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26 Cards in this Set

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Name antiandrogens
FINASTERIDE, FLUTAMIDE, KETOCONAZOLE, SPIRONOLACTONE
MoA of FINASTERIDE
5 alpha reductase inhibitor (dec conversion of testosterone to dihydrotestosterone)
Clinical uses of FINASTERIDE
tx of BPH; male-pattern baldness (promotes hair growth)
MoA of FLUTAMIDE
nonsteroidal competitive inhibitor of androgens at testosterone receptor
Clinical uses of FLUTAMIDE
prostate carcinoma
MoA of KETOCONAZOLE and SPIRONOLACTONE
inhib steroid synthesis
Clinical uses of KETOCONAZOLE and SPIRONOLACTONE
polycystic ovarian syndrome to prevent hirsutism
name a GnRH analog
LEUPROLIDE
effects of LEUPROLIDE when given in pulsatile vs. continuous fashion?
pulsatile: GnRH agonist properties

continuous: GnRH antagonist properties
effects of pulsatile LEUPROLIDE on LH/FSH/estrogen
suppress FSH and LH -> suppresses ovarian estrogen production
clinical uses of LEUPROLIDE
infertility (pulsatile), prostate cancer (continuous--use with flutamide), uterine fibroids
toxicity of LEUPROLIDE
antiandrogen, nausea, vomiting
Rx for erectile dysfunction?
SILDENAFIL, VARDENAFIL
MoA of SILDENAFIL, VARDENAFIL
inhib cGMP phophodiesterase, causing inc cGMP, smooth musc relaxation in the corpus cavernosum, increased blood flow, penile erection
toxicity of SILDENAFIL, VARDENAFIL
headache, flushing, dyspepsia, blue-green color vision; risk of life-threatening hypotension in pts taking nitrates
MoA of CLOMIPHENE
partial agonist at estrogen receptors in pit gland (functions as competitive inhibitor, blocking activation by stronger endogenous estrogens)
effects of CLOMIPHENE on FSH/LH
in premenopausal women, disrupts feedback inhibition to GnRH, increases release of FSH/LH-> stimulates ovulation (inc gametogenesis and steroidogenesis in ovaries)
clinical uses of CLOMIPHENE
tx of infertility (anovulation)
CLOMIPHENE toxicity
hot flashes, ovarian enlargement, multiple simultaneous pregnancies, visual disturbances
Rx for postcoital abortifacient
MIFEPRISTONE (RU-486)
MoA of MIFEPRISTONE
competitive inhibitor of progestins at progesterone receptors -> prevents implantation
toxicity of MIFEPRISTONE
heavy bleeding, GI effects (nausea, vomit, anorexia), abdominal pain
advantages of oral contraception
reliable, dec risk of endometrial and ovarian cancer, dec incidence of ectopic pregnancy, dec pelvic infections, regular menses
disadvantages of oral contraceptives
taken daily, no STD protection, inc triglycerides, depress, weight gain, nausea, HTN, hypercoagulable state
uses of hormone replacement therapy (HRT)
relief or prevention of menopausal sx (hot flashes, vaginal atrophy, etc), and osteoporosis (due to dec estrogen levels)
risk of unopposed estrogen replacement therapy? what is done to avoid this?
inc risk of endometrial cancer; add progesterone