Reproductive Pharmacology For Step 1

Front 1

finasteride

Back 1

- antiandrogen, 5-alpha reductase inhibitor (converts testosterone to DHT)
- useful in BPH, promotes hair growth

Front 2

flutamide

Back 2

- competitive inhibitor of androgens at the testosterone receptor
-used in prostate carcinoma

Front 3

ketoconazole

Back 3

- an antifungal that inhibits steroid synthesis
- polycystic ovarian syndrome
- side effect- gynecomastia, amenorrhea

Front 4

spironolactone

Back 4

- inhibits steroid binding
- side effects include gyencomastia & amenorrhea

Front 5

leuprolide

Back 5

- GnRH analog with agonist properties when used in a pulsatile fashion and ANTAGonist properties when used continuously
- used for infertility(pulse it), prostate cancer (continuous, use w/ flutamide), uterine fibroids
tox: nausea, vomiting, antiandrogen

Front 6

sildafenil, vardenafil

Back 6

- inhibit cGMP phosphodiesterase causing increased cGMP, smooth muscle relaxtion in corpus cavernosum, increase blood flow and penile erection
- treat erectile dysfunction
- tox: headache, flushing, dyspepsia, **risk of life threatening hypoTN in pts taking nitrates**, impaired blue-green color vision

Front 7

mifepristone (RU-486)

Back 7

- morning after pill
- competitive inhibitor of progestins at progesterone receptors
- used for termination of pregnancy. given with misoprostol (PGE1 analog)
tox: heavy bleeding, GI effects, abdominal pain

Front 8

oral contraception

Back 8

- prevent estrogen surge so LH surge doesn't occur, no ovulation

Front 9

hormone replacement therapy

Back 9

- used for relief/prevention of menopause symptoms and osteoporosis
- unopposed estrogen therapy increase risk for endometrial cancer

Front 10

dinoprostone

Back 10

-PGE2 analog causing cervical dilation and uterine contraction
- used to induce labor

Front 11

ritodrine/terbutaline

Back 11

- beta 2 agonists that relax the uterus
- used to reduce premature uterine contractions

Front 12

anastrozole, exemestane

Back 12

-aromatase inhibitors (it converts testosterone & DHT to estrogen)
- used in postmenopausal women with breast cancer

Front 13

testosterone

Back 13

- agonist at androgen receptors
- treat hypogonadism and promote development of secondary sex characteristics, treat ER+ breast cancer (exemestane)
tox: masculinization in females, inhibit leydig cells thereby reducing inratesticular testosterone, gonadal atrophy, premature closure of epiphyseal plates. increase LDL, decrease HDL

Front 14

estrogens (ethinyl estradiol, DES, mestranol)

Back 14

- binds estrogen receptors
- used for ovarian failure, menstrual abnormalities, HRT, use in men with androgen dependent prostate cancer
tox: increase risk of endometrial cancer, bleeding in postmenopausal women, CLEAR CELL ADENOCARCINOMA of vagina in females exposed to DES in utero

Front 15

progestins

Back 15

- bind progesterone receptors, reduce growth and increase vascularization of the endometrium
- used in oral contraceptives and in the tx of endometrial cancer, abnormal uterine bleeding

Front 16

clomiphene

Back 16

- estrogen partial agonist in pituitary, prevents normal feedback inhibition and increase release of LH, FSH to stimulate ovualtion
- used to treat infertility & PCOS.
may cause multiple simultaneous pregnancies

Front 17

tamoxifen

Back 17

- estrogen antagonist on breast tissue
-used to prevent and treat recurrence of ER+ breast cancer

Front 18

raloxifene

Back 18

- estrogen agonist on bone, reduces resorption of bone
-used to treat osteoporosis (estrogen inhibits osteoclasts and stimulates osteoblasts)