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43 Cards in this Set
- Front
- Back
What are examples of estrogens used in contraceptives?
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1) ethinyl estradiol
2) mestranol |
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How does estrogen effect the body?
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1) increases serum proteins
2) decreases bone resorption 3) increases coagulation 4) increases TAG levels 5) decreases LDL |
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What will continuous estrogen do to GnRH levels?
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inhibit its secretion especially with a progestin
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When estrogen is used in HRT what is there increased risk of developing?
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1) endometrial cancer
2) small increase in breast cancer, MI and stroke |
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What are dose dependent toxic effects of estrogen?
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nausea, breast tenderness, migraines, thromboembolic effects, gallbladder disease, hypertriglyceridemia, and HTN
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What does diethystilbestrol cause in the daughters of mothers that took it?
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vaginal adenocarcinoma, infertility, and ectopic pregnancy... Note mothers take to avoid spontaneous abortion
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What are older progestins? Which are newer? What is difference between newer and older?
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1) older: L-norgestrel and norethindrone
2) newer: norgestimate and desogestrel 3) newer ones are less androgenic |
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What processes in body do progestins affect?
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1) carbohydrate metabolism
2) increase fat deposition |
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Why are progestins used in HRT with estrogen?
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lower risk of endometrial cancer
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What are the toxic effects of progestins?
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1) increase BP
2) decrease HDL 3) longterm use in premenopausal women causes reversible decrease in bone density |
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Up until what point can postcoital contraceptives be given? What is benefit of using progestin only pill?
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1) 72 hours
2) fewer side effects |
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At point should progestins be given to inhibit ovulation?
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before LH surge
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Women taking combination oral contraceptives are less likely to develop what?
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1) ovarian cysts
2) ovarian and endometrial cancer 3) benign breast disease 4) PID 5) ectopic pregnancy 6) iron deficiency anemia 7) RA |
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Women taking combination oral contraceptives are more likely to develop what? What are normal side effects?
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1) MI
2) stroke 3) DVT 4) PE 5) nausea, breast tenderness, headache, skin pigmentation and depression |
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What is the MOA of tamoxifen? How does it affect different tissues? What is there increased risk of?
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1) an antagonist of estrogen responsive breast cancer
2) agonist at endometrium causing endometrial hyperplasia and increased risk of endometrial cancer |
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What are side effects of tamoxifen? What drug is similar to tamoxifen?
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1) hot flushes (antagonistic)
2) DVT (agonist) 3) prevents osteoporosis 4) toremifene |
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What is raloxifene approved for? How is it different from tamoxifen? What are side effects?
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1) prevention of osteoporosis
2) no endometrial effects 3) hot flushes, increased DVT |
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What is clomiphene used for? What is its MOA?
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1) induce ovulation in anovulatory women
2) blocks estrogen receptors in pituitary reduce negative feedback of LH and FSH which increases gonadotropins |
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What is the MOA of fulvestrant? When is it used?
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1) pure estrogen receptor antagonist
2) breast cancer resistant to tamoxifen |
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Which drugs are aromatase inhibitors?
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1) anastrozole, letrozole
2) exemestane (irreversible) |
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What is the MOA of danazol?
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1) inhibit P450 enzymes involved in gonadal steriod synthesis
2) is also a partial agonist of progestin, androgen, and glucocorticoid receptors |
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What is the MOA of leuprolide?
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1) GnRH agonist
2) continuous administration prevents LH and FSH release by suppressing GnRH release |
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What is used for treating precocious puberty in children? What can this treatment be used for in women?
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1) leuprolide
2) short term treatment of endometriosus and uterine fibroids 3) treatment beyond 6 months causes osteoporosis |
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What is the MOA of mifepristone? when can it be given?
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1) RU-486 is antagonist of progesterone and glucocorticoids
2) abortions up to 49 days after last menstrual period |
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What can mifepristone be given with to help ensure a complete abortion?
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1) misopristol a PGE analog
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What two hormones can testosterone be synthesized from?
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1) progesterone
2) DHEA |
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Which steroids have an increased ratio of anabolic to androgenic effects?
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1) oxandrolone
2) stanozolol |
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Which lab values are increased with testosterone? What happens to bone density
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1) increased RBC
2) decreased urea nitrogen excretion 3) more positive nitrogen balance 4) maintains bone density |
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Excessive doses of androgens in men can result in what?
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1) feminization from feedback inhibition of pituitary and conversion of exogenous testosterone to estrogen
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What does excess testosterone in both sexes cause?
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1) cholestatic jaundice
2) increased liver enzymes 3) hepatocellular carcinoma |
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what is the MOA of flutamide? When is it used?
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1) competitive antagonist of androgen receptors
2) used in prostate carcinoma |
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What is spironolactone used for?
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1) K+ sparing diuretic
2) inhibits androgen receptors in women with hirsutism |
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Which two drugs are used in prostatic carcinoma?
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1) leuprolide
2) flutamide |
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What is the MOA of ketoconazole?
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inhibits gonadal and adrenal steroid synthesis
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What is the MOA of cyproterone?
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blocks androgen receptor complex
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Antiestrogen drugs used for fertility and breast cancer respectively
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Clomiphene and tamoxifen
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Common SE of tamoxifen and raloxifene
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Hot flashes
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Selective estrogen receptor modulator (SERM) used for prevention of osteoporosis and prophylaxis in women with risk factors for breast cancer
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Raloxifene
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Non-steroidal estrogen agonist causes clear cell adenocarcinoma of the vagina in daughters of women who used it during pregnancy
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Diethylstilbestrol (DES)
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Oral contraceptive available in a transdermal patch
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Ortho-Evra
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Anabolic steroid that has potential for abuse
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Nandrolone, oxymetholone, and oxandrolone
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Anti-androgen used for hirsutism in females
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Cyproterone acetate
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Drug is used with testosterone for male fertility
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Leuprolide
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