Reproduction Pharmacology

Front 1

What are the clinical uses of finasteride (propecia)?

Back 1

Benign prostate hyperplasia and male-pattern baldness

Front 2

What is the mechanism of finasteride?

Back 2

5alpha reductase inhibitor --> decreases conversion of testosterone to dihydotestosterone

Front 3

What is the clinical use of flutamide?

Back 3

Prostate carcinoma

Front 4

What is the mechanism of flutamide?

Back 4

Non-steroidal competitive inhibitor of androgens at the testosterone receptor

Front 5

Ketoconazole and spironolactone can be used to treat polycystic ovarian syndrome and hirsutism. What are some potential side effects?

Back 5

Gynecomastia and amenorrhea

Front 6

How does ketoconazole act?

Back 6

Inhibit steroid synthesis

Front 7

How does spironolactone act?

Back 7

Inhibit steroid binding

Front 8

What is the clinical use of leuprolide?

Back 8

Infertility (pulsatile), prostate cancer (continuous - use with flutamide), uterine fibroids

Front 9

What is the mechanism of leuprolide?

Back 9

GnRH analog - agonist when pulsatile; antagonist when continuous

Front 10

What is the toxicty of leuprolide?

Back 10

Antiandrogen, nausea, vomiting

Front 11

What are the clinical uses of sildenafil and vardenafil?

Back 11

Erectile dysfunciton

Front 12

What is the mechanism of sildenafil and vardenafil?

Back 12

Inhibit cGMP phosphodiesterase --> increase cGMP smooth muscle relaxation in corpus cavernosum, increased blood flow and penile erection

Front 13

What is the toxicity of sildenafil and vardenafil?

Back 13

Headache, flushing, dyspepsia, impaired blue-green color vision; do not take nitrates! Risk of life-threatening hypotension

Front 14

What is the clinical use of mifepristone (RU-486)?

Back 14

Termination of pregancy (admin with misoprostol)

Front 15

What is the mechanism of mifepristone?

Back 15

Competitive inhibitor of progestins at progesterone receptor

Front 16

What is the toxicity of mifepristone?

Back 16

Heavy bleeding, GI effects: nausea, vomiting, anorexia, abdominal pain

Front 17

What is the effect of oral contraceptives on endometrial and ovarian cancer?

Back 17

Decrease risk of both

Front 18

What is dinoprostone?

Back 18

PGE2 analog that causes cervical dilation and uterine contraction --> induces labor

Front 19

What is ritodrine/terbutaline?

Back 19

Beta2 agonists that relax the uterus

Front 20

What is anastrozole?

Back 20

Aromotase inhibitor used in postmenopausal women with breast cancer

Front 21

What is the clinical use of methyltestosterone?

Back 21

Treat hypogonadism and promote development of secondary sex characteristics; stimulation of anabolism to promote recovery after burn or injury; treat ER-positive breast cancer (exemestane)

Front 22

What is the toxicity of methyltestosterone?

Back 22

Masculinization in females, decreases intratesticular testosterone in mlaes by inhibiting Leydig cells, leading to gonadal atrophy; premature closure of epiphyseal plates; increase LDL, decrease HDL

Front 23

What is the clinical use of ethinyl estradiol, DES, mestranol?

Back 23

Hypogonadism or ovarian failure, menstrual abnormalities, HRT in postmenopausal women; androgen-dependent cancer in men

Front 24

What is the toxicity of ethinyl estradiol, DES, mestranol?

Back 24

Increase risk of endometrial cancer, bleeding in postmenopausal women, clear cell adenocarcinoma of vagina in females exposed to DES in utero, increased risk of thrombi; contraindicated in ER-positive breast cancer

Front 25

What is the clinical use of progestins?

Back 25

Oral contraceptives + treatment of endometrial cancer and abnormal uterine bleeding

Front 26

What the clinical use of clomiphene?

Back 26

Infertility and PCOS

Front 27

What is the mechanism of clomiphene?

Back 27

Partial agonist at estrogen receptors in hypothalamus --> prevent normal feedback inhibition and increase release of LH and FSH from pituitary --> stimulate ovulation

Front 28

What is the toxicity of clomiphene?

Back 28

Hot flashes, ovarian enlargement, multiple simultaneous pregnancies, visual disturbances

Front 29

What is the clinical use and mechanism of tamoxifen?

Back 29

Estrogen antagonist on breast tissue; treat and prevent recurrence of ER-positive breast cancer

Front 30

What is the clinical use and mechanism of raloxifene?

Back 30

Estrogen agonist on bone; reduces reabsorption --> treat osteoporosis