Female Pharm

Question 1

what is the MoA of leuprolide?

Answer 1

it is a GnRH agonist that actually desensitizes the pituitary to GnRH

Question 2

what is the first med to give in infertility rx?

Answer 2

leuprolide

Question 3

what is goal of giving leuprolide in infertility?

Answer 3

to wipe slate clean of hormones

Question 4

once you give leu[rolide in infertility rx, what is next?

Answer 4

give hCG and rFSH

Question 5

what is the MoA of clomiphene?

Answer 5

estrogen antagonist so it inhibits the negative feedback that estrogen has on the HPG axis

Question 6

what is the drug that inhibits estrogen action on HPG axis?

Answer 6

clomiphene

Question 7

when do you give clomiphene in infertility rx? why?

Answer 7

during the follicular phase to induce the LH surge

Question 8

what are side effects of clomiphene? why these?

Answer 8

mood swings and hot flashes…because of post menopausal like effect of losing estroge

Question 9

what is another SE of clomiphene?

Answer 9

VTE

Question 10

how do you treat secondary hypogonadism in males?

Answer 10

clomiphene or gonadotropins

Question 11

what do you use to treat obesity associated infertility?

Answer 11

anastrozole

Question 12

what is MoA of anastrozole?

Answer 12

aromatase inhibitor

Question 13

explain how aromatase inhibitors work to fix infertility?

Answer 13

block conversion of testosteron to estradiol so increase testosterone levels

Question 14

where is common location for turning testosterone into estradiol?

Answer 14

in adipose tissue, hence why obese ppl may be infertile

Question 15

name the five uterotonic drugs to give during labor

Answer 15

misprostol
dinoprostone
carboprost
oxytocin
methylergonovine

Question 16

what is MoA of misoprostol/dinoprostine in labor?

Answer 16

they are prostaglandin stimulators that lead to more calcium release and contraction

Question 17

what is intracellular pathway for contraction of SM in labor?

Answer 17

phospholipase C activates IP3 and this increases calcium

Question 18

what is MoA of carboprost in labor?

Answer 18

PGF2 receptor agonist that activates PLC

Question 19

what is MoA of mehtylergonovine in labor?

Answer 19

serotonin agonist that activates PLC

Question 20

what are tocolytics?

Answer 20

drugs given to stop uterine contractions

Question 21

what are four drug classes that are tocolytics?

Answer 21

B agonist
CCB
NSAID
Ca2 binder

Question 22

name the b agonist used as tocolytic

Answer 22

terbutaline

ritodrine

Question 23

name the CCB used in tocolytic

Answer 23

nifedipine

Question 24

name the NSIAD used as tocolytic?

Answer 24

indomethacin

Question 25

what is the Ca binder used as tocolytic?

Answer 25

MgSO4

Question 26

what three drug classes can you give for PMS/PMDD?

Answer 26

OCPs leuprolide SSRIs

Question 27

what is issue in PMS/PMDD?

Answer 27

body doesnt handle fluctuations in estrogen and porgestoeron well

Question 28

how does leuprolide work in preventing issues in PMS/PMDD?

Answer 28

prevents release of FSH/LH and therefore you do not get any estrogen or progesterone

Question 29

how do OCPs work in preventing issues in PmS/PMDD?

Answer 29

keep estrogen and progesterone high so you dont get fluctuations

Question 30

what can you do to help with symptoms of menopause?

Answer 30

give OCPs or progesterone replacement

Question 31

givin estrogen replacemtn in menopause comes with what risks?

Answer 31

endometrial hyperplasia

Question 32

how do OCPs help with endometriosis?

Answer 32

inhibit growth of endometrial tissue and inhibit the HPG axis

Question 33

what is MoA of ulipristal?

Answer 33

inhibits the HPG axis and reduces endometril tissue growth by being a progesterone agonist

Question 34

what is the MoA of danazol?

Answer 34

inhibits the HPG by increasing free testosterone through binding up the SHBG

Question 35

how can leuprolide help with endometriosis?

Answer 35

downregulates the GnRH and inhibits gonadotropin release so you dont get endometrial growth as extensive as usual

Question 36

how do aromatase inhibitors help with endometriosis?

Answer 36

they inhibit estrogen synthesis by the endometrial tissue

Question 37

name the two aromatase inhibitors used for endometriosis?

Answer 37

letrozole and anastrazole

Question 38

what do you give for infertility issues in PCOS?

Answer 38

clomiphene

Question 39

how does clomiphene help with infertility in PCOS?

Answer 39

it slows the increased pulsatile frequency of the GnRH and restores the normal cycle of hormones

Question 40

what are four drugs to give for PCOS hirsutism issue?

Answer 40

spironolactone OCPs flutamide finasteride

Question 41

how do flutamide and spironolactone help with hirsutism?

Answer 41

block the testosterone and DHT androgen receptors

Question 42

how does finasteride help with hirsutism?

Answer 42

blocks 5a reductase so no T into DHT

Question 43

how do OCPs help with hirsutism?

Answer 43

stimulate expression of SHBG so decrease free testosterone

Question 44

what is the first class of meds used in most breast cancer?

Answer 44

SERMs

Question 45

what are the SERMS for BC?

Answer 45

tamoxifen and raloxifene

Question 46

how does tamoxifen work for BC RX?

Answer 46

competitively antagonizes the estrogen receptors on the breast tissue

Question 47

what is SE of SERM rx?

Answer 47

increased risk of VTE

Question 48

aside from SERMs what else is use in rx of BC?

Answer 48

aromatase inhibitors

Question 49

how do aromatase inhibitors help with BC?

Answer 49

inhibit the changing of androgen into estrogen

Question 50

when will aromatase inhibitors not be effective in rx of BC?

Answer 50

in premenopausal women

Question 51

why are aromatase inhibitors not effective in rx of BC in premenopausal women?

Answer 51

no estrogen is made to disinhibit the HPG so it will keep working to make more hormones

Question 52

what SERM is best for BC?

Answer 52

tamoxifene

Question 53

what SERM is best for bone growth?

Answer 53

raloxifene

Question 54

what SERM is best for hypothalamus issues?

Answer 54

clomphene

Question 55

is the SERM used for BC pro or anti estrogen?

Answer 55

anti estrogen

Question 56

is the SERM used for osteoporosis pro or anti estrogen?

Answer 56

pro

Question 57

is the SERM used for hypothalamus issues pro or anti estrogen?

Answer 57

anti estrogen