Gonadal Hormones

Question 1

Esthinyl estradiol

Answer 1

Synthetic steroidal estrogen

Component of OCP

Question 2

Mestranol

Answer 2

Synthetic steroidal estrogen

Question 3

Quinestrol

Answer 3

Synthetic steroidal estrogen

Question 4

Diethylstilbestrol (DES)

Answer 4

Synthetic non-steroidal estrogen

SE: Adenocarcinoma of the vagina

Question 5

Chlorotrianisene

Answer 5

Synthetic non-steroidal estrogen

Question 6

Methallenestril

Answer 6

Synthetic non-steroidal estrogen

Question 7

Tamoxifen

Answer 7

SERM (estrogen receptor antagonist in breast, partial agonist in endometrium and bone)

Prevention, palliative, adjuvant therapy for breast CA

SE: malignant neoplasm of endometrium (give for

Question 8

Clomiphene

Answer 8

SERM (estrogen receptor antagonist in hypothalamus and pituitary, partial agonist in ovaries) Disinhibits GnRH release and increases LH and FSH

Female infertility dt ovulatory disorder

SE: Thromboembolism, ovarian cysts and hypertrophy, flushing/vasomotor symptoms

Question 9

Raloxifene

Answer 9

SERM (estrogen receptor antagonist in uterus and breast, agonist in bone)

Osteoporosis prevention and tx

SE: retinal vascular occlusion, venous thromboembolism, hot flashes, leg cramps

Decreases risk of invasive breast CA in postmenopausal women with osteoporosis

Question 10

Fulvestrant

Answer 10

SERM (competitively inhibits estrogen binding to receptor. No agonist activity)

Tx of E2 receptor+ metastatic breast CA with disease progression

SE: nausea, asthenia, pain, hot flashes, HA

Question 11

Anastrozole

Answer 11

Competitive aromatase inhibitor

Tx and prevention of E2 receptor+ early metastatic breast cancer

SE: osteoporosis, thrombophlebitis, profuse vaginal bleeding, hypercholestrerolemia, edema, rash, nausea, HA, depression, dyspnea

Question 12

Letrozole

Answer 12

Competitive aromatase inhibitor

Tx and prevention of E2 receptor+ early metastatic breast cancer

SE: osteoporosis, thrombophlebitis, profuse vaginal bleeding, hypercholestrerolemia, edema, rash, nausea, HA, depression, dyspnea

Question 13

Exemenstane

Answer 13

Irreversible aromatase inhibitor

Tx and prevention of E2 receptor+ early metastatic breast cancer

SE: osteoporosis, thrombophlebitis, profuse vaginal bleeding, hypercholestrerolemia, edema, rash, nausea, HA, depression, dyspnea

Question 14

Formestane

Answer 14

Irreversible aromatase inhibitor

Tx and prevention of E2 receptor+ early metastatic breast cancer

SE: osteoporosis, thrombophlebitis, profuse vaginal bleeding, hypercholestrerolemia, edema, rash, nausea, HA, depression, dyspnea

Question 15

Norgesterel

Answer 15

Progestin only contrceptive (decreases pulsation of GnRH, slows tubal peristalsis, decreases endometrial receptivity, thickens cervical mucus)

Question 16

Norethindrone

Answer 16

Progestin only contrceptive (decreases pulsation of GnRH, slows tubal peristalsis, decreases endometrial receptivity, thickens cervical mucus)

Question 17

Medroxyprogesterone acetate

Answer 17

Progestin only contrceptive (decreases pulsation of GnRH, slows tubal peristalsis, decreases endometrial receptivity, thickens cervical mucus)

Given parenterally q 3 months

Question 18

Etonogestrel

Answer 18

Progestin only contrceptive (decreases pulsation of GnRH, slows tubal peristalsis, decreases endometrial receptivity, thickens cervical mucus)

Implant - effective for 3 years

Question 19

Combined birth control

Answer 19

Suppress GnRH, LH, FSH, and follicular development, slows tubal peristalsis, decreases endometrial receptivity, thickens cervical mucus

CX: Breast/endometrial CA, CVA or CAD, cholestatic jaundice of pregnancy, liver tumors, severe HTN, prolonged immobilizaiton, female smokers over 35, thrombotic disorders

SE: AV thromboembolism, PE, cerebral thrombosis, gallbladder disease, HTN, hepatic neoplasm, breast tenderness, bloating, migraine, weight chage

Norgestrel and levonorgestrel have highest androgenic activity

Question 20

Mifepristone

Answer 20

Inhibits progesterone binding to receptor

Abortion (through day 49)

SE: prolonged bleeding time, bacterial infections, sepsis, N/V/D, cramps, headaches

Question 21

Levonorgestrel

Answer 21

Progestin that blocks LH surge to disrupt normal ovulation, produce endometrial changes, prevent implantation

Prevention of unwanted pregnancy

SE: N/V, HA, dizziness, mastalgia

Question 22

Premarine

Answer 22

Conjugated equine estrogen

HRT Therapy

CX: Breast cancer

Question 23

Estrace

Answer 23

Micronized estradiol

HRT Therapy

CX: Breast cancer

Question 24

Cenestrin

Answer 24

Conjugated synthetic estrogens

HRT Therapy

CX: Breast cancer

Question 25

Vivelle, estraderm, estrogel

Answer 25

Transdermal estrogens

HRT Therapy

CX: Breast cancer

Question 26

Testosterone enanthate

Answer 26

Replacement of testosterone to produce androgenic effects

Tx: hypogonadism

SE: cholestatic jaundice, liver carcinoma, BPH, prostate cancer, gynecomastic, acne, HA

Question 27

Testosterone cypionate

Answer 27

Replacement of testosterone to produce androgenic effects

Tx: hypogonadism

SE: cholestatic jaundice, liver carcinoma, BPH, prostate cancer, gynecomastic, acne, HA

Question 28

Flutamide

Answer 28

Competitive inhibitor of DHT and testosterone binding to receptor

For metastatic prostate CA, BPH

SE: hepatotoxicity, hematopoeitic disorder, diarrhea, nausea, rash, hot flashes

Question 29

Spironolactone

Answer 29

Competitive inhibitor of DHT and testosterone binding to the receptor

Hirsutism, HTN, acne, edema with CHF, cirrhosis or nephrotic syndrome, hypokalemia

SE: GI hemorrhage, hyperK, metabolic acidosis, agranulocytosis SLE, gynecomastic, dyspepsia, lethargy, impotence, rash

Question 30

Finasteride

Answer 30

Selective inhibitor of 5 a-reductase (T to DHT) in prostate, liver, and skin

BPH, androgenic alopecia

SE: neoplasm of male breast, breast tenderness, decreased libido, erectile dysfunction, ejaculatory disorder

DO NOT USE IN WOMEN