estrogens

Question 1

what is the mechanism of mifepristone

Answer 1

blocks glucocorticoid and progestin receptors. used as an abortifacient.

Question 2

what does metyrapone do

Answer 2

blocks 11-hydroxylase.

Question 3

estrogens

Answer 3

premarin (from horse), ethinyl estradiol, mestranol. diethylstillbesterol (DES)

Question 4

uses of the estrogens

Answer 4

female hypogonadism, HRT, contraception, dysmenorrhea, uterine bleeding, acne, prostate cancer.

Question 5

SE of estrogens

Answer 5

nausea, breast tenderness, endometrial hyperplasia. gallbladder, migraine, bloating. increases blood coagulation. cancer risk. (endometrial and breast).

Question 6

what is a unique SE of DES

Answer 6

that mothers that took it and breast fed offspring at a higher risk for vaginal adenocarinoma.

Question 7

anastrozole

Answer 7

aromatase inhibitor that decreases estrogen synthesis.

Question 8

use of anastrozole

Answer 8

estrogen dependent post-menopausal breast cancer.

Question 9

clomifene

Answer 9

fertility pill. decreases the inhibition of FSH/LH causing ovlation and pregnancy

Question 10

SE of clomifene

Answer 10

multiple births.

Question 11

selective estrogen receptor modulators

Answer 11

tamoxifen and raloxifene

Question 12

tamoxifen

Answer 12

variable effects depending on tissue. agonist in bone, antagonist in breast, partial in the endometrium.

Question 13

SE of tamoxifen

Answer 13

increases risk for endometrial cancer

Question 14

uses of tamoxifen

Answer 14

estrogen receptor positive breast cancer and prophylaxis in high risk.

Question 15

raloxifene

Answer 15

agonist in bone. antagonist in breast and endometrium

Question 16

SE of raloxifene

Answer 16

if used in menopause there is no increased cancer risk.

Question 17

uses of raloxifene

Answer 17

prophylaxis of postmenopausal osteoporosis.

Question 18

progestin agonists

Answer 18

medroxyprogesterone, norrthindrone, desogestrel.

Question 19

desogestrel special.

Answer 19

synthetic, devoid of androgenic and antiestrogenic activity.

Question 20

uses for the progestins

Answer 20

contraceptives. HRT. they decrease the risk of cancer when used with estrogens.

Question 21

what are the SE of the progestins

Answer 21

dereased HDL, increased LDL, glucose intolerance. breakthrough bleeding. androgenic (hirsutism and acne), antiestrogenic (block lipid changes), weight gain, depression.

Question 22

oral contraceptives

Answer 22

combos of estrogens and progestins. suppress the gonadotropins esp mid cycle LH surge. carry the normal SE of the estrogens and progestins

Question 23

what are the interactions for the oral contracetives

Answer 23

decreased effectiveness when used with antimicrobials and enzyme inducers

Question 24

what are the SE of oral contraceptives

Answer 24

liver adenomas!

Question 25

what are the positives for using oral contraceptives

Answer 25

decreases risk of endometrial cancer, ovarian cancer, dysmennorhea, endometriosis, PID, osteoporosis

Question 26

androgens agents

Answer 26

methyltestosterone and derivatives, oxandrolone, nandrolone.

Question 27

uses of the androgens

Answer 27

male hypogonadism and anabolic effects for increasing muscle mass, RBC, decrease in nitrogen excretion. klinfeltersl

Question 28

SE of the androgens

Answer 28

excessive masculinization, cholestatic jaundice, aggression, dependence, premature closure of the epiphysis.

Question 29

what are the androgren antagonists

Answer 29

flutamide, leuprolide, finastride

Question 30

flutamide uses

Answer 30

prostatic cancer that is androgen +

Question 31

leuprolide uses

Answer 31

GnRH analog that blocks the androgen receptor. used in prostate cancer.

Question 32

finastride uses

Answer 32

5-alpha reductase inhibitor. prevents the testosterone to DHT conversion. BPH and male pattern baldness.

Question 33

what are the cautions with finastride

Answer 33

teratogen

Question 34

ocreotide

Answer 34

somatostatin analog used for acromegaly, carcinoid syndrome, secretory GI tumors.