Female Pharm Flashcards
Derived from cholesterol, how man carbons are in the skeleton of Natural estrogen?
18
What are the 3 forms of natural estrogen?
1-Estrone (E1-menopause)
2-Estradiol (E2-reproductive yrs)
3-Estriol (E3-Pregnancy)
What are two synthetic estrogens?
1-Ethinyl estradiol (Steroidal)
2-Diethylstilbestrol (non-steroidal)
What are two clinical uses for estrogen?
1-Primary hypogonadism
2-Postmenopausal
*Estrogen should always be used in the smallest effective dose
Which progesterone drug can be used to reduce endometrial hyperplasia and postmenopausal bleeding?
Medroxyprogresterone
Synthesized in the ovary, testes and adrenal cortex, what hormone group are characterized by their 21 carbon skeleton?
Progestins
*progesterone the most important
What are the two types of synthetic progestins?
1-21-carbon compounds that are most like Progesterone (medroxyprogesterone)
2-19 nor, 13 ethyl compounds with lower androgenic activity (norgestimate)
*metabolized in liver
Secondary sex traits, increase CNS, endometrial growth, blood vessel maintenance, reduced bone re-absoprtion and enhanced coagulability are accomplished by?
Estrogen
Pro gestational effects, increased fat deposition, decreased CNS, increase insulin,, aldosterone, body temperature and decreased PCO2 during pregnancy and luteal phase are accomplished by?
Progestins
What are 4 clinical uses for progestins?
1-Hormone replacement therapy
2-Oral contraception
3-Long term ovarian suppression (endometriosis, bleeding disorders)
4-To test estrogen secretion
*Can increase BP
Which hormonal contraception prevents ovulation 99.5%, suppresses FSH and LH and decreases chance of conception?
Combination (low dose estrogen + progestin)
Which hormonal contraception prevents ovulation 60-80%, causes thickening of cervical mucus and endometrial alterations?
Progestin only
*Minipill
What are the 3 forms of combination oral contraceptives?
1-Monophasic (constant dosage)
2-Biphasic (dosages change once during cycle)
3-Triphasic (dosage changes twice during cycle, most natural)
What are 5 alternative hormonal contraceptive methods?
1-Implantable (etonorgestrel) 2-I.M. injection (medroxyprogesterone) 3-Intravaginal rings (E and P) 4-IUD (P only) 5-Transdermal combo (E and P)
What might interact with oral contraceptives making them less effective?
Antibiotics
Oral contraception is contraindicated in what 4 groups of patients?
1-Thrombophlebitis
2-Cardiovascular/cerebrovascular disorders
3-Vaginal Bleeding of unknown cause
4-Estrogen dependent neoplasms
Which drug is a competitive partial antagonist of estradiol at the ER in the breast and is the 1st selective estrogen receptor modulator?
Tamoxifen
*used for breast cancer
Which drug is an antagonist at progesterone and glucocorticoid receptors and is effective as a postcoital contraceptive?
Mifespristone (RU-486)
*morning after pill
Which synthetic steroid suppresses ovarian function by inhibiting mid cycle LH and FSH surge?
Danazol
*may cause weight gain, edema, oily skin, decreased breast, deep voice, headache, cramps and hot flash
Which drug is a partial estrogen agonist and causes a surge of gonadotropins and estrogen leading to ovulation?
Clomiphene
*works in hypothalamus, used for patients wanting to get pregnant or maintain testosterone in men
______ is responsible for male sex traits and is converted by 5a-reductase to _______, its active form
Testosterone
Dihydrotestosterone
*converted to estradiol by aromatase
In hypogonadal men, which drug can be used to induce growth spurt and development of secondary sex traits?
Testosterone enanthate
*can be used to enhance libido and treat breast engorgement in women
What are 3 adverse effects of testosterone?
1-Masculinizing effects (especially in women)
2-Hepatic dysfunction
3-Prostatic hyperplasia
Which anti fungal medication acts as a steroid synthesis inhibitor?
Ketoconazole
Which drug is an inhibitor of 5a-reductase thus preventing testosterone conversion?
Finasteride
Which three drugs are receptor inhibitors of androgens?
1-Cyproterone acetate (reduce men libido, women with hirsutism)
2-Flutamide (prostatic carcinoma)
3-Spironolactone (diuretic that also reduces androgen levels)
Which peptide hormone is used to induce or argument labor and elicit milk ejection?
Oxytocin
Which two drugs are used as corticosteroid therapy to increase release of surfactants into the alveolar space of the fetus?
1-Betamethasone
2-Dexamethasone
Which two drugs are used as galactagogues by interacting with D2 receptors and increasing prolactin release and milk production?
1-Metoclopramide (galactagogue of choice)
2-Domperidone (less toxicity, does not cross BBB or into milk)
Which local anesthetic is a category B and crosses the placental barrier?
Lidocaine
Which three antibiotics are Cat B and can be prescribed during pregnancy?
Penicillin
Amoxicillin
Clindamycin
