Repro Pharma Flashcards

1
Q

The mechanism by which finasteride relieves signs & symptoms of benign prostatic hyperplasia?

a. Competitively antagonize androgen receptor
b. Decrease LH & FSH synthesis
c. Decrease dihydrotestosterone synthesis
d. Reduce testosterone synthesis

A

C

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2
Q

Which one of the following statements applies to Nandrolone?

a. Causes virilization more than testosterone in females (paraphrasing)
b. can delay the epiphysis closure in children
c. Is useful in patients with hypoproteinemia
d. Enhances the pituitary LH secretions

A

-

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3
Q

What drug potentiates the effect of Tamoxifen in the treatment of advanced breast cancer?

A

Letrozole

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4
Q

What is a progestin antagonist that can be used to induce abortion during 1st trimester of pregnancy?

a. Gossypol
b. Mestranol
c. Levonorgestrel
d. Clomiphene
e. Mifepristone

A

E

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5
Q

Which of the following treats benign prostate hyperplasia by decreasing dihydrotestosterone?

a. Finasteride
b. Ketoconazole

A

A

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6
Q

What is the mechanism of action of Cabergoline?

A

Dopamine agonist

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7
Q

A nurse was treated for breast cancer for a year. She later developed resistance against tamoxifen. Which drugs should she take to overcome this problem?

a. Clomiphene
b. Estrogen
c. Letrozole
d. Oral contraceptives
e. Raloxifene

A

C

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8
Q

What drug is bio transformed into a metabolite that inhibits FSH release?

a. Mestranol
b. Ethinylestradiol

A

A
Note: Mestranol is a precursor of Ethinyl estradiol, which acts partly by inhibiting FSH release because it is an estrogen analogue.

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9
Q

Which of the following is true regarding hormone replacement therapy in post-menopausal women?

a. It is most effective if used early enough
b. It induces bone deposition by osteoblasts
c. It is used in higher doses than contraceptives

A

A

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10
Q

What inhibits prolactin?

a. Dopamine
b. Prolactin
c. Testosterone
d. LH

A

A

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11
Q

What antagonizes estrogen in the hypothalamus to treat infertility?

a. Mestranol
b. Clomiphene
c. Nandrolone
d. Raloxifene
e. Fluoxymesterone

A

B

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12
Q

What is used to treat breast cancer?

a. Mestranol
b. Clomiphene
c. Nandrolone
d. Raloxifene
e. Fluoxymesterone

A

D

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13
Q

What is tamoxifen?

a. Estrogen agonist
b. Estrogen antagonist
c. Estrogen agonist/antagonist

A

C

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14
Q

What is the mechanism of action of Norethindrone as an oral contraceptive?

a. Blocks progesterone receptor
b. Enhances GR secretion
c. Increase sensitivity of pituitary gland
d. Thickens cervical mucosa
e. Increases or enhances follicular growth

A

D

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15
Q

Which estrogen receptor modulator stimulates ovulation?

A

Clomiphene
Clomiphene antagonizes the action of estrogen in the pituitary gland and hypothalamus → decreased estrogen negative feedback → increased LH and FSH → Ovulation

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16
Q

What is true regarding norgestimate?

a. Can be taken in pregnancy
b. Contraindicated in breastfeeding
c. Estrogen analog
d. IncreaseHDL
e. Minimal androgenic activity

A

E

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17
Q

What is an alpha-adrenergic receptor blocker that is used in the treatment of an enlarged prostate?

A

Terazosin

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18
Q

What is the mechanism of action of clomiphene?

A

It antagonizes the effect of negative feedback of estrogen on the pituitary and
hypothalamus

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19
Q

Which drug is used for the treatment of post-menopausal osteoporosis?

A

Raloxifene

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20
Q

How does clomiphene exert its action?

A

By activating the hypothalamic pituitary axis

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21
Q

A woman was found to have low bone mineral density and has a family history of hormone positive breast cancer. Based on your pharmacological knowledge, which drug should be given to her

A

Raloxifene

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22
Q

Which estrogen receptor modulator is used in advanced breast cancer?

A

Tamoxifen

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23
Q

What is the mechanism of action of clomiphene?

A

Stops inhibitory effect of estrogen on LH/FSH

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24
Q

What is the characteristic of Raloxifene?

A

Estrogen agonist on bones, antagonist on breast

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25
Q

A patient wanted to use raloxifene over ethinyl estrogen for infertility/breast cancer. What would make her choose raloxifene?

A

Positive family history of breast cancer

26
Q

A 30-year-old female with fertility, amenorrhea, and galactorrhea. What is used to treat her condition?

A

Bromocriptine

27
Q

Which is a progesterone receptor blocker

A

Mifepristone (RU 486)

28
Q

What is a characteristic of selective estrogen modulators?

A

They may act as agonist or antagonist depending on the target tissue

29
Q

What is a contraindication for HRT?

A

Active liver disease

30
Q

What is an absolute contraindication for HRT?

A

Ischemic heart disease

31
Q

What drug inhibits 5 alpha reductase?

A

Finasteride

32
Q

Which of the following is correct regarding leuprolide?

A

Prevents LH and FSH secretion

33
Q

What is true regarding clomiphene?

A

Enhances ovulation by blocking the inhibitory effects of estrogen

34
Q

What is a property of a category c drug?

a. Drug has no known fetal risk
b. Drugs potential risks outweigh drug benefits
c. Experimental studies show adverse effect of drug

A

C

35
Q

Which of the following drugs suppress lactation?

a. Anticonvulsants
b. Antithyroid drugs
c. Hydrochlorothiazide
d. Penicillin
e. Warfarin

A

C

36
Q

What drug causes damage in growing cartilage

A

Quinolone

37
Q

What drug is implicated in phocomelia?

a. Diethylstilbestrol
b. Retinoids
c. Thalidomide
d. Warfarin

A

C

38
Q

Which of the following has a high molecular weight and does not cross the placenta?

a. Aspirin
b. Heparin
c. Phenytoin
d. Valproate
e. Warfarin

A

B

39
Q

Which of the following causes nasal hypoplasia?

a. Aspirin
b. Heparin
c. Phenytoin
d. Valproate
e. Warfarin

A

E

40
Q

What describes the characteristics of drugs during breastfeeding?

a. Benzodiazepines are considered safe drugs during breastfeeding
b. Heparin passes easily to the milk compartment
c. Ionized drugs cross to milk compartment more than unionized drugs
d. Most drugs pass to milk compartment by passive diffusion
e. Transfer of drugs into breast milk depend on half-life of the drug

A

D

41
Q

Which of the following drugs is considered category X according to the FDA risk classification for drugs?

a. Amoxicillin
b. Heparin
c. Phenytoin
d. Warfarin

A

D

42
Q

Choose the appropriate match of the maternal condition and the drug that can be safely prescribed to treat it.

a. Aspirin–pain
b. Captopril–HTN
c. Insulin – type 2 diabetes
d. Quinolone–infection

A

C

43
Q

What drug causes premature closure of ductus arteriosus when taken before delivery?

A

Aspirin

44
Q

Metabolism of which drug increases during pregnancy due to induction of hepatic microsomal enzymes?

a. Aspirin
b. Phenytoin
c. Retinoids
d. Warfarin

A

B

45
Q

Which drug causes cleft lip and palate, and nasal hypoplasia?

a. Aspirin
b. Phenytoin
c. Retinoids
d. Warfarin

A

D

46
Q

What is true about drugs during pregnancy?

a. Drugs that cause vasoconstriction can decrease birth weight
b. Ionized drugs pass easier than non-ionized drugs
c. Most of them pass through placenta via active transport
d. They are not metabolized in the placenta

A

A

47
Q

A woman had a child with a cleft palate. She claimed that she had taken amoxicillin prior to being pregnant. What would you tell her to disprove the causal relationship between amoxicillin and the cleft palate?

a. IV amoxicillin is only teratogenic
b. More than 7 days of amoxicillin is teratogenic
c. She took the drug before the “all or none” phase of pregnancy
d. The dosage of amoxicillin was below threshold

A

C

48
Q

Why is heparin, which doesn’t cross the placenta, always given to pregnant women who need anticoagulation?

a. High molecular weight
b. Lipid soluble
c. Non-protein bound
d. Very short half-life

A

A

49
Q

A pregnant woman gave birth to a baby with cleft palate. She recalls using amoxicillin five times daily for seven days during the 20th week of gestation; she is convinced that the congenital abnormality in her baby is because of that drug. What would confer strong evidence against that?

A

It is not related to the drug because the palate closes in the first trimester

50
Q

A pregnant woman was on phenytoin to control her epileptic seizures. However, she developed seizures during pregnancy. What would explain that?

A

The total concentration of phenytoin has deceased during pregnancy

51
Q

A pregnant woman on valproic acid develops seizure after 26 weeks. What is the pharmacological cause?

a. Decrease in steady state concentration
b. Decrease in CYR450 oxidase

A

A

52
Q

What drug can inhibit lactation and should be avoided during breastfeeding?

A

Thiazide

53
Q

Which of the following drugs should be avoided in mothers who are breastfeeding?

a. Benzodiazepines
b. Insulin
c. Methyldopa
d. Penicillin
e. Warfarin

A

A

54
Q

What drug is used to treat hyperthyroidism in pregnant women?

A

Propylthiouracil

55
Q

Which drug and for what condition can be used in pregnancy?

A

Methyldopa – pregnancy

56
Q

What is true about Alprostadil?

a. It is an inhibitor of PDE5
b. It stimulates the production of cAMP
c. It stimulates the production of cGMP
d. It was originally developed as blood pressure lowering medication

A

B

57
Q

What drugs are contraindicated in patients taking nitrates or a 1-adrenergic antagonists?

A

Selective PDE5 inhibitors

58
Q

What is the pharmacological action of alprostadil, a prostaglandin analogue, intreating erectile dysfunction?

a. Decrease blood pressure
b. Decrease cGMP
c. Increase blood flow to cavernous tissue
d. Inhibit phosphodiesterase in blood vessels

A

C

59
Q

What leads to erectile dysfunction as a side effect?a. Alprostadil

b. Atenolol
c. Papaverine
d. Phentolamine
e. Sildenafil
f. Tamsulosin
g. Testosterone

A

B

60
Q

In what cases is testosterone used to treat erectile dysfunction?

a. Alcoholism
b. Depression
c. Diabetes
d. Hypogonadism

A

D

61
Q

What is the mechanism of action of sildenafil in the treatment of erectile dysfunction?

A
  • Increases the level of nitric oxide in the tissue

- Inhibits phosphodiesterase type 5