reproductive

Question 0

menotropin

Answer 0

hMG(human menopausal gonadotropin)
acts as FSH and LH
stimulates hormone release and follicle relase->fertilization

Question 1

Leuprolide

Answer 1

1. GnRH analog with agonist properties when used in pulsatile fashion
   Ex. infertiliy
2. antagonist when used in continuous fashion(down regulate receptor in pituitary–>decrease GSH/LH)
   Ex. prostate cancer(with flutamide), uterine fibroids (continous), precocious puberty (continous)
   Tox: antiandrogen, N/V(男女不分让人恶心)

Question 2

tesosterone

Answer 2

1.agonist at androgen receptor
2.treats hypogonadism and development of 2ndary sex characteristics
stimulation of anabolism to promote recovery after burn or injury
3. causes masculinization in females,
reduces intratesticular testosterone in male by inhibiting release of LH(-feedback)–>gonadal atrophy
premature closure of epiphyseal plattes, increase LDL,decrease HDL.

Question 3

methyltestosterone

Answer 3

1.agonist at androgen receptor
2.treats hypogonadism and development of 2ndary sex characteristics
stimulation of anabolism to promote recovery after burn or injury
3. causes masculinization in females,
reduces intratesticular testosterone in male by inhibiting release of LH(-feedback)–>gonadal atrophy
premature closure of epiphyseal plattes, increase LDL,decrease HDL.

Question 4

finasteride

Answer 4

5-alpha-reductase inhibitor(decrease conversion of testosterone to DHT)
useful in BPH
also promotes hair growth-used to treat male-pattern baldness

Question 5

flutamide

Answer 5

nonsteriodal competitive inhibitor of androgens at testosterone receptor
used in prostate carcinoma

Question 6

ketoconazole

Answer 6

inhibits steroid synthesis (inhibits 17,20-desmolase)
ketoconazole and spironolactone are used in the treatment of polycystic ovarian syndrome to prevent hirsutism
sideeffect: gynecomastia and amenorrhea

Question 7

sipronolactone

Answer 7

inhibits steroid binding
aldosterone receptor antagonist in the cortical collecting tubule
used to treat polycystic ovarian syndrome to prevent hirsutism
sideeffect: gynecomastia and amenorrhea
Spironolactone and eplerenone

Question 8

estrogen

ethinyl estradiol, DES,mestranol

Answer 8

1. bind estrogen receptors
2. hypogonadism or ovarian failure, menstrual abnormalities, HRT in postmenopausal women; use in men with androgen-dependent prostate cancer
3. increase risk of endometrial cancer, bleeding in postmenopausal, clear cell adenocarcinoma of vagina in female exposed to DES in utero
   increase risk of thrombi
   CI:ER+ breast cancer, history of DVTs

Question 9

Clomiphene

Answer 9

partial agonist at estrogen receptor in hypothalamus
prevents normal feedback inhibition and increase release of LH and FSH from pituitary, stimulates ovulation
used to treat infertility and polycystic ovarian syndrome
hot flashes, ovarian enlargment, multiple stimultaneous pregnancies and visual disturbance

Question 10

Tamoxifen

Answer 10

antagonist on breast tissue

used to treat and prevent recurrence of ER+ breast cancer

Question 11

Raloxifene

Answer 11

agonist on bone, antagonist on breast and uterus
reduces resorption of bone
used to treat osteoporosis

Question 12

hormone replacement therapy

Answer 12

relief or prevention of menopausal symptoms (hot flashs, vaginal atrophy) and osteoporosis (increase estrogen, decrease osteoclast activities);
unopposed estrogen replacement therapy (ERT), increase risk of endometrial cancer, so progesterone is added.
possible increase CV risk

Question 13

anastrozole

Answer 13

aromatase inhibitors used in postmenopausal women with breast cancer

Question 14

exemestane

Answer 14

aromatase inhibitors used in postmenopausal women with breast cancer

Question 15

progestins

Answer 15

1. binds progesterone receptor, reduce growth and increase vascularization of endometrium
2. used in oral contraceptives and in the treatment of endometrial cancer and abnormal uterine bleeding

Question 16

mifepristone

RU-486

Answer 16

1. competitive inhibitor of progestins at progesterone receptor
2. termination of pregnancy. administered with misoprosol (PGE1)
3. heavy bleeding, GI effects (N/V, anorexia), abdominal pain

Question 17

oral contraception

synthetic progestins, estrogen

Answer 17

estrogen and progestin inhibits LH/FSH –> prevent estrogen surge–> no LH surge–> no ovulation
progestins cause thickening of the cervical mucus, limiting access of sperm; also thickening of endometrial is less suitable for the implant.
CI: smoker>35yrs (increase risk for cardiovascular disease), pt with history of thromboembolism and stroke or E-dependent tumor

Question 18

terbutaline

Answer 18

beta2-agonist that relaxes the uterus

reduces premature uterine contractions

Question 19

tamsulosin

Answer 19

alpha1-antagonist used to treat BPH by inhibiting smooth muscle contraction
selective for Alpha1A,D receptor(found in prostate)vs vascular alpha1 B receptor

Question 20

ritodrine

Answer 20

beta2-agonist that relaxes the uterus

reduces premature uterine contractions

Question 21

metaproterenol

Answer 21

beta2-agonist that relaxes the uterus

reduces premature uterine contractions

Question 22

TERAZOSIN

Answer 22

alpha1 blocker

BPH

Question 23

sildenafil

Answer 23

inhibit phosphodiesterase 5, causing increase of cGMP, smooth muscle relaxation in the corpus cavernosum
increase blood flow, and penile erection
tox: headache, flushing, dyspepsia,
impaired blue-green color vision.
risk of life-threatening hypotension in patients taking nitrates

Question 24

vardenafil

Answer 24

inhibit phosphodiesterase 5, causing increase of cGMP, smooth muscle relaxation in the corpus cavernosum increase blood flow, and penile erection tox: headache, flushing, dyspepsia, impaired blue-green color vision. risk of life-threatening hypotension in patients taking nitrates

Question 25

danazol

Answer 25

synthetic androgen that acts as partial agonist at androgen receptors endometriosis and hereditary angioedema weight gain, edema, acne hirsutism, masulinization, decrease HDL levels, hepatotoxicity