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Year II Pharmacology Term 5 > Gonadal Hormones > Flashcards

Gonadal Hormones Flashcards

1
Q

GnRH secretion is

A

pulsatile & periodic in order to be stimulatory

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2
Q

When to LH hormones (gnrh sections) lenthen

A

During sleep

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3
Q

WHich chromosome is GnRH on

A

8

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4
Q

GnRH is what type of hormone

How many peptides in final form

A

Peptie

92 propetide

10 active form

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5
Q

GnRH admistation

A

IM

Nasal

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6
Q

Clincal Use

A

Suppression of estrogen production in hormone-dependent breast or prostate cancer

Delay the onset of precocious puberty

Delay puberty in transgendered youth who are too young for hormone-replacement therapy

Hypergonadism: Disrupts the GnRH pulse generator.

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7
Q

What is a tumor flare

How is it managedj

A
  • Bolus release caues initial LH & FSH

managed by estrogen or androgen antagonists.

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8
Q

Side effects of GnRH in males

A

Increased risk of diabetes, MI, sudden cardiac death, stroke; monitor blood glucose and for signs/symptoms of CVD during therapy.
Co-symptomatic with androgen suppression/Low Testosterone.
Risk of ureteral obstruction or spinal cord compression (monitor during 1st month of therapy).

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9
Q

Side effects of GnRH in females

A

Non-diagnosed abnormal vaginal bleeding: not recommended.
Risk factors for decreased bone mineral density (e.g. chronic alcohol, tobacco, anticonvulsants, corticosteroids).
Premenopausal women: use nonhormonal contraception during and for 12 weeks after therapy or until menses resume.
Nursing mothers: not recommended.

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10
Q

Estrongen

Uses

A

Uses

  • Contracption
  • HRT
  • Oncology (anti-estrogens>estrogens)
  • Male to female transger promotion
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11
Q

Tamofen

Mechanism
Use

A

Mechanism

  • Selective estrogen antagonist
  • Non-stimulatoryu in breat but stimulatory in uterus = uterine cancer

Use
- Reduce risk of breast cancer recurrence

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12
Q

Arimidex

Mechanism
Use

A

Mechanism

  • Blocks conversion of testerone to estradiol
  • Causes decrease in estrogen and increase in testosterone

Use
- Reduce risk for breast cancer

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13
Q

Estrogen contradictions

A

Pregnancy
Lactation
Breast cancer
Personal breast cancer history
Familial breast cancer history
In post-menopausal women HRT can increase the risk of ovarian cancer, breast cancer, stroke, dementia, blood clots.
All of these risks are greater in smokers.

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14
Q

Anti-estrogen contraindications

A

Pregnancy
Lactation
Uterine Cancer
Personal uterine cancer history

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15
Q

Progesterone

Use (2)

Contradications

A

Use

  • Support pregnancy where there is a high risk of miscarriage.
  • Counteract the thickening of the uterine lining caused by post-menopausal estrogen

Contraindications

  • Depression
  • Migraines
  • Tobacco use
  • Clotting disorders
  • Siezures
  • SLE
  • Breast Cancer
  • Ovarian Cancer
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16
Q

Mifepristone

Mechanism
Use
Contraindications

A

Mechanism
- Anti-progesterones

Use
- “Morning after pill”

  • Post-coital contraceptive
    Interferes with progesterone signalingendometrial thickening and implantation
  • Abortifacient
    Sufficient to cause miscarriage of implanted embryo in 1st trimester

Contraindications

  • IUD
  • Ectopic Pregnancy
  • Adrenal failure
  • Hemorrhagic disorders
  • Porphyria
  • Prolonged anti-coagulant use
  • Prolonged corticosteroid use
17
Q

WHat is ADAM

Treatment?

A

Androgen Deficiency in Aging Men

ART be considered (unless otherwise contra-indicated) when total serum testosterone is < 200ng/dL (6.9nM)

18
Q

Mechanism of admistration

Testerone esters
Alkylated testerone
Transdermal systems

A

Testerone esters - pareneterally
Alkylated testerone- Oral active & liver toxixity
Transdermal systems

19
Q

Androgen Replacement

Use

A

Androgen Defiency

  • hypopituitarism and hypogonadism
  • ADAM (aka andropause)
  • Female to male transgender promotion

Gynecologic Disorders
- Post-partum breast engorgement
- Endometriosis
= Chemotherapy in ER-positive Breast tumors in pre-menopausal women (very rarely used)

  • Anemia
  • Osteoporosis
  • Growth stimulation (delayed puberty in males)
  • Anabolic abuse in sports
  • Mammery hyperplasia & breast cancer
20
Q

Arimidex

Mechanism

A

Aromatase inhibitors (e.g. Arimidex) not only block estrogen production but also enhance androgen levels

21
Q

Contraindications of androgen enhancement

A 
Pregancy
CDV defect
Prostate cancer or BPH
Hepatic disease
Hypercalcemia
Renal disease
Soya lecithin hypersensitivity
Tartrazine dye hypersensitivity
22
Q

Finasterdine

Mechamism
Use
No effect on
SE

A

Mechanism
5 Reductase Inhibitor

Use
benign prostatic hyperplasia (Proscar, Avodart) and male patterned baldness (Propecia).

NOT EFFECTIVE AGAINST PROSTATE CANCER, HPA axis

Dose
Oral

SE

  • Decreased libido
  • Impotense
23
Q

Only 5 Reductase Inhibitor withought decreased impotence or libido

A

Tamsulosis

24
Q

6 SE of andorgen enhancement

A

Masculinization of women and pre-pubertal children

Disruption of CNS development in early life

Alkyl-substituted Androgens are associated with hepatic dysfunction

Associated with increased water-retention and edema

Androgens like other steroids will increase the expression and activity of the Cyp enzymes, particularly in the liver. This may in turn increase the metabolism of other drugs, thereby decreasing their efficacy.

Increased risk of prostatic hyperplasia and prostate cancer.

25
Q

4 Adverse effects of Anti-androgen Therapy

A

ppression of gonadal function, loss of libido.

Disruption of male pubertal development.

Elevated hepatic enzymes, hepatic failure

Hyperplasia of mammary epithelia.

Androgens have been used successfully against estrogen-dependent breast cancers, but are rarely used currently because of negative side-effects such as masculinization, hirsuitism etc.

26
Q

4 contraindictaions effects of Anti-androgen Therapy

A

Contraindicated in women who are pregnant or who may become pregnant.

Contraindicated in male patients with carcinoma of the prostate or breast.

Special caution when using androgens to generate a growth spurt.

Androgen therapy has been associated with hepato-cellular carcinoma.

27
Q

Estrogen can reduce symptoms of which neurological disorder

A

MS!

Year II Pharmacology Term 5 (9 decks)

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