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Pharmacology > Reproductive > Flashcards

Reproductive Flashcards

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1
Q

what is leuprolide

A

GnRH analog

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2
Q

leuprolide mechanism

A

pulsatile –> GnRH agonist

continuous –> GnRH antagonist (downregulates receptor) –> decrease FSH and LH

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3
Q

clinical use of pulsatile leuprolide

A

infertility

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4
Q

clinical use of continuous leuprolide (3)

A
  1. prostate cancer (with flutamide)
  2. uterine fibroids
  3. precocious puberty
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5
Q

three types of estrogen drugs

A
  1. ethinyl estradiol
  2. DES
  3. mestranol
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6
Q

clinical use of estrogens (3)

A
  1. hypogonadism or ovarian failure
  2. HRT
  3. androgen-dependent prostate cancer
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7
Q

side effects of estrogens

A
  1. increase risk endometrial cancer

2. increase risk thrombi

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8
Q

complications in female baby from DES exposure in utero

A

clear cell adenocarcinoma of vagina

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9
Q

contraindications for estrogen administration

A

ER+ breast cancer

history of DVTs

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10
Q

clomiphene drug class

A

selective estrogen receptor modulators (SERMs)

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11
Q

tamoxifen drug class

A

selective estrogen receptor modulators (SERMs)

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12
Q

raloxifene drug class

A

selective estrogen receptor modulators (SERMs)

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13
Q

clomiphene mechanism

A

antagonist at estrogen receptors in hypothalamus

prevents feedback inhibition –> increase LH and FSH release –> stimulates ovulation

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14
Q

clinical use clomiphene

A

infertility due to anovulation (i.e. PCOS)

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15
Q

side effects clomiphene (4)

A
  1. hot flashes
  2. ovarian enlargement
  3. multiple pregnancies
  4. visual disturbances
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16
Q

tamoxifen mechanism

A

estrogen receptor antagonist in breast, agonist in bone and uterus

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17
Q

clinical use tamoxifen

A

ER+ breast cancer

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18
Q

side effects tamoxifen (2)

A
  1. endometrial cancer

2. thromboembolic events

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19
Q

raloxifene mechanism

A

estrogen receptor agonist in bone, antagonist in uterus

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20
Q

clinical use raloxifene

A

osteoporosis (decreases resorption of bone)

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21
Q

side effects raloxifene (1)

A
  1. thromboembolic events
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22
Q

clinical use hormone replacement therapy (HRT) (2)

A
  1. relief of menopausal symptoms

2. osteoporosis (increase estrogen –> decrease osteoclast activity)

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23
Q

side effects HRT (2)

A
  1. endometrial cancer (unopposed estrogen, so add progesterone)
  2. cardiovascular risk
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24
Q

what is anastrozole

A

aromatase inhibitor

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25
what is exemestane
aromatase inhibitor
26
clinical use anastrozole
used in postmenopausal women with breast cancer
27
clinical use exemestane
used in postmenopausal women with breast cancer
28
progestin mechanism
bind progesterone receptors --> decrease growth and increase vascularization of endometrium
29
clinical use progestin (2)
1. oral contraceptives | 2. endometrial cancer
30
mifepristone (RU-486) mechanism
competitive inhibitor of progestin (at progesterone receptors)
31
clinical use mifepristone
termination of pregnancy (give with misoprostol -- PGE1)
32
side effects mifepristone (2)
1. heavy bleeding | 2. GI effects
33
mechanism oral contraceptives
estrogen and progestins inhibit LH/FSH --> prevent estrogen surge --> prevent ovulation progestins: thickening of cervical mucus (sperm can't get in) and inhibit endometrial proliferation (can't implant)
34
contraindications for oral contraceptives (3)
1. smokers > 35 2. hx of thromboembolism or stroke 3. hx estrogen-dependent tumor
35
what is terbutaline
beta-2 agonist
36
mechanism terbutaline
beta-2 agonist --> relaxes uterus --> decrease contraction frequency
37
what drug decreases contraction frequency during labor?
terbutaline (beta-2 agonist)
38
what is danazol?
synthetic androgen
39
mechanism danazol
synthetic androgen, partial agonist at androgen receptors
40
clinical use danazol (2)
1. endometriosis | 2. hereditary angioedema
41
side effects danazol (5)
1. weight gain 2. edema 3. acne, hirsuitism, masculinization 4. decrease HDL 5. hepatotoxicity
42
mechanism testosterone
agonist at androgen receptors
43
mechanism methyltestosterone
agonist at androgen receptors
44
clinical use testosterone / methyltestosterone (3)
1. hypogonadism 2. promotes secondary sex characteristics 3. anabolism for burn/injury recovery
45
side effects testosterone / methyltestosterone (4)
1. masculinization 2. inhibits release LH (negative feedback) --> gonadal atrophy 3. premature closure epiphyseal plates 4. increase LDL, decrease HDL
46
what are four antiandrogens?
1. finasteride 2. flutamide 3. ketoconazole 4. spironolactone
47
what is finasteride?
5-alpha reductase inhibitor
48
mechanism finasteride
inhibits 5-alpha reductase --> prevents conversion of testosterone to DHT
49
clinical use finasteride (2)
1. BPH | 2. male-pattern baldness (hair growth)
50
what is flutamide?
nonsteroidal competitive inhibitor of androgens at the testosterone receptor
51
clinical use flutamide
prostate carcinoma
52
what is ketoconazole?
antiandrogen, inhibits 17,20-desmolase
53
ketoconazole mechanism
inhibits 17,20-desmolase --> inhibits steroid synthesis
54
what is spironolactone?
antiandrogen
55
mechanism spironolactone
inhibits steroid binding
56
clinical use ketoconazole
PCOS (prevent hirsuitism)
57
what does tamoxifen do to LDL levels?
normalizes LDL and cholesterol in ovarian failure from breast cancer
58
clinical use spironolactone
PCOS (prevent hirsuitism)
59
what two drugs are used in PCOS to prevent hirsuitism?
spironolactone and ketoconazole
60
side effects spironolactone (2)
1. gynecomastia | 2. amenorrhea
61
side effects ketoconazole (2)
1. gynecomastia | 2. amenorrhea
62
what is tamsulosin?
alpha-1 antagonist used to treat BPH
63
mechanism tamsulosin
alpha-1 antagonist --> inhibits smooth muscle contraction | selective for alpha-1 receptors on prostate and not on vasculature
64
clinical use tamsulosin
BPH
65
mechanism sildenafil
inhibits phosphodiesterase 5 --> increase cGMP --> smooth muscle relaxation in corpus cavernosum --> erection
66
mechanism vardenafil
inhibits phosphodiesterase 5 --> increase cGMP --> smooth muscle relaxation in corpus cavernosum --> erection
67
clinical use sildenafil
erectile dysfunction
68
clinical use vardenafil
erectile dysfunction
69
side effects sildenafil
1. headache 2. flushing 3. impaired blue-green vision 4. heartburn (dyspepsia) 5. risk life-threatening hypotension in pts taking nitrates
70
side effects vardenafil
1. headache 2. flushing 3. impaired blue-green vision 4. heartburn (dyspepsia) 5. risk life-threatening hypotension in pts taking nitrates
71
can you use sildenafil/vardenafil in patients taking nitrates?
NO!! (risk life-threatening hypotension)

Pharmacology (8 decks)

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