Estrogen/Progestin Antagonists

Question 1

Selective Estrogen Receptor Modulators (SERMs)

Answer 1

Clomiphene
Tamoxifen
Raloxifene

Question 2

Aromatase Inhibitors

Answer 2

Anastrazole
Letrozole

Question 3

GnRH agonist

Answer 3

Leuprolide

Question 4

GnRH receptor antagonist

Answer 4

Ganirelix
Cetrorelix

Question 5

Treatment of anovulatory infertility

Answer 5

Clomiphene

Weak estrogen agonist

Question 6

MOA of Clomiphene

Answer 6

Blocks ER in hypothalamus and pituitary, increasing FSH and LH Secretion → inducing follicle development and ovulation

Question 7

A/E of Clomiphene

Answer 7

Multiple births

Question 8

Tamoxifen

Tamoxifen → 4-hydroxytamoxifen (30-100x affnity to FR)

Answer 8

Estrogen antagonist: breast tissue and CNS

Estrogen agonist: endometrium, liver and bone

Question 9

Prevention and adjuvant treatment of hormone-responsive breast cancer

Answer 9

Tamoxifen

Question 10

S/E of Tamoxifen

Answer 10

Hot flushes, thromboembolism, endometrial hyperplasia

Question 11

Approved for osteoporosis and prevention of breast cancer in postmenopausal women

Answer 11

Raloxifene
Antagonist effects in breast, CNS, and endometrium
Agonist effects in the liver

Question 12

First line treatment for locally advanced or metastatic breast cancer in postmenopausal women

Answer 12

Aromatase inhibitors
Anastrazole
Letrozole

Question 13

Adjuvant treatment of hormone-responsive breast cancer

Answer 13

Anastrazole

Question 14

Aromatase inhibitor used for treatment of anovulatory infertility

Answer 14

Letrozole

Question 15

Weak cytochrome P450 inhibitor and partial agonist of progestin and androgen receptors

Answer 15

Danazol

Question 16

Synthetic steroid acting as progesterone receptor antagonist when progesterone is present

Answer 16

Mifepristone - for medical abortion

Used in combination with a prostaglandin (eg, misoprostol) for medical a