Gonadal Hormones and Inhibitors

Question 1

Androgen Receptor Antagonist

Answer 1

Flutamide, Bicalutamide, Nilutamide

Cyproterone, Cyproterone Acetate

Question 2

Androgen Synthesis Inhibitor/5-Alpha Reductase Inhibitor

Answer 2

Finasteride

Dutasteride

Question 3

MOA: FINASTERIDE

Answer 3

inhibits 5 alpha reductase enzyme that converts testosterone to DHT (most potent form)

Question 4

Anabolic Steroids

Answer 4

Oxandrolone, Nandrolone Decanoate

Question 5

Used in male hypogonadism

Answer 5

Androgens - Testosterone, Methyltestosterone, Testosterone Cypionate, Oxymetholone, Mesterolone

Question 6

Used in illegal performance enhancement by athletes

Answer 6

Anabolic Steroids

oxandrolone, nandrolone decanoate

Question 7

Used in Prostate CA

Answer 7

Flutamide, Bicalutamide, Nilutamide

Question 8

Used in hirsutism

Answer 8

Cyproterone, Cyproterone acetate

Question 9

Used in BPH

Answer 9

Finasteride, Dutasteride

Question 10

SERM

Answer 10

Tamoxifen
Toremifene
Raloxifene
Clomiphene

Question 11

Aromatase Inhibitors

Answer 11

Anstrozole
Letrozole
Exemestane

Question 12

Ovarian Inhibitor (Anti-Androgen)

Answer 12

Danazol

Question 13

GNRH AGONISTS

Answer 13

Leuprolide
Gonadorelin
Goserelin
Histrelin
Nafarelin
Triptorelin

Question 14

GNRH ANTAGONISTS

Answer 14

Ganirelix
Cetrorelix
Abarelix
Degarelix

Question 15

Glucocorticoid and Progesterone Receptor Antagonist

Answer 15

Mifepristone

Question 16

Use: Tamoxifen, Toremifene

Answer 16

Hormone-responsive Breast Cancer

ER+ PR+

Question 17

Use: Raloxifene

Answer 17

Osteoporosis

preferred
increases bone mineral density without estrogenic effects on endometrial tissue

Question 18

Use: Clomiphene

Answer 18

Induction of ovulation

antagonizes estrogen receptors in the pituitary thus inhibiting the negative feedback by estrogen = increase LH and FSH

Question 19

Enzyme that converts Testosterone to Estrogen (Estradiol)

Answer 19

Aromatase

Question 20

Irreversible aromatase inhibitor

Answer 20

Exemestane

Question 21

Pharmacologic antagonist of glucocorticoid and progesterone receptors used in medical abortion

Answer 21

Mifepristone

Question 22

AE of Tamoxifen

Answer 22

Increased risk for endometrial hyperplasia, endometrial CA, DVT

Question 23

AE of Raloxifene

Answer 23

Increased risk for DVT

Question 24

Side effect of Clomiphene

Answer 24

Multiple pregnancies (10%)

Increased risk of low-grade ovarian cancer with long term use

Question 25

Full Estrogen receptor antagonist

Answer 25

FLUVESTRANT

Question 26

Intermittent GnRH agonists will result to

Answer 26

increased FSH AND LH secretion

Question 27

Prolonged continuous administration of GnRH Agonists will result to

Answer 27

reduced LH and FSH secretion due to downregulation of GnRH receptors

Question 28

What should be given with GnRH agonists to prevent temporary exacerbation in treating prostate CA?

Answer 28

Flutamide

Question 29

Uses: GnRH Agonists

Answer 29

Ovarian Suppression Controlled ovarian hyperstimulation Advanced Prostate CA

Question 30

MOA: Danazol

Answer 30

Weak CYP450 inhibitor Partial agonists of progestin and androgen receptors

Question 31

Use: Danazol

Answer 31

Endometriosis Fibrocystic Disease Hemophilia Angioneurotic edema

Question 32

Emergency contraception

Answer 32

Levonorgestrel | Ethinyl Estradiol + Levonorgestrel

Question 33

Emergency contraception must be taken within ?

Answer 33

72 hours

Question 34

Progestin-only Contraceptive

Answer 34

Medroxy-Progesterone Acetate

Question 35

Absolute Contraindications to OCPs

Answer 35

``` >35y who smokes >15 sticks per day with IHD or multiple CVD risk factors with previous stroke hx complicated VHD complicated solid organ transplantation HTN SLE Cirrhosis, hepatic adenoma or hepatoma Pregnancy and early postpartum (<12d) undiagnosed AUB ```

Question 36

Relative Risk to OCP

Answer 36

Hypertension controlled Taking anticonvulsants Post bariatic surgery

Question 37

PROGESTINS

Answer 37

``` norgestrel norethindrone ethynodiol megestrol desogestrel norelgestromin norgestimate etonogestrel progesterone LEVONORGESTREL dydrogesterone ulipristal tibolone norethisterone dienogest ```

Question 38

Progestin used as an appetite stimulant

Answer 38

Megestrol

Question 39

a synthetic steroid with weak estrogrenic, progestogenic and androgenic effect used in menopausal hormone therapy, postmenopausal osteoporosis and endometriosis

Answer 39

TIBOLONE

Question 40

Use: Progestins

Answer 40

HRT, contraception, assisted reproduction, anovulation induction

Question 41

Synthetic estrogen associated with Clear Cell vaginal adenocarcinoma

Answer 41

DES or Diethylstilbestrol

Question 42

ESTROGENS

Answer 42

``` Ethinyl Estradiol Mestranol Estradiol Cypionate Premarin Estriol ```