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Pharma 5 > Gonadal Hormones > Flashcards

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
Q

Mifepristone

A

Antiprogestin

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26
Q

Mifepristone Indications

A

Cushing’s syndrome
Endometriosis
Meningioma
Breast cancer

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27
Q

Post-coital contraception dose of Mifepristone

A

600mg

28
Q

Contraception therapy (Estrogen + Progestin)

A

21 days constant dose followed by 7 days without hormone

29
Q

Withrawal bleeding occurs during

A

off-period

30
Q

Each of the 21 pills per month have the same amount of E and P

A

Monophasic

31
Q

Progestin dose is varied over the “on” period (21 days)

A

Multiphasic

32
Q

Primary MOA of contraception

A

Negative feedback on the hypothalamus and anterior pituitary–> No LH surge —> No ovulation

33
Q

Secondary MOA of contraception

A

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
Q

Contraception effectiveness

A

2-3 pregnancies per 100 women years

35
Q

When will you use Progestin only mini pill?

A

When estrogen is contraindicated

36
Q

Progestin effectiveness

A

3 pregnancies per 100 women years (LESS EFFECTIVE)

37
Q

Oral contraceptives other uses

A

Acne
Hirsutism
Menstrual disturbances

38
Q

Contraindication of Oral contraceptives

A

Thrombophlebitis/Thromboembolic disorders
CAD
Known or suspected neoplasms

39
Q

Important OC relative contraindications

A

Heavy smoker

>35-45 y/o

40
Q

Progestin ADR

A

Reduction of plasma HDL
Acne -especially androgenic progestins
Depression

41
Q

Androgen Anabolic effects

A

Inc muscle mass
Inc RBC mass
Inc bone density

42
Q

Androgen virilizing effects

A

Spermatogenesis
SExual fxn
Penile and hair growth

43
Q

Uses of androgens

A 
Hypogonadism
Anemia
Endometriosis (Danazol)
Growth stimulators
Osteoporosis
44
Q

Androgens ADR

A

Virilization in women - Hirsutism
Men- Gynecomastia, Dec spermatogenesis
Children- closure of epiphyseal plates

45
Q

Androgens Contraindications

A

Pregnancy
Prostate cancer

*HCC reported in aplastic anemic px treated with androgen

46
Q

Suppresses the feedback enhancement of FSH and LH

A

Cyproterone and Cyproterone acetate

47
Q

Cyproterone and Cyproterone acetate uses

A

Hirsutism-women

Excessive sexual drive-men

48
Q

Treats prostatic carcinoma but causes gynecomastia

A

Flutamide

49
Q

Treats metastatic carcinoma of the prostate

A

Bicalutamide and Nilutamide

50
Q

Bicalutamide and Nilutamide in combination with ______ reduces tumor flare

A

GnRH

51
Q

Approved for use following surgical castration

A

Nilutamide

52
Q

Reduces 17a-hydroxylase activity lwering testosterone and androstenedione levels

A

Spironolactone

53
Q

Spirinolactone uses

A

Hirsutism

also inhibits ALDOSTERONE

54
Q

5a reductase inhibitor

A

Finasteride

55
Q

Converts testosterone to dihydrotestosterone

A

5a reductase

56
Q

Finasteride uses

A

Prostatic Hypertrophy
Hirsutism
Early male pattern baldness

57
Q

Q: Bone resorption

A

Estrogen

58
Q

Q: Estrogens may increase

A

Endometrial cancer

59
Q

Q: SERMs?

A

act as agonist at some, antagonist at some

60
Q

Q: Least likely adverse effect of Tamoxifen

A

Osteoporosis

61
Q

Q: Causes post ovulatory maturation and secretory changes in endometrium

A

Progesterone

62
Q

Q: Suitable candidate for oral contraceptive

A

27 year old with occasional headache due to eye strain

63
Q

Q: Increases lean body mass

A

Testosterone

64
Q

Q: Suppress prostatic growth and least likely to affect LIBIDO

A

Finasteride

65
Q

Q: Antiandrogen indication

A

Prostate cancer

Pharma 5 (3 decks)

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