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lecom pharmacology notecards > chapter 29- reproduction > Flashcards

chapter 29- reproduction Flashcards

1
Q

what is the mechanism of action of finasteride

A

selective inhibitor of type 2 5alpha-redutcase (inhibits peripheral testosterone conversion to DHT)

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2
Q

where is type 2 5alpha-reductase highly expressed

A

prostate

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3
Q

what is the mechanism of action of dutasteride

A

inhibits both type 1 and type 2 5alpha-reductase

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4
Q

what is the clinical application of finasteride

A

androgenic alopecia and BPH

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5
Q

what is the clinical application of dutasteride

A

BPH

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6
Q

what are some side effects seen with finasteride and dutasteride

A

breast tenderness, decreased libido, ED, ejaculatory disorder

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7
Q

what are some contraindications for finasteride/dutasteride use

A

known/suspected pregnancy; women and children

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8
Q

what symptoms does finasteride and dutasteride improve

A

symptoms of decreased urine flow

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9
Q

what is the mechanism of action of anastrozole and letrozole

A

competitive inhibitors of aromatase

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10
Q

what is the mechanism of action of exemestane and formestane

A

irreversible (covalent) inhibitors of aromatase

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11
Q

what is the clinical application of anastrozole, letrozole, exemestane, formestane

A

treatment and prevention of estrogen receptor-positive early stage, locally advanced and metastatic breast cancer

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12
Q

what is the most serious common adverse effect seen with anastrozole, letrozole, exemestane, formestane use

A

osteoporotic fractures

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13
Q

what is the mechanism of action of tamoxifen

A

estrogen recetor antagonist in breast tissue and partial agonist in endometrium and bone

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14
Q

what is the mechanism of action of clomiphene

A

estrogen receptor antagonist in hypothalamus and anterior pituitary gland and a partial agonist in ovaries

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15
Q

what is the mechanism of action of raloxifene

A

estrogen receptor agonist activity in bone, but antagonist in breast and endometrium

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16
Q

what is the clinical application of tamoxifen

A

prevention of breast cancer; palliative treatment of metastatic breast cancer

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17
Q

what is the clinical application of clomiphene

A

female infertility due to ovulatory disorder (induces ovulation)

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18
Q

what is the clinical application of bazedoxifene

A

osteoporosis

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19
Q

what is the clinical application of ospemifene

A

vulvovagnial atrophy, vaginal dryness

20
Q

what is the clinical application of fulvestrant

A

treatment of ER positive metastatic breast cancer in postmenopausal women with disease progression following anti-estrogen therapy

21
Q

what are some adverse effects seen with tamoxifen

A

malignant neoplasm of endometrium, strokes, hot flashes, abnormal menstruation

22
Q

what are some adverse effects seen with clomiphene

A

thromboembolism; ovarian cysts, ovarian hypertrophy, vasomotor symptoms

23
Q

what are some adverse effects seen with fulvestrant

A

nausea, asthenia, pain, vasodilation (hot flashes)

24
Q

what are some contraindications for tamoxifen

A

history of DVT or PE

25
Q

what are some contraindications for clomiphene

A

pregnancy; uncontrolled thyroid or adrenal dysfunction; liver disease; endometrial carcinoma; ovarial cysts; organic intracranial lesion

26
Q

what are some contraindications for fulvestrant

A

pregnancy

27
Q

what are some contraindications for flutamide

A

severe hepatic impairment

28
Q

what are some contraindications for spironolactone

A

anuria, hyperkalemia, acute renal insufficiency

29
Q

what are some contraindications for mifepristone

A

chronic adrenal failure, ectopic pregnancy, inherited porphyria, undiagnosed adnexal mass

30
Q

what is the clinical application of flutamide

A

metastatic prostate cancer; BPH

31
Q

what are some adverse effects seen with flutamide

A

hepatotoxicity, disorders of hematopoietic system

32
Q

what are some adverse effects seen with spironolactone

A

hyperkalemic metabolic acidosis, GI hemorrhage, agranulocytosis, SLE

33
Q

what is the mechanism of action of spironolactone

A

aldosterone receptor antagonist that also has significant antagonist activity at the androgen receptor

34
Q

what derivation of spironolactone is sometimes used as progestin in some estrogen-progestin contraceptives

A

drospirenone

35
Q

what are some adverse effects seen with mifepristone

A

prolonged bleeding time, bacterial infections, sepsis

36
Q

what is the clinical application of mifepristone

A

abortion (through day 63 of pregnancy)

37
Q

what is the clinical application of asoprisnil

A

investigational agent for treatment of endometriosis and uterine leiomyomata (fibroids)

38
Q

what is the mechanism of action of mifepristone

A

progesterone receptro antagonist

39
Q

what is the mechanism of acute of asoprisnil

A

progesterone receptor antagonist that inhibits growth of tissues derived from endometrium and myometrium

40
Q

what combination estrogen-progestin contraception participants have the highest androgenic activity

A

Norgestrel and levonorgestrel

41
Q

what combination estrogen-progestin contraception participants have moderate androgenic activity

A

norethindrone and norethindone acetate

42
Q

what combination estrogen-progestin contraception participants have low androgen receptor cross reactivity

A

ethynodiol, norgestimate, gestodene, desogestrel

43
Q

what combination estrogen-progestin contraceptive component can also be used as emergency contraception (morning after)

A

Levonorgestrel

44
Q

what are some adverse effects for progestin-only contraceptives

A

irregular periods, breast tenderness, nausea, dizziness, headache

45
Q

what are some contraindications for progestin-only contraceptives

A

acute liver disease, benign or malignant liver tumors, known/suspected breast cancer, pregnancy

46
Q

what progestin-only contraceptive can be given parenterally every 3 months

A

medroxyprogestoerone acetate

47
Q

what are some contraindications for androgens used for hormone replacement

A

breast cancer in men; prostate cancer; pregnancy when used in women

lecom pharmacology notecards (22 decks)

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