Br Pharmacology: Gonadal Hormones And Inhibitors

Front 1

What are examples of estrogens used in contraceptives?

Back 1

1) ethinyl estradiol
2) mestranol

Front 2

How does estrogen effect the body?

Back 2

1) increases serum proteins
2) decreases bone resorption
3) increases coagulation
4) increases TAG levels
5) decreases LDL

Front 3

What will continuous estrogen do to GnRH levels?

Back 3

inhibit its secretion especially with a progestin

Front 4

When estrogen is used in HRT what is there increased risk of developing?

Back 4

1) endometrial cancer
2) small increase in breast cancer, MI and stroke

Front 5

What are dose dependent toxic effects of estrogen?

Back 5

nausea, breast tenderness, migraines, thromboembolic effects, gallbladder disease, hypertriglyceridemia, and HTN

Front 6

What does diethystilbestrol cause in the daughters of mothers that took it?

Back 6

vaginal adenocarcinoma, infertility, and ectopic pregnancy... Note mothers take to avoid spontaneous abortion

Front 7

What are older progestins? Which are newer? What is difference between newer and older?

Back 7

1) older: L-norgestrel and norethindrone
2) newer: norgestimate and desogestrel
3) newer ones are less androgenic

Front 8

What processes in body do progestins affect?

Back 8

1) carbohydrate metabolism
2) increase fat deposition

Front 9

Why are progestins used in HRT with estrogen?

Back 9

lower risk of endometrial cancer

Front 10

What are the toxic effects of progestins?

Back 10

1) increase BP
2) decrease HDL
3) longterm use in premenopausal women causes reversible decrease in bone density

Front 11

Up until what point can postcoital contraceptives be given? What is benefit of using progestin only pill?

Back 11

1) 72 hours
2) fewer side effects

Front 12

At point should progestins be given to inhibit ovulation?

Back 12

before LH surge

Front 13

Women taking combination oral contraceptives are less likely to develop what?

Back 13

1) ovarian cysts
2) ovarian and endometrial cancer
3) benign breast disease
4) PID
5) ectopic pregnancy
6) iron deficiency anemia
7) RA

Front 14

Women taking combination oral contraceptives are more likely to develop what? What are normal side effects?

Back 14

1) MI
2) stroke
3) DVT
4) PE
5) nausea, breast tenderness, headache, skin pigmentation and depression

Front 15

What is the MOA of tamoxifen? How does it affect different tissues? What is there increased risk of?

Back 15

1) an antagonist of estrogen responsive breast cancer
2) agonist at endometrium causing endometrial hyperplasia and increased risk of endometrial cancer

Front 16

What are side effects of tamoxifen? What drug is similar to tamoxifen?

Back 16

1) hot flushes (antagonistic)
2) DVT (agonist)
3) prevents osteoporosis
4) toremifene

Front 17

What is raloxifene approved for? How is it different from tamoxifen? What are side effects?

Back 17

1) prevention of osteoporosis
2) no endometrial effects
3) hot flushes, increased DVT

Front 18

What is clomiphene used for? What is its MOA?

Back 18

1) induce ovulation in anovulatory women
2) blocks estrogen receptors in pituitary reduce negative feedback of LH and FSH which increases gonadotropins

Front 19

What is the MOA of fulvestrant? When is it used?

Back 19

1) pure estrogen receptor antagonist
2) breast cancer resistant to tamoxifen

Front 20

Which drugs are aromatase inhibitors?

Back 20

1) anastrozole, letrozole
2) exemestane (irreversible)

Front 21

What is the MOA of danazol?

Back 21

1) inhibit P450 enzymes involved in gonadal steriod synthesis
2) is also a partial agonist of progestin, androgen, and glucocorticoid receptors

Front 22

What is the MOA of leuprolide?

Back 22

1) GnRH agonist
2) continuous administration prevents LH and FSH release by suppressing GnRH release

Front 23

What is used for treating precocious puberty in children? What can this treatment be used for in women?

Back 23

1) leuprolide
2) short term treatment of endometriosus and uterine fibroids
3) treatment beyond 6 months causes osteoporosis

Front 24

What is the MOA of mifepristone? when can it be given?

Back 24

1) RU-486 is antagonist of progesterone and glucocorticoids
2) abortions up to 49 days after last menstrual period

Front 25

What can mifepristone be given with to help ensure a complete abortion?

Back 25

1) misopristol a PGE analog

Front 26

What two hormones can testosterone be synthesized from?

Back 26

1) progesterone
2) DHEA

Front 27

Which steroids have an increased ratio of anabolic to androgenic effects?

Back 27

1) oxandrolone
2) stanozolol

Front 28

Which lab values are increased with testosterone? What happens to bone density

Back 28

1) increased RBC
2) decreased urea nitrogen excretion
3) more positive nitrogen balance
4) maintains bone density

Front 29

Excessive doses of androgens in men can result in what?

Back 29

1) feminization from feedback inhibition of pituitary and conversion of exogenous testosterone to estrogen

Front 30

What does excess testosterone in both sexes cause?

Back 30

1) cholestatic jaundice
2) increased liver enzymes
3) hepatocellular carcinoma

Front 31

what is the MOA of flutamide? When is it used?

Back 31

1) competitive antagonist of androgen receptors
2) used in prostate carcinoma

Front 32

What is spironolactone used for?

Back 32

1) K+ sparing diuretic
2) inhibits androgen receptors in women with hirsutism

Front 33

Which two drugs are used in prostatic carcinoma?

Back 33

1) leuprolide
2) flutamide

Front 34

What is the MOA of ketoconazole?

Back 34

inhibits gonadal and adrenal steroid synthesis

Front 35

What is the MOA of cyproterone?

Back 35

blocks androgen receptor complex

Front 36

Antiestrogen drugs used for fertility and breast cancer respectively

Back 36

Clomiphene and tamoxifen

Front 37

Common SE of tamoxifen and raloxifene

Back 37

Hot flashes

Front 38

Selective estrogen receptor modulator (SERM) used for prevention of osteoporosis and prophylaxis in women with risk factors for breast cancer

Back 38

Raloxifene

Front 39

Non-steroidal estrogen agonist causes clear cell adenocarcinoma of the vagina in daughters of women who used it during pregnancy

Back 39

Diethylstilbestrol (DES)

Front 40

Oral contraceptive available in a transdermal patch

Back 40

Ortho-Evra

Front 41

Anabolic steroid that has potential for abuse

Back 41

Nandrolone, oxymetholone, and oxandrolone

Front 42

Anti-androgen used for hirsutism in females

Back 42

Cyproterone acetate

Front 43

Drug is used with testosterone for male fertility

Back 43

Leuprolide