2 - Endocrine Pharmacology pt. 2 Flashcards
What are the progesterone replacement drugs used to treat?
- Menstrual disorders
- Prevention of habitual abortion
- Endometriosis
- Contraception
What are the synthetic modified forms of progesterone?
- norethindrone
- medroxyprogesterone (Provera)
What is used for the treatment of abnormal uterine bleeding, secondary amenhorrhea, endometrial cancer?
medroxyprogesterone (Provera)
What is testosterone used for?
- Delayed male puberty
- Hypogonadism
- Inoperable female breast cancer
- Loss of libido in postmenopausal women
What are anabolic steroids used for and what are the popular ones?
Used to increase muscle mass and physcial performance
- nandrolone phenpropionate (Durabolin)
- methandrosternolone (Dianabol)
- oxandrolone (Anavar)
- stanozolol (Winstrol)
What are the different types of preparations of birth control pills?
-
Combination
- Estrogen and progestin - 99% effective
- 7 days of placebo during menstruation
- **Sequential **
- Different amounts of progestin with same amount of estrogen
-
Single Entity Type
- Progestin only “minipills”
- Estrogen only “morning after” - Plan B
- DES - rape/incest cases
- RU-486 (progesterone antagonist) - medical termination of intrauterine pregnancy
What is the long acting progestin that abolishes menstrual cycle as long as it is given leading to ovarian and endometrial atrophy?
IM (DepoProvera)
What is the 3-month Depo-Provera shot?
- Depo Provera
- Hormone injection that lasts for 3 months to prevent pregnancy
- Stops ovaries from releasing eggs
What are the mechanisms of action of oral contraceptives?
- Inhibition of ovulation
- Estrogen - inhibits FSH secretion
- Progesterone - inhibits release of LH
- Progesterone alters endometrium development
What are some dental considerations of patients taking oral contraceptives?
- Mimics effects of pregnancy on gingiva
- Mild inflammation
- Decrease defense to plaque bacteria
Describe the drug interaction of oral contraceptives and antibiotics.
- Antibiotics alter normal bacterial flora in small intestine - where oral contraceptives are “activated” and absorbed
- Risk for ovulation and pregnancy
What does the ADA recommend to patients when they are given antibiotics while they are taking OC’s?
- Recommend an alternative form of birth control until the start of her next cycle
Which antibiotics do not affect OC steroid levels in women taking combination OCs?
- Tetracycline
- Doxycycline
- Ampicillin
- Metronidazole
- Fluconazole
- Fluoroquinolones
What are the different types of Bone Drugs?
- SERMS - Selective Estrogen Receptor Modulators (“designer” estrogens)
-
bisphosphonates
- Oral: Fosamax, Actonel, Boniva
What is raloxifene (Evista) and what does it do?
- It’s a SERM
- Activates estrogen receptors in bone
- Anti-resorptive action on bone
- **It can also reduce risk of invasive breast cancer in postmenopausal women. **
What are the best available bone building drugs that inhibit osteoclastic activity?
Bisphosphonates
What are the oral bisphosphonates and what are they used for?
Prevention and treatment of osteoporosis
- alendronate (Fosamax)
- risedronate (Actonel)
- ibandronate (Boniva)
What are the IV bisphosphonates and what are they used for?
Treatment of bone pathologies
- etidronate disodium (Didronel)
- pamidronate (Aredia)
- zoledronic acid (Zometa)
- tiludronate (Skelid)
What is the IV drug used for osteoporosis prevention?
zoledronic acid (Reclast)
What are the common side effects of bisphosphonates?
- Erosive esophagitis
- Headache, GI distress
- Osteonecrosis of the jaw
When are most cases of jaw osteonecrosis seen?
In patients undergoing chemotherapy with bisphosphonates who also recieved steroids
What are the 4 therapeutic uses of hormones?
- Replace
- Diagnose
- Stimulate
- Inhibit
What is the only hypothalamci releasing hormone used as a drug? And what is it used for?
Gonadotropin-releasing hormone (GnRH)
Used for ovulation induction in women with primary hypothalamic amenorrhea
- clomiphene (Clomid) is analog used as ovulatory stimulant
How is GnRH used in men?
Treatment of idiopathic hypogonadotropic hypogonadism
What is ACTH and what’s it used for?
- Anterior pituitary hormone
- Used as diagnostic tool - adrenal dysfunction
What is the most abundant hormone in anterio pituitary?
Growth Hormone
Now made from recombinant DNA techniques
What anterior pituitary hormone induces ovulation and regulates progesterone secretion in women, testosterone secretion in men?
Luteinizing Hormone (LH)
What are the non-pituitary gonadotropins?
- Human menopausal gonadotropin (HMG) = menotropins
- Human chorionic gonadotropin (HCG) - pregnancy test
- Vasopressin
- Oxytocin (Pitocin)
High levels of what can trigger uterine contractions?
Vasopressin
What hormone increases plasma calcium and maintains at 10 mg %?
Parathyroid hormone
What is the hormonal form of vitamin D?
Calcitriol
What is used in medicine to treat hypercalcemia, by decreasing plasma calcium and phosphate levels?
thyrocaclitonin (calcitonin)
What does Vitamin D-3 (cholecalciferol) do?
- Promotes gut absorption of calcium
- Stimulates osteoclast proliferation and bone resorption
What is the common preparation of vitamin D?
ergocalciferol (vitamin D2, calciferol)
What are the effects of vitamin D and systemic disease?
- Increased Vit D - decreased colon cancer risk
- Decreased Vit D - Increased risk for prostate, breast and ovarian cancer
