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Gonadal Hormones Flashcards

1
Q

Estrogens Indications

A 
Hypogonadism
Hirsutism
Amenorrhea
Dysmenorrhea
Osteoporosis
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2
Q

Estrogen physiology

A

Increases bone density
Endometrial growth (inc endometriosis)
Vasodilation>Vasoconstriction- but inc blood pressure?
Inc angiotensinogen

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3
Q

When taken orally, Estrogen does

A

Alter liver metabolism

  • inc plasma proteins prod
  • inc HDL and TG
  • dec cholesterol and LDL
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4
Q

Estrogen strongly binds with

A

SHBG- with lower affinity with ALBUMIN

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5
Q

Estradiol—>Estrone?

A

Peripheral tissue

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6
Q

Estradiol to:

  • Estriol
  • Estrone
  • 2-Hydroxyestrone?
A

Liver

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7
Q

To lessen effects of Estrogen on lipid profiles

A

Patch>Oral

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8
Q

Estrogen ADR

A

Hypertriglyceridemia
Endometrial Hyperplasia
Edema, Hypertension
POSTMENOPAUSAL UTERINE BLEEDING

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9
Q

Estrogen-Progestin ADR

A

Inc Breast cancer risk
Inc CAD
Inc Thromboembolic episodes

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10
Q

Most active endogenous estrogen and has the highest affinity for estrogen receptor

A

Estradiol

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11
Q

Have weak uterine effects

A

Estrone and Estriol

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12
Q

Associated with vaginal carcinoma in daughters of women who took this drug during pregnancy

A

DES

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13
Q

Antiestrogens

A

SERM

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14
Q

Tamoxifen

A

Partial agonist- BREAST

Full agonist- BONE and ENDOMETRIUM

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15
Q

ANTAGONIST in both breast and endometrium

A

Raloxifene

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16
Q

Treatment of breast cancer with increased incidence of endometrial cancer

A

Tamoxifen

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17
Q

Prevention and treatment of osteoporosis, breast cancer prophylaxis

A

Raloxifene

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18
Q

Treatment of infertility with assoc 10% of multiple pregnancy

A

Clomiphene

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19
Q

Reduces uterine cancer but increases blood clot risk

A

Raloxifene

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20
Q

Treatment for breast cancer patients who are resistant to Tamoxifen

A

Anastrazole

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21
Q

Anastrazole inhibits

A

Aromatase (Non-steroidal)

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22
Q

Inhibit ovarian fxn
Treat endometriosis
Treat fibrocystic dse

A

Danazol-a testosterone derivative

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23
Q

Progesterone Indications

A

Contraception
Estrogen replacement
Uterine bleeding
Delay premature labor

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24
Q

Progesterone physiology

A

Lipoprotein lipase stimulation = fat deposition
Aldosterone antagonist in Na and H2O retention
Ventilatory response to CO2
Alveolobular dev’t of breast
Inhibits uterine contraction
LH surge

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25
Mifepristone
Antiprogestin
26
Mifepristone Indications
Cushing's syndrome Endometriosis Meningioma Breast cancer
27
Post-coital contraception dose of Mifepristone
600mg
28
Contraception therapy (Estrogen + Progestin)
21 days constant dose followed by 7 days without hormone
29
Withrawal bleeding occurs during
off-period
30
Each of the 21 pills per month have the same amount of E and P
Monophasic
31
Progestin dose is varied over the "on" period (21 days)
Multiphasic
32
Primary MOA of contraception
Negative feedback on the hypothalamus and anterior pituitary--> No LH surge ---> No ovulation
33
Secondary MOA of contraception
E and P suppresses FSH --> P thickens cervical mucus --> P makes endometrium unsuitable for implantation --> P impairs tubal tansport of ovum (relaxes fallopian tube)
34
Contraception effectiveness
2-3 pregnancies per 100 women years
35
When will you use Progestin only mini pill?
When estrogen is contraindicated
36
Progestin effectiveness
3 pregnancies per 100 women years (LESS EFFECTIVE)
37
Oral contraceptives other uses
Acne Hirsutism Menstrual disturbances
38
Contraindication of Oral contraceptives
Thrombophlebitis/Thromboembolic disorders CAD Known or suspected neoplasms
39
Important OC relative contraindications
Heavy smoker | >35-45 y/o
40
Progestin ADR
Reduction of plasma HDL Acne -especially androgenic progestins Depression
41
Androgen Anabolic effects
Inc muscle mass Inc RBC mass Inc bone density
42
Androgen virilizing effects
Spermatogenesis SExual fxn Penile and hair growth
43
Uses of androgens
``` Hypogonadism Anemia Endometriosis (Danazol) Growth stimulators Osteoporosis ```
44
Androgens ADR
Virilization in women - Hirsutism Men- Gynecomastia, Dec spermatogenesis Children- closure of epiphyseal plates
45
Androgens Contraindications
Pregnancy Prostate cancer *HCC reported in aplastic anemic px treated with androgen
46
Suppresses the feedback enhancement of FSH and LH
Cyproterone and Cyproterone acetate
47
Cyproterone and Cyproterone acetate uses
Hirsutism-women | Excessive sexual drive-men
48
Treats prostatic carcinoma but causes gynecomastia
Flutamide
49
Treats metastatic carcinoma of the prostate
Bicalutamide and Nilutamide
50
Bicalutamide and Nilutamide in combination with ______ reduces tumor flare
GnRH
51
Approved for use following surgical castration
Nilutamide
52
Reduces 17a-hydroxylase activity lwering testosterone and androstenedione levels
Spironolactone
53
Spirinolactone uses
Hirsutism also inhibits ALDOSTERONE
54
5a reductase inhibitor
Finasteride
55
Converts testosterone to dihydrotestosterone
5a reductase
56
Finasteride uses
Prostatic Hypertrophy Hirsutism Early male pattern baldness
57
Q: Bone resorption
Estrogen
58
Q: Estrogens may increase
Endometrial cancer
59
Q: SERMs?
act as agonist at some, antagonist at some
60
Q: Least likely adverse effect of Tamoxifen
Osteoporosis
61
Q: Causes post ovulatory maturation and secretory changes in endometrium
Progesterone
62
Q: Suitable candidate for oral contraceptive
27 year old with occasional headache due to eye strain
63
Q: Increases lean body mass
Testosterone
64
Q: Suppress prostatic growth and least likely to affect LIBIDO
Finasteride
65
Q: Antiandrogen indication
Prostate cancer

Pharma 5 (3 decks)

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