Androgens, HPA axis drugs, SH antagonist

Question 1

Leuprolide

Answer 1

Prostate cancer, endometriosis, Central precocious puberty, hypogonadotrophic hypogonadism, prevents premature LH surges (controlled ovulation stimulation)

Agonist to GnRH receptors; downregulation when given continuously, stimulation when puslatile

Can cause hypogonadism w/ continuous treatment

Question 2

Ganirelix

Answer 2

Prevents premature LH surges (controlled ovulation stimulation), prostate cancer

Antagonist at GnRH receptor

Can cause hypogonadism w/ continuous treatment

Question 3

Urofollitropin

Answer 3

Ovulation hyperstimulation

Mimics FSH

Can cause ovarian hyperstimulation syndrome (ovaries become swollen and painful); multiple pregnancies

Question 4

Placental hCG

Answer 4

Initiates ovulation, male infertility

Mimics LH

Can cause ovarian hyperstimulation syndrome (ovaries become swollen and painful); multiple pregnancies

Question 5

Menotropins (hMG)

Answer 5

Use in ovulation hyperstimulation and male infertility

Mimics FSH and LH

Can cause ovarian hyperstimulation syndrome (ovaries become swollen and painful); multiple pregnancies

Question 6

Bromocriptine

Answer 6

Parkinson’s Disease, Hyperprolacitinemia

Agonist at DA receptors

GI disturbance, Hypotension, Psych disturbance, ergotism at high doses (Convulsive symptoms and vasoconstriction in extremeties)

Question 7

Oxytocin

Answer 7

Increased uterine contractions

Question 8

Methyltestosterone, oxandrolone

Answer 8

Male hypogonadism, reverse protein loss after surgery or trauma, illicit use in athletes

Steroid receptor

Masculinization, acne, gynecomastia, dec sperm count, premature closure of epiphysis, hepatic dysfunction, cholestatic jaundice, aggression

Question 9

Flutamide

Answer 9

Prostate cancer, BPH flare

Androgen receptor antagonist

Hepatic failure, hot flashes, gynecomastia

Question 10

Finasteride

Answer 10

BPH, male pattern baldness

5-alpha reductase inhibitor, blocks conversion to dyhydrotestosterone

loss of libido, ED

Question 11

Spironolactone

Answer 11

Hypertension, edema, hypokalemia, hirsutism, hyperaldosteronism, PCOS

Androgen receptor antagonist, aldosterone receptor antagonist

Hyperkalemia, metabolic acidosis, gynecomastia

Question 12

Ketoconozole

Answer 12

Androgen receptor positive prostate cancer, Cushing’s, anti-fungal

Inhibits steroid synthesis at higher concentrations, anti-fungal drug

Loss of libido, gynecomastia, GI distress, hepatic dysfunction

Question 13

Tamoxifen

Answer 13

Hormone responsive breast cancer, osteoporosis

Estrogen R antagonist at breast and agonist at bone and endometrium

increased risk of endometrial cancer, hot flashes, venous thrombosis (avoid long periods of immobility)

Question 14

Raloxifen

Answer 14

Osteoporosis, reduces risk of breast cancer

Estrogen antagonist at breast and endometrium but agonist at bone

NO increased risk of endometrial cancer, hot flashes, venous thrombosis (avoid long periods of immobility)

Question 15

Clomiphene

Answer 15

Stimulation of ovulation

Partial agonist at estrogen receptors

Hot flashes

Multiple births

Question 16

Danazol

Answer 16

Endometriosis (not preferred), severe fibrocystic breath disease

Inhibits ovarian steroid synthesis, binds androgen, progesterone and glucocorticoid receptor

Wt. gain, edema, decrease breast size, acne, oily skin, increased hair growth, deepened voice

Question 17

Anastrazole

Answer 17

Breast Cancer

Aromatase inhibitor, decreased estrogen synthesis

Nausea, weakness, hot flashes, osteoporosis

Question 18

Fulvestrant

Answer 18

Breast Cancer

estrogen R antagonist that downregulates and degrades the receptor

nausea, weakness, hot flashes

Question 19

Mifeprestone (RU-486)

Answer 19

Abortion, postcoital contraception, Cushings

Progesterone and glucocorticoid antagonist

Prolonged bleeding, vomiting, diarrhea, abdominal pain

Used w/ prostaglandin E1

Question 20

Allendronate

Answer 20

Biphosphonate derivative used in the treatment of osteoporosis (not a sex hormone derivative)