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225 Cards in this Set
- Front
- Back
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Dexamethasone MOA
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Chemical substitute for endogenous cortisol
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DDAVP MOA
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Vasopressin analog, only has V2 activity
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Recombinant GH
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Somatropin
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IGF-1 tyrosine kinase receptor agonist
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Mecasermin
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Adverse effects of GH
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Slipped femoral epiphysis, hyperglycemia, increased intracranial pressure, increased risk of leukemia
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Contraindication for GH
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Active malignancy
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Adverse effects of mecasermin
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Similar to GH--increased intracranial pressure, hypoglycemia
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Treatment for DI
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Desmopressin or vasopressin
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Desmopressin MOA
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Selective agonist at V2 receptor in kidney with little affinity for V1 receptors in blood vessels
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Adverse effects of desmopressin
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Headaches, hyponatremia
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Vasopressin MOA
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Non-selective agonist of G-protein coupled V1 and V2 receptors
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Adverse effect of vasopressin
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Hypertension, hyponatremia, seizures, CNS toxicity
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Octreotide MOA
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Acts at somatostatin receptors to inhibit release of GH, requires functional somatostatin receptors
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Adverse effects of octreotide
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Gallstones, GI disturbances, hyperglycemia, may reduce insulin levels
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Lantreotide MOA
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Long-acting somatostatin analogue used as alternative to octreotide
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Pegvisomant MOA
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GH receptor antagonist in liver, doesn't require intact somatostatin receptors
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Adverse effects of pegvisomant
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Changes in liver enzymes
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Conivaptan MOA
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Non-selective V1 and V2 receptor antagonist to reduce hypertension and hyponatremia
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Tolvaptan MOA
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V2 antagonist
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Common causes of hyperprolactinemia
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Adenomas and D2 receptor antagonist drugs like antipsychotics
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Bromocriptine MOA
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Non-selective D1 and D2 agonist
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Cabergoline MOA
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Selective D2 agonist
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Adverse effects of bromocriptine and cabergoline
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Nausea, orthostatic hypotension, cardiovascular risks, burning sensation, CNS issues in susceptible patients
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Adverse effects of oxytocin
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Sustained tetanic contractions, edema, water intoxication, can activate vasopressin receptors
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Aldosterone MOA
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Increases transcription of Na/K ATPase to increase Na absorption and blood volume
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Inhibits phospholipase A2 to prevent formation of arachidonic acid
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Corticosteroids
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Inhibits cyclooxygenase to prevent formation of prostaglandins
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NSAIDs
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Metabolic effects of glucocorticoid agonists
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Stress response--increased blood sugar, gluconeogenesis, insulin resistance, increase protein breakdown, muscle catabolism, lipolysis, altered fat distribution
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Effect of hydrocortisone on mineralocorticoid receptor
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Increased BP, decreased K, increased water retention,
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Effect of hydrocortisone on glucocorticoid receptor
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Increased blood sugar, decreased muscle and protein, truncal fat distribution
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Fludrocortisone MOA
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Provides aldosterone-like activity
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Treatment for Addison's disease
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Hydrocortisone and fludrocortisone
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Ketoconazole MOA
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CYP P450 inhibitor, inhibits several steroid hormone synthesis enzymes
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Adverse effects of ketoconazole
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Hepatotoxicity, reduces androgen levels, drug interactions
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Metyrapone MOA
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Competitive inhibition of 11 beta-hydroxylase to decrease cortisol synthesis, used in conjunction with aminoglutethimide
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Adverse effects of metyrapone
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HTN, shift synthesis towards androgen pathway
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Aminoglutethimide MOA
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Competitive inhibition of desmolase and aromatase to decrease production of all adrenal steroid hormones causing buildup of cholesterol, used in conjunction with metyrapone
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Adverse effects of aminoglutethimide
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Nausea, dizziness, orthostatic hypotension, decreases thyroxine synthesis (symptom of hypothyroidism)
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Spironolactone MOA
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Non-selective aldosterone receptor and androgen receptor antagonist and potassium sparing diuretic
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Adverse effects of spironolactone
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Gynecomastia
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Eplerenone MOA
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Selective aldosterone receptor antagonist
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Phenoxybenzamine MOA
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Irreversible non-competitive inhibitor of alpha adrenergic receptors to stabilize BP
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Adverse effects of phenoxybenzamine
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Orthostatic hypotension or severe hypotension
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Propranolol MOA
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Non-selective competitive beta adrenergic antagonist to treat tachycardia, given after alpha blocker stabilizes BP
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Bilateral adrenal hyperplasia management
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Spironolactone therapy
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Adrenal adenoma management
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Surgery
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Levothyroxine MOA
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T4 converted to T3 to bind to TRE and alter mRNA transcription
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Adverse effects of levothyroxine
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Resemble thyrotoxicosis--increased basal metabolism and body temperature, atrial fibrillation, severe anxiety, insomnia
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Drugs that reduce conversion of T4 to T3
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Propanolol, corticosteroids, aminoglutethimide
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Liothyronine MOA
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Activates T3 receptor, highly potent with rapid onset--ideal for emergencies
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Adverse effects of liothyronine
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Cardiotoxicity, increased risk of arrhythmias, increased incidence of anxiety and insomnia, contraindication if history of cardiovascular disease
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Treatments for hyperthyroidism
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Radioactive iodine, thiourea drugs, surgery
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Thioamides MOA
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Inhibit peroxidase and block iodine organification, block coupling of iodotyrosines, decrease conversion of T4 to T3, reduce thyroid hormone levels and treats thyroid storms
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Thioamide drugs
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Propylthiouracil (PTU) and methimazole
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Short-acting, less potent thioamide, avoid in children due to hepatotoxicity
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PTU
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Longer-acting, more potent thioamide with less hepatotoxicity but greater risk of agranulocytosis
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Methimazole
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Adverse effects of thioamides
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GI upset, macropapular rash, hypothyroidism, hepatitis, lupus-like syndrome, agranulocytosis, vasculitis, jaundice
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Thyroid storm treatment
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Propanolol, hydrocortisone, IV PTU, supportive therapy
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Typical 1st line treatment for type 2 DM
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Insulin secretagogues and biguanides
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Biguanide
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Metformin
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Metformin MOA
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Decreases hyperglycemia without hypoglycemia, works on hepatic enzymes to reduce gluconeogenesis and stimulate glycolysis, doesn't require functional beta cells, may promote weigh loss
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Adverse effects of metformin
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Nausea, diarrhea, potentially fatal lactic acidosis if renal impairment present
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Contraindication for metformin
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Kidney dysfunction
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Incretin modulators
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Exenatide and sitagliptin
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Exenatide MOA
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Glucagon-like peptide receptor agonist, injectable incretin mimic derived from gila saliva, potentiates insulin release, decreases glucagon, promotes weight loss, adjunct to metformin or sulfonylurea
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Adverse effects of exenatide
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Nausea, diarrhea, pancreatitis, serious renal dysfunction if there is concurrent HTN, renal impairment, elderly, or severely dehydrated
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Sitagliptin MOA
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Inhibitis dipeptidyl peptidase-4, blocking GLP-1 breakdown to increase GLP-1
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Adverse effects of sitagliptin
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Pancreatitis, monitor renal function
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Thiazolidinediones (TZD)
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Rosiglitazone and pioglitazone
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TZD MOA
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Activates peroxisome proliferator-activated receptor gamma (PPAR gamma) to delay decrease in blood glucose, increases GLUT-1 and GLUT-4 gene expression, increases muscle glucose uptake, redistributes fat to decrease insulin resistance but causes weight gain
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Adverse effects of TZD
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Increased risk of fractures in postmenopausal females, weight gain, fluid retention/edema, delayed onset of benefit, increased risk of congestive heart failure
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Sulfonylurea MOA
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Acts at pancreatic receptor SUR to close K channels to potentiate insulin release in response to glucose uptake, rapid onset, long duration, makes beta cells function more efficiently but can lose efficacy as disease progresses
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2nd gen sulfonylureas (insulin secretagogues)
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Glimepiride, glyburide, glipizide
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Adverse effects of sulfonylureas
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Weight gain, hypoglycemia, hemolytic anemia if G6PD deficient
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Non-sulfonylurea insulin secretagogues
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Repaglinide and nateglinide
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Repaglinide MOA
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Closes K channels similar to sulfonylureas, rapid onset
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Nateglinide MOA
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Transient, very rapid but short-acting effect to close K channels to increase insulin release
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Acarbose MOA
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Alpha glucosidase inhibitor, decrease post-prandial glucose absorption, poor patient compliance limits use
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Adverse effects of acarbose
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Stomach cramps, flatulence
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1st gen sulfonylureas
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Tolbutamide and tolazamide
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Insulin MOA
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Increases cellular uptake of glucose and decreases blood glucose, increases cellular K
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Rapid onset/short-acting insulins
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Lispro, glulisine, aspart
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Lispro MOA
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Ultra short duration, great for post-prandial control, commonly used in insulin pump
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Glulisine MOA
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Short duration, analog of regular insulin approved for injection or insulin pump
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Aspart MOA
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4-6 hour duration analog of regular insulin approved for injection or insulin pump
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Short-acting insulin
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Regular insulin
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Regular insulin MOA
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Short-acting crystalline insulin identical to human insulin, only insulin available for IV use, 1st line for ketoacidosis or severe hyperglycemia
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Intermediate-acting insulin
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NPH insulin
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NPH insulin MOA
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Decreased solubility and delayed absorption, mixed with rapid onset insulin for post-prandial control
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Long-acting insulins
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Glargine and detemir
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Glargine MOA
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Slow onset, long-acting peakless insulin for basal glycemic control, maintains continuous level
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Detemir MOA
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Slow onset, long-acting, shorter duration than glargine
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Adverse effects of insulin
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Hypoglycemia, hypokalemia, lipodystrophy
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Pramlintide MOA
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Amylin analog, slows gastric emptying and increases satiety, decreases glucagon secretion, injectable adjunct with insulin therapy, stabilizes post-prandial peaks and valleys in type 1 DM, suppresses post-prandial glucagon secretion and reduces food intake in type 2 DM
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Adverse effects of pramlintide
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Slows absorption of other medications, nausea
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Hypoglycemia treatment
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High glucose food like juice or candy if conscious, IV glucose or IM glucagon if unconscious or vomiting
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Glucagon MOA
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Potent hyperglycemic appropriate for emergency use to reverse severe insulin-induced hypoglycemia, increases myocardial contractility
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Treatment of CAH
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Hydrocortisone, fludrocortisone, and NaCl supplementation
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Methotrexate MOA
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Antimetabolite and antifolate that competitively and irreversibly inhibits DHFR
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Medical management of ectopic pregnancy
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Methotrexate
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Mifepristone MOA
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Binds progesterone receptors and has anti-progesterone effects, softens and dilates cervix, causes decidual necrosis, increases prostaglandin release, enhances uterine sensitivity to administered prostaglandin
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Misoprostol MOA
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Prostaglandin PGE1 that binds to myometrial cells to cause contractions leading to expulsion of tissue, softens and dilates cervix
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Adverse effects of misoprostol
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Diarrhea and longer induction times through oral administration, more effective and fewer side effects through vaginal administration but infection risk is higher
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Estrogen of pregnancy
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Estriol
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Function of estrogen
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Endometrial growth during pregnancy, inhibition of prolactin secretion, growth of mammary ducts, enlargement of and increased blood supply to fetus, softening of symphysis pubis and pelvic ligaments, regulates bone density in fetus
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Human placental lactogen
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Potent lactogenic and GH-like activity, maternal lipolysis to provide FFA for energy, causes insulin resistance, can cause gestational diabetes, potent angiogenic
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Treatment for placenta accreta
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Planned surgical delivery, blood products available, preop placement of balloon catheters in iliac arteries for occlusion or embolization of pelvic vessels, placenta may be left in situ and patient treated with methotrexate
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Safe effective treatment for nausea in pregnancy
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Doxylamine and vitamin B6
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Treatment for invasive mole
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Methotrexate
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Treatment for gestational choriocarcinoma
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Methotrexate if no evidence of metastases, combined chemo regimen if metastases
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Treatment for placental site tumor
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Hysterectomy
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Maternal exposure to anti-convulsants results in…
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Fetal hydantoin syndrome--broad nasal bridge, hypertelorism, short nose, bowed upper lip
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1st trimester maternal exposure to Accutane results in…
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High rate of fetal loss, malformations of cranium, face, heart, CNS and thymus, rare microtia or anotia,
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1st trimester maternal exposure to ACE inhibitors results in…
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Cardiovascular and CNS defects
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2nd and 3rd trimester maternal exposure to ACE inhibitors results in…
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Effects on developing kidney--oligohydramnios with pulmonary hypoplasia, joint contractures, hypocalvaria, renal failure, decreased BP and death
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1st trimester maternal exposure to warfarin results in…
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Nasal and midface hypoplasia, stippled vertebrae and femoral epiphyses
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2nd and 3rd trimester maternal exposure to warfarin results in…
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Hemorrhage, optic atrophy and blindness, agenesis of corpus callosum
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Effect of maternal depression during pregnancy
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Altered reaction to acoustic and vibratory stimuli, preterm birth, poor state regulation, behavioral, sleep and cognitive disorders
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SSRI maternal exposure results in…
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Respiratory distress, jitteriness, irritability, increased tone, feeding difficulties, seizures
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Fetal alcohol syndrome
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Growth restriction, craniofacial abnormalities, CNS dysfunction, cardiac defects, behavioral disturbances
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Maternal exposure to cocaine results in…
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Placental abruption, intrauterine growth restriction, prematurity, CNS and GI dysfunction
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Maternal exposure to heroin results in…
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Accelerates lung maturation, prenatal onset growth deficiency, prematurity, neonatal abstinence syndrome
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Preeclampsia management
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Hospitalization, lower BP, seizure prophylaxis, urgent delivery for fetal distress, intrauterine growth restriction, or worsening of maternal disease
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Seizure prophylaxis
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MgSO4
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MgSO4 MOA
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Not clearly understood, could be vasodilation of cerebral vasculature, inhibition of platelet aggregation, protection of endothelial cells from free radicals
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Adverse effects of MgSO4
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Diaphoresis, flushing, nausea, vomiting, muscle weakness, pulmonary edema, hypotension, blurred vision, lethargy, CNS depressant
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Antidote for MgSO4 toxicity
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Calcium gluconate
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Increases frequency, intensity, and tone of myometrial contractions
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Thrombin
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Tocolytics
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Calcium channel blockers, MgSO4, terbutaline, 17-OH progesterone
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Contraindications for tocolytics
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Premature rupture of membranes, placental abruption, severe preeclampsia or eclampsia, chorioamnionitis
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Calcium channel blocker MOA
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Delays labor by inhibiting oxytoci-induced uterine contractions through Ca channel block, has lower CV concerns than beta2 agonists
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Nifedipine
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Calcium channel blocker
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Adverse effects of calcium channel blockers
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Hypotension, excessive vasodilation, pulmonary edema, avoid grapefruit juice
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MgSO4 tocolytic MOA
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Mg uncouples excitation-contraction in myometrial cells and decreases Ca uptake while activating intracellular adenylyl cyclase, not recommended for preterm labor anymore as Mg crosses placenta and baby born floppy
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Absolute contraindication for MgSO4
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Myasthenia gravis, monitor in patients with renal dysfunction
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Terbutaline MOA
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Beta2 agonist, increase intracellular adenylyl cyclase resulting in drop in intracellular Ca and interferes with activity of myosin light chain kinase, causes mymetrial relaxation, rapid onset of action so useful for tetanic uterine contractions
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Adverse effects of terbutaline
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Tremor, palpitations, shortness of breath, pulmonary edema (rare), increase HR, peripheral vasodilation, hypotension, bronchial relaxation, tachyphylaxis
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Contraindications for terbutaline
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Cardiac disease, poorly controlled DM or hyperthyroidism
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17-OH progesterone MOA
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Progesterone receptor modulator that decreases estrogen-mediated enhancement of oxytocin-induced contractions, prophylaxis against preterm labor in women with history of PTL
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Oxytocin MOA
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Activates uterine Gq-PLC coupled oxytocin receptor to increase myometrial Ca influx, activates DAG & IP3 2nd messengers, increased intracellular Ca activated CaM
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Methergine MOA
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Ergot alkaloid alpha adrenergic receptor agonist that increases uterine contraction and tone
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Contraindications for methergine
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HTN, can increase pulmonary artery pressure, cerebral hemorrhage, preeclampsia
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Prostaglandin MOA
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Activate PGE-Gq coupled receptor to increase DAG and IP3 to activate protein kinase C, increase intracellular Ca and enhance myometrial gap junction formation, induce synchronous contractions
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Carboprost trimethamine
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Prostaglandin used for post partum hemorrhage
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Contraindication for carboprost trimethamine
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Asthma
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Adverse effects of carboprost trimethamine
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Nausea, vomiting, headache, fever
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Treatment for chlamydia
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Azithromycin and doxycycline
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Treatment for gonorrhea
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Ceftriaxone or cefixime
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Treatment for PID
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Ceftriaxone and doxycycline with or without metranidazole
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Treatment for condyloma
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Imiquimod, podophyllum resin, cryotherapy, surgical excision
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Imiquimod MOA
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Topical immune modulator that induces local IFN-alpha and other cytokines to active adaptive immune system
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Podophyllum resin MOA
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Inhibits cell mitosis and viral DNA synthesis to arrest viral replication
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Adverse effects of podophyllum resin
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Teratogen, renal and hepatotoxicity with ingestion (topical use only), CNS effects with overdose or excessive systemic absorption
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HSV antiviral therapy (acyclovir) MOA
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Inhibits DNA synthesis and viral replication by replacing guanine to produce non-functional DNA strands
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Treatment for BV
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Clindamycin or metronidazole or tinidazole
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Metronidazole MOA
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Prodrug that undergoes reduction to form highly reactive nitro radical anion that challenges integrity of bacterial DNA
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Adverse effects of metronidazole
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Disulfiram reaction, metallic taste
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Clindamycin MOA
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Protein synthesis inhibitor, binds to 50s ribosomal subunit
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Adverse effects of clindamycin
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Diarrhea, pseudomembranous colitis, vomiting
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Treatment for Trichomonas vaginalis
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Nitrimidazole, metronidazole, or tinidazole and treat partner
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Treatment for uncomplicated VVC
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Long list, miconazole or fluconazole usually
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Treatment for recurrent VVC
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Oral fluconazole or topical therapy
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Treatment for non-albicans VVC
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Non-fluconazole azole drug and boric acid capsules
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Treatment for embryonal rhabdomyosarcoma
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Chemotherapy
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Treatment for lichen sclerosus
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Clobetasol--ultrapotent topical corticosteroids
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Clobetasol MOA
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Anti-inflammatory and antimitotic
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Adverse effects of clobetasol
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HPA axis suppression, atrophy, hypopigmentation, allergic contact dermatitis, avoid abrupt withdrawal
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Treatment for lichen simplex chronicus
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Topical medium-strength steroids, fluconazole as prophylaxis against Candida
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Management for hidradenitis suppurativa
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Stage 1--antiandrogenics, antibiotics, zinc gluconate, intralesional steroids
Stage 2--antibiotics, oral/lesional steroids, zinc gluconate, early local unroofing Stage 3--antibiotics, oral/lesional steroids, wide excision |
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Treatment options for endometriosis
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NSAIDs--anti-inflammatory/analgesic
OCs/progestins--pseudopregnancy state GnRH analogs--pseudomenopausal state Danazol--androgens SERMs, aromatase inhibitors--anti-estrogen drugs Mifepristone--anti-progestin drugs Surgical strategies |
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Treatment for adenomyosis
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Symptom management with NSAIDs, progesterone, hysterectomy only definitive treatment
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Management of PCOS
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Reduce risk of diabetes and metabolic syndrome, correct abnormal bleeding, reduce risk of endometrial cancer, correct symptoms of hyperandrogenism (acne and hirsutism), improve acanthosis nigricans
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Treatment of PCOS
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COCs, metformin, antiandrogens
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Flutamide MOA
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Androgen receptor agonist/antagonist
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Finasteride MOA
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Selective 5-alpha reductase inhibitor
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Treatment of acanthosis nigricans
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Correction of hyperinsulinemia with Lac Hydrin lotion
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Clomiphene citrate MOA
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Non-steroidal selective estrogen receptor modulator for ovulation induction
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Adverse effects of estrogen HRT
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Nausea, fluid retention, breast tenderness, gallstones, breast cancer, VTE
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Contraindications for estrogen HRT
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Migraines, untreated HTN, undiagnosed genital bleeding, untreated endometrial hyperplasia, history of breast cancer, active liver disease, history of MI or stroke, active or recent thromboembolic disease
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Adverse effects of progesterone HRT
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Weight gain, androgenic effects, HTN, breast tenderness, breast cancer, counteracts estrogen's effects on blood lipids, withdrawal uterine bleeding, moodiness/depression
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Hot flash relief
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Progestin-only therapy for women who can't tolerate estrogen
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Venlafaxine MOA
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SNRI antidepressant, provides vasomotor symptom relief to postmenopausal women, improves depression and mood swings
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Clonidine MOA
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Alpha2 adrenergic agonist that provides symptom relief to postmenopausal women but side effects limit use
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Gabapentin MOA
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GABA analogue anticonvulsant
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1st line treatment for estrogen responsive breast cancer
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Tamoxifen
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Tamoxifen MOA
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Mixed ER agonist/antagonist, antagonist in breast and hypothalamus, agonist in blood and endometrial tissues, partial agonist in bone, metabolized by cyp450 enzymes to more bioactive metabolites
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Toremifene MOA
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Mixed ER agonist/antagonist profile similar to tamoxifen, alternative to tamoxifen for tamoxifen-resistant breast cancer
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Raloxifene MOA
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Mixed ER agonist/antagonist profile similar to tamoxifen, antagonist in uterus, more potent agonist in bone, approved to treat osteoporosis
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Anastrazole MOA
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Non-steroidal type II aromatase inhibitor, competitive aromatase inhibitor, reduces estrogen levels, decreases tumor growth, effective alternative for tamoxifene-resistant ER+ breast cancer if menopausal, long term use decreases risk of endometrial cancer
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Adverse effects of anastrazole
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Estrogen depletion--osteoporosis, hot flashes, insomnia, depression, bone pain, increased risk of bone fractures, lose estrogen protective effects on blood lipids
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Exemestane MOA
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Steroidal type I aromatase inhibitor, irreversible aromatase inhibitor, depletes aromatase
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Adverse effects of exemestane
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Androgenic effects, other side effects similar to type II AIs
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Fulvestrant MOA
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Estrogen receptor antagonist, competitive antagonist at estrogen alpha and beta receptors, down-regulates ER in tumor, effects not tissue specific
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Management of follicular cyst
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Conservative follow-up, oral contraceptive may be used for suppression of new cysts but does not speed resolution of existing cyst
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Scale of progesterone androgenicity
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Levonorgestrel>norgestrel>etonogestrel>norethindrone>desogestrel>norgestimate>norelgestromin>drospirenone
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Adverse effects of estradiol
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Nausea, migraines, gallstones, edema, water retention, increases BP, increases renin, VTE, breast cancer
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Adverse effects of progestin
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Androgenic effects--hirsutism, weight gain, acne, increased LDL, breakthrough bleeding
Moodiness/depression Glucose intolerance |
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Danazol MOA
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Progesterone partial agonist with high androgenic effects, causes anovulation, amenorrhea, and endometrial atrophy
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Contraindications of danazol
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Dyslipidemia, pregnancy, liver dysfunction
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Adverse effects of danazol
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Androgenic, hypoestrogenic, hepatic impairment, thrombosis, intracranial HTN
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GnRH agonists
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Leuprolide, goserelin, nafarelin
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GnRH agonist MOA
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Long-acting, continuous stimulation suppresses gonadotropin release via negative feedback, anovulatory hypoestrogen/hypoprogesterone state
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Adverse effects of GnRH agonist
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Hot flushes, bone loss, pharmacologic menopause symptoms
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Tranexamic acid MOA
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Antifibrinolytic, competitively inhibits plasminogen activation to reduce plasmin activity, highly effective at reducing blood loss
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Adverse effects of tranexamic acid
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Nausea, diarrhea, thrombosis, hypotension
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Treatment for priapism
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Oral pseudophedrine, intracavitary aspiration, intracavitary phenylephrine injection
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Treatment for BPH
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Androgen antagonists, smooth muscle relaxers, 5-alpha reductase inhibitors
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Treatment for prostate cancer
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Radical prostatectomy, cryotherapy, microwave irradiation, watchful waiting, hormonal therapy, radiation therapy
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Prostate therapies
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GnRH antagonists--degarelix
GnRH agonist--leuprolide Aromatase synthesis inhibitors Androgen synthesis inhibitors--aminoglutethimide, ketoconazole 5-alpha reductase inhibitors--finasteride, dutasteride Androgen receptor antagonist--flutamide |
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Treatment for BPH
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Adrenergic antagonists--doxazosin, terazosin, alfuzosin
5-alpha reductase inhibitors |
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Adrenergic antagonist MOA
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Antagonists of alpha 1B adrenergic receptors, relax prostate smooth muscle at bladder neck to allow urination, doesn't shrink prostate size, doesn't solve underlying problem
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Adverse effects of adrenergic antagonist
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Syncope, orthostatic hypotension, dizziness, nasal congestion, miosis, priapism, impaired ejaculation
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Uroselective adrenergic antagonist
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Tamsulosin
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Tamsulosin MOA
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Selective alpha 1A adrenergic antagonist in prostate and penis, less hypotension, less vascular effects, less nasal congestion, still has ocular and ejaculatory problems
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5-alpha reductase inhibitor MOA
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Competitive enzyme inhibitors of 5-alpha reductase reduce DHT production, reduces prostate size
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Dutasteride MOA
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Non-selective 5-alpha reductase inhibitor used for more severe BPH
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Adverse effects of 5-alpha reductase inhibitor
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Decrease serum PSA, impotence/libido decreases, slight increase in risk of male breast cancer
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Androgen synthesis inhibitor MOA
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Inhibit steps involved in adrenal steroid and androgen synthesis to treat hormonally-responsive prostate cancer, decreases prostate size
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Androgen receptor antagonist MOA
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Competitive antagonist at DHT receptor, used in combination with synthesis inhibitor or GnRH inhibitor for hormonally-responsive prostate carcinoma
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Adverse effects of flutamide
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Gynecomastia, impotence/libido decreases, hepatic dysfunction, hot flushes, bone loss
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GnRH antagonist MOA
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Competitive antagonist at pituitary GnRH receptor, shuts down gonadotropin production in pituitary, rapidly reduces gonadotropin and testosterone levels, used for advanced prostate cancer
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Adverse effects of GnRH antagonist
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Impotence, libido loss, hot flushes, bone loss, worsens HTN, prolongs Q-T interval
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PDE5 inhibitor MOA
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Stops breakdown of cGMP, smooth muscle relaxation, effective for ED in renal failure patients
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Contraindication for PDE5 inhibitor
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Nitrate therapy
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Direct vasodilators for intra-corporal injection
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PGE1--caverject, edex
Paparvarine Mixtures |
