Female Pharm

Question 1

Derived from cholesterol, how man carbons are in the skeleton of Natural estrogen?

Answer 1

18

Question 2

What are the 3 forms of natural estrogen?

Answer 2

1-Estrone (E1-menopause)
2-Estradiol (E2-reproductive yrs)
3-Estriol (E3-Pregnancy)

Question 3

What are two synthetic estrogens?

Answer 3

1-Ethinyl estradiol (Steroidal)

2-Diethylstilbestrol (non-steroidal)

Question 4

What are two clinical uses for estrogen?

Answer 4

1-Primary hypogonadism
2-Postmenopausal

*Estrogen should always be used in the smallest effective dose

Question 5

Which progesterone drug can be used to reduce endometrial hyperplasia and postmenopausal bleeding?

Answer 5

Medroxyprogresterone

Question 6

Synthesized in the ovary, testes and adrenal cortex, what hormone group are characterized by their 21 carbon skeleton?

Answer 6

Progestins

*progesterone the most important

Question 7

What are the two types of synthetic progestins?

Answer 7

1-21-carbon compounds that are most like Progesterone (medroxyprogesterone)
2-19 nor, 13 ethyl compounds with lower androgenic activity (norgestimate)

*metabolized in liver

Question 8

Secondary sex traits, increase CNS, endometrial growth, blood vessel maintenance, reduced bone re-absoprtion and enhanced coagulability are accomplished by?

Answer 8

Estrogen

Question 9

Pro gestational effects, increased fat deposition, decreased CNS, increase insulin,, aldosterone, body temperature and decreased PCO2 during pregnancy and luteal phase are accomplished by?

Answer 9

Progestins

Question 10

What are 4 clinical uses for progestins?

Answer 10

1-Hormone replacement therapy
2-Oral contraception
3-Long term ovarian suppression (endometriosis, bleeding disorders)
4-To test estrogen secretion

*Can increase BP

Question 11

Which hormonal contraception prevents ovulation 99.5%, suppresses FSH and LH and decreases chance of conception?

Answer 11

Combination (low dose estrogen + progestin)

Question 12

Which hormonal contraception prevents ovulation 60-80%, causes thickening of cervical mucus and endometrial alterations?

Answer 12

Progestin only

*Minipill

Question 13

What are the 3 forms of combination oral contraceptives?

Answer 13

1-Monophasic (constant dosage)
2-Biphasic (dosages change once during cycle)
3-Triphasic (dosage changes twice during cycle, most natural)

Question 14

What are 5 alternative hormonal contraceptive methods?

Answer 14

1-Implantable (etonorgestrel)
2-I.M. injection (medroxyprogesterone)
3-Intravaginal rings (E and P)
4-IUD (P only)
5-Transdermal combo (E and P)

Question 15

What might interact with oral contraceptives making them less effective?

Answer 15

Antibiotics

Question 16

Oral contraception is contraindicated in what 4 groups of patients?

Answer 16

1-Thrombophlebitis
2-Cardiovascular/cerebrovascular disorders
3-Vaginal Bleeding of unknown cause
4-Estrogen dependent neoplasms

Question 17

Which drug is a competitive partial antagonist of estradiol at the ER in the breast and is the 1st selective estrogen receptor modulator?

Answer 17

Tamoxifen

*used for breast cancer

Question 18

Which drug is an antagonist at progesterone and glucocorticoid receptors and is effective as a postcoital contraceptive?

Answer 18

Mifespristone (RU-486)

*morning after pill

Question 19

Which synthetic steroid suppresses ovarian function by inhibiting mid cycle LH and FSH surge?

Answer 19

Danazol

*may cause weight gain, edema, oily skin, decreased breast, deep voice, headache, cramps and hot flash

Question 20

Which drug is a partial estrogen agonist and causes a surge of gonadotropins and estrogen leading to ovulation?

Answer 20

Clomiphene

*works in hypothalamus, used for patients wanting to get pregnant or maintain testosterone in men

Question 21

______ is responsible for male sex traits and is converted by 5a-reductase to _______, its active form

Answer 21

Testosterone

Dihydrotestosterone

*converted to estradiol by aromatase

Question 22

In hypogonadal men, which drug can be used to induce growth spurt and development of secondary sex traits?

Answer 22

Testosterone enanthate

*can be used to enhance libido and treat breast engorgement in women

Question 23

What are 3 adverse effects of testosterone?

Answer 23

1-Masculinizing effects (especially in women)
2-Hepatic dysfunction
3-Prostatic hyperplasia

Question 24

Which anti fungal medication acts as a steroid synthesis inhibitor?

Answer 24

Ketoconazole

Question 25

Which drug is an inhibitor of 5a-reductase thus preventing testosterone conversion?

Answer 25

Finasteride

Question 26

Which three drugs are receptor inhibitors of androgens?

Answer 26

1-Cyproterone acetate (reduce men libido, women with hirsutism)
2-Flutamide (prostatic carcinoma)
3-Spironolactone (diuretic that also reduces androgen levels)

Question 27

Which peptide hormone is used to induce or argument labor and elicit milk ejection?

Answer 27

Oxytocin

Question 28

Which two drugs are used as corticosteroid therapy to increase release of surfactants into the alveolar space of the fetus?

Answer 28

1-Betamethasone

2-Dexamethasone

Question 29

Which two drugs are used as galactagogues by interacting with D2 receptors and increasing prolactin release and milk production?

Answer 29

1-Metoclopramide (galactagogue of choice)

2-Domperidone (less toxicity, does not cross BBB or into milk)

Question 30

Which local anesthetic is a category B and crosses the placental barrier?

Answer 30

Lidocaine

Question 31

Which three antibiotics are Cat B and can be prescribed during pregnancy?

Answer 31

Penicillin
Amoxicillin
Clindamycin