effects of the hormone
What is the side effect of mifepristone?
What is misoprostol?
How do OCs work?
Inhibit LH/FSH surge via negative feedback so there is no ovulation.
Progestins cause thickening of cervical mucus so limits sperm access, inhibit endometrial proliferation so it is less accepting of implantation
What are the contraindications for OCs?
Smoking over age 35
Hx of thromboembolism or stroke
Hx of estrogen dependent tumor
What is terbutaline?
B2-agonist that relaxes uterus - tocolysis
What is tamsulosin?
Alpha-1 antagonist used for BPH
Selective for 1AD receptors in the prostate
What are the normal side effects of alpha blockers?
Ortho static hypotension
What are the side effects of tamsulosin?
Does not cause orthostatic hypotension
What is the MOA of sildenafil?
Inhibit phosphodiesterase 5 causing an increase in cGMP, smooth muscle relaxation in corpus cavernosum
What are the side effects of sildenafil?
Impaired blue-green color vision
What are the contraindications for afils?
Patients with angina on nitrates
Alpha blockers for BPH
What is danazol?
Synthetic androgen that acts as a partial agonist
What is danazol used for?
What are the side effects of danazol?
Exogenous testosterone effects?
inhibits HPG axis = dec intratesticular testosterone = dec testicular size = azoospermia
How do you treat 5-alpha-reductase deficiency?
How do you treat hydatidiform mole?
How do you treat Preeclampsia & Eclapsia?
IV magnesium sulfate
(both prevent & treat seizures)
bed rest, monitor, dec Na intake, tx HTN (methyldopa)
deliver fetus as soon as viable
How do you treat endometritis?
gentamycin + clindamycin
may add ampicillin
How do you treat endometriosis?
How do you treat Adenomyosis?
What are the treatment strategies for PCOS?
Medroxyprogesterone (dec LH & androgenesis) or low dose-OCPs
Spironolactone (tx acne & hirsutism)
Clomiphene (stimulates ovulation -- if want to get pregnant)
Metformin (+DM or metabolic syndrome)
What is the treatment for BPH?
alpha1- antagonists = terazosin & tamulosin
(cause relaxation of smooth muscle)
finasteride (inhibits production of DHT from Testosterone)
What are the effects of leuprolide in the use of prostate cancer?
It decreases circulating levels of testosterone by decreases LH release from the pituitary.
Less LH influence on the Leydig cells results in less testosterone production
What are the side effects of terbutaline?
Neonatal intraventricular hemorrhage
What may cause blindness and retinal neovascularizatiom in a neonate?
Positive end expiratory pressure used for ARDS
What are the complications of surfactant treatment?
Transient hypoxia and hypotension
Blockage of endotracheal tube