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Endo / Repro Final > Class of 2017 Pharm Review > Flashcards

Class of 2017 Pharm Review Flashcards

1
Q

What is the drug used for estrogen replacement during menopause?

A

17-a-ethinylestradiol

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2
Q

What are the side effects of 17-a-ethinylestradiol?

A

Increased risk of MI, Stroke, endometrial carcinoma

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3
Q

What is norethindrone?

A

Progesterone equivalent

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4
Q

What are the side effects of norethindrone?

A

Increased risk of MI, stroke, breast cancer

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5
Q

What are the indications for estrogen or progesterone therapy?

A

hypogonadism, contraception, menospause

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6
Q

What is the DoC for menopausal syndrome treatment?

A

Ospemifene

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7
Q

What class of drug is Ospemifene and its MoA?

A
  • SERM: partial agonist for bone and endometrium, partial antagonist for breast
  • Promotes vaginal epithelial growth
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8
Q

What is the main concern of SERM use?

A

Endometrial hyperplasia and carcinoma

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9
Q

What SERM is used for infertility and polycystic ovarian syndrome?

A

Clomiphene Citrate

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10
Q

What is the MoA of clomiphene citrate?

A

Reduce estrogen hypothalamus negative feedback –> promote FSH and LH –> ovulation

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11
Q

What is the main side effect associated with Clomiphene Citrate?

A

Induced menopause due to estrogen block

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12
Q

What is the primary use of Letrozole?

A

Infertility

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13
Q

What is the MoA of letrozole?

A

Aromatase inhibitor: Blocks estrogen production –> FSH / LH stimulation –> ovulation

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14
Q

Drug for fat, infertile woman?

A

Metformin

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15
Q

What drugs (2) are used in a low to medium risk premenopausal, estrogen - receptor positive patient?

A

Tomoxifen or raloxifene

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16
Q

What drugs are used in a low to medium risk postmenopausal, estrogen - receptor positive breast cancer patient?

A

Tamoxifen, raloxifene, or letrozole (aromatase inhibitor)

17
Q

What treatment (Rx) is used in a estrogen negative breast cancer patient?

A

Chemo

18
Q

What is the limitation of SERMs?

A

5 year limit, will convert to breast agonist after this

19
Q

What drugs will SERMs interact with?

A

SSRIs (CYP2D6 conversion)

20
Q

What are three aromatase inhibitors?

A

Letrozole, anastrozole, exemestane

21
Q

What is the MoA of aromatase inhibitors?

A

prevent estrogen production from androgens

22
Q

What are the first line and second line drugs (classification) used in estrogen receptor positive breast cancer in post menopausal women?

A

SERM and Aromatase inhibitors, respectively

23
Q

What are the benefits of aromatase inhibitors, when compared to SERMs?

A

No risk of endometrial cancer
No risk of thromboembolic
Effective after 5 years

24
Q

What is the MoA and indication for Fulvestrant?

A

Estrogen receptor antagonist

Breast cancer resistant to tamoxifen

25
Q

What are the GnRH agonists?

A

Leuprolide, Goserelin, Abarelix

26
Q

What must be given with GnRH agonists, for how long, and why?

A

Estrogen antagonist, for two weeks, to prevent the effects of the initial FHS and LH flare

27
Q

What biotech drugs can be given for HER2/erbB-2 positive breast cancers?

A

Trastuzumab, Pertuzumab, and Lapatinib (if Trast unresponsive)

28
Q

What is the most effective contraceptive?

A

IUD

29
Q

What is the MoA of IUDs?

A

Cu coating causes sterile inflammation and PMNs kill sperm

30
Q

What is the major adverse effect of estrogen / progesterone OCPs?

A

Thromboembolism

31
Q

What are the two (one unique) major risks associated with intravaginal contraceptives?

A

Cervical displasia (unique), thromboembolism

32
Q

What is the emergency contraceptive?

A

Levonorgestrel

33
Q

What is the MoA of levonorgestrel and its limitation?

A

Progesterone analog prevents ovulation

Must be taken within 3 days of coitus

34
Q

What are the categories of medications, as they relate to pregnancy, and the categorical meanings?

A

A: No Risk, human studies performed
B: Animal studies show no risk, but no human trials. Animal studies show risk, but human ones don’t.
C: Animal studies show increased risk, but no human trials. Or no studies conducted.
D: Proven risk, but may be outweighed by benefits
X: Proven risk, benefit

Endo / Repro Final (31 decks)

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