Reproductive Pharmacology Flashcards Preview

USMLE Step 1 > Reproductive Pharmacology > Flashcards

Flashcards in Reproductive Pharmacology Deck (19):
1

GnRH analog that can be used as antagonist or agonist

Leuprolide (pulsatile--agonist, continuous--antagonist) downregulates GnRH receptor in pituitary --> decreased FSH/LH

2

Uses of leuprolide? Toxicities?

infertility (pulsatile), prostate cancer (continuous use with flutamide), uterine fibroids (continous), precocious puberty (continuous); Has anti-androgen effects

3

What are risks of estrogen use?

increased risk of endometrial cancer, bleeding in postmenopausal women, clear cell adenocarcinoma of vagina (DES exposure in utero), increased risk of thrombi

4

What are some SERMS?

clomiphene, tamoxifen, raloxifene

5

Antagonist at estrogen receptors in hypothalamus

Clomiphene; SERM that prevents normal feedback inhibition and increases release of LH and FSH from pituitary to stimulate ovulation; use to treat infertility due to anovulation (PCOS)

6

Antagonist of estrogen receptors at breast tissue

Tamoxifen; SERM that is also agonist at uterus/bone. Ass w/ endometrial cancer, thromboembolic events; Primarily used to treat ER+ breast cancer

7

Antagonist of estrogen receptors at uterus

Raloxifene: SERM that is agonist on bone also; increases risk of thromboembolic events; decrease resorption of bone-->used to treat osteoporosis

8

What are risks of unopposed estrogen therapy?

increased risk of endometrial cancer (thats why you add progesterone); possibly increased cardiovascular risk

9

Anastrazole/exemestane

aromatase inhibitors used in post-menopausal women with breast cancer (decrease conversion of androgens to estrogens)

10

Progestins

bind progesterone receptors to decrease growth and increase vascularization of endometrium---used in OCPs and treatment of endometrial cancer, abnormal bleeding

11

Mifepristone

competitive inhibitor of progestins at progresterone receptor--used to terminate pregnancy; administered with misoprostol (PGE1)

12

Terbutaline

B2 agonist that relaxes the uterus, used to decrease contraction frequency in women during labor

13

Danazol

synthetic androgen used in endometriosis and hereditary angioedema; androgen effects and decreased HDL levels/hepatotoxic

14

What effects to testosterone have on serum lipids?

Increase LDL and decrease HDL

15

Finasteride

5 alpha reductase inhibitor (blocks conversion of testoterone to DHT), used in BPH and promotes hair growth at the cost of gynecomastia and decreased sexual performance

16

Flutamide

competitive inhibitor of testosterone receptor used in Prostate Ca

17

Used in treatment of PCOS to prevent hirsutism

Ketoconazole (inhibits 17,20 desmolase; steroid synthesis), Spironolactone (inhibits steroid binding, 17 alpha hydroxylase, 17,20 desmolase); both cause gynecomastia and amenorrhea

18

Tamsulosin

alpha1 antagonist used to treat BPH by inhibiting smooth muscle contraction; selective for alpha1A,D receptors found only on prostate

19

Sildenafil/vardenafil

PDE5 inhibitors, cause increase cGMP, NO release, smooth muscle relaxation in corpus cavernosum; can cause headache, heartburn, impaired vision, life threatening hypotension in patients also taking nitrates