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Flashcards in Repro Pharm Deck (59):
1

Which drugs cause gynecomastia?

Some Drugs Cause Awkward Knockers:
Spironolactone
Digoxin
Cimetidine
Alcohol
Ketoconazole

2

What is leuprolide?

GnRH analog with agonist properties when used in pulsatile
fashion
Antagonist when given continuously

3

What is leuprolide used for?

Infertility (pulsatile)
Prostate cancer (continuous - use with flutamide)
Uterine fibroids (continue)
Precocious puberty (continuous)

4

What are the side effects of leuprolide?

Antiandrogen
Nausea
Vom

5

What is testosterone used for?

Hypogonadism
Promotion of secondary sex characteristics
Stimulation of anabolism after burns or injury

6

What are the side effects of testosterone?

Masculinization in females
Inhibits LH in males so gonadal atrophy
Premature closure of epiphyseal plates
Increases LDL
Decreases HDL

7

What is finasteride?

A five alpha reductase inhibitor

8

What is finasteride used for?

Male pattern baldness
benign prostatic hypertrophy

9

What is flutamide?

A nonsteroidal competitive inhibitor of androgens at the testosterone receptor

10

What is flutamide used for?

Prostate cancer

11

What are the side effects of finasteride?

ED
Hirsutism

12

What is the drawback of finasteride?

It takes 6 months for the full effect

13

What is saw palmetto?

A 5 alpha reductase inhibitor and androgen receptor blocker

14

What is the MOA of ketoconazole?

Inhibits steroid synthesis (17,20 desmolase - present in theca cells)

15

What is ketoconazole used for?

PCOS

16

What are the side effects of spironolactone and ketoconazole?

Gynecomastia
Amenorrhea

17

What is the MOA of spironolactone?

Inhibits steroid binding

18

What are estrogens used for?

Hypogonadism
Ovarian failure
Menstrual abnormalities
HRT in post meno women
And prostrate cancer

19

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

20

What are the contraindications to using estrogen?

Hx of DVT
ER positive breast cancer

21

What are the selective estrogen receptor modulators?

Clomiphene
Tamoxifen
Raloxifene

22

What is clomiphene?

Partial agonist at estrogen receptors in hypothalamus
Prevents normal feedback inhibition
Increases LH and FSH from pituitary to stimulate ovulation.

23

What is clomiphene used for?

Infertility
PCOS

24

What are the side effects of clomiphene?

Hot flashes
Ovarian enlargement
Multiple simultaneous pregnancies
Visual disturbances

25

What is tamoxifen?

Antagonist of estrogen receptors at breast tissue and partial agonist at endometrium
Used to treat ER positive breast cancer

26

What is raloxifene?

Agonist of estrogen receptors on bone --> decreases resorption of bone

27

What is HRT?

For relief and prevention of meno sx and osteoporosis (increase estrogen and decrease osteoclasts activity)

28

What is the risk of unopposed estrogen therapy?

Increased risk of endometrial cancer and CV risk

29

What is anastrozole/exemesrane?

Aromatase inhibitors used in post meno women with breast cancer

30

What are progestins used for?

OC
Tx of endometrial cancer and abnormal uterine bleeding
Causes reduced growth and vascularization of endometrium

31

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

32

What is the side effect of mifepristone?

Heavy bleeding
N/V
Anorexia
Ab pain

33

What is misoprostol?

PGE1

34

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

35

What are the contraindications for OCs?

Smoking over age 35
Hx of thromboembolism or stroke
Hx of estrogen dependent tumor

36

What is terbutaline?

B2-agonist that relaxes uterus - tocolysis

37

What is tamsulosin?

Alpha-1 antagonist used for BPH
Selective for 1AD receptors in the prostate

38

What are the normal side effects of alpha blockers?

Reflex tachycardia
Syncope
Ortho static hypotension
Asthenia

39

What are the side effects of tamsulosin?

Ejaculation problems
Nasal stuffiness
Asthenia
Does not cause orthostatic hypotension

40

What is the MOA of sildenafil?

Inhibit phosphodiesterase 5 causing an increase in cGMP, smooth muscle relaxation in corpus cavernosum

41

What are the side effects of sildenafil?

Headache
Flushing
Dyspepsia
Impaired blue-green color vision

42

What are the contraindications for afils?

Patients with angina on nitrates
Alpha blockers for BPH

43

What is danazol?

Synthetic androgen that acts as a partial agonist

44

What is danazol used for?

Endometriosis
Hereditary angioedema

45

What are the side effects of danazol?

Weight gain
Edema
Acne
Hirsutism
Masculinization
Decrease HDL
Hepatotoxicity

46

Exogenous testosterone effects?

inhibits HPG axis = dec intratesticular testosterone = dec testicular size = azoospermia

47

How do you treat 5-alpha-reductase deficiency?

DHT

48

How do you treat hydatidiform mole?

Methotrexate
D&C

49

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

50

How do you treat endometritis?

gentamycin + clindamycin
may add ampicillin

51

How do you treat endometriosis?

Oral contraceptives
Leuprolide
Danazol
NSAIDs

52

How do you treat Adenomyosis?

Hysterectomy

53

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)
weight reduction

54

What is the treatment for BPH?

alpha1- antagonists = terazosin & tamulosin
(cause relaxation of smooth muscle)
finasteride (inhibits production of DHT from Testosterone)

55

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

56

What are the side effects of terbutaline?

Neonatal intraventricular hemorrhage
Hypoglycemia
Hypocalcemia
Ileus

57

What may cause blindness and retinal neovascularizatiom in a neonate?

Positive end expiratory pressure used for ARDS

58

What are the complications of surfactant treatment?

Transient hypoxia and hypotension
Blockage of endotracheal tube
Pulmonary hemorrhage

59

What is the clinical use of mifepristone?

Used for abortions up to 49 days after conception.