gonadotropins

Question 1

what is licensed for treatment of endometriosis and for the relief of severe pain and tenderness in benign fibrocystic breast disease where other measures have proved unsatisfactory.

Answer 1

Danazol

Question 2

use of danazol

Answer 2

licensed for the treatment of endometriosis and for the relief of severe pain and tenderness in benign fibrocystic breast disease where other measures have proved unsatisfactory

Question 3

what unlicensed indication may danazol be effective in the long term management of

Answer 3

hereditary angioedema

Question 4

name 2 luteinising hormone releasing hormone antagonists which inhibit the release of gonadotrophins (luteinising hormone and follicle stimulating hormone)

Answer 4

cetrorelix
ganirelix

Question 5

what are the 3 hormone gonadotropins

Answer 5

human gonadotropins include follicle stimulating hormone (FSH) and luteinizing hormone (LH) which are made in the pituitary, and chorionic gonadotropin (hCG) which is made by the placenta

Question 6

what are Cetrorelix and ganirelix

Answer 6

luteinising hormone releasing hormone antagonists, which inhibit the release of gonadotrophins (luteinising hormone and follicle stimulating hormone)

Question 7

Cetrorelix and ganirelix are luteinising hormone releasing hormone antagonists, which inhibit the release of gonadotrophins (luteinising hormone and follicle stimulating hormone).

When are they used

Answer 7

treatment of infertility by assisted reproductive techniques.

Question 8

Gonadorelin analogues are used in the treatment of …

Answer 8

endometriosis, precocious puberty, infertility, male hypersexuality with severe sexual deviation, anaemia due to uterine fibroids (together with iron supplementation), breast cancer, prostate cancer and before intra-uterine surgery

Question 9

why is leuprorelin and triptoreline used 3-4 months before surgery of uterine fibroids

Answer 9

reduces the uterine volume, fibroid size and associated bleeding.

Question 10

Once any serious underlying cause for breast pain has been ruled out, most women will respond to reassurance and reduction in dietary fat; withdrawal of the following drugs may also help resolve pain

Answer 10

oral contraceptive or of hormone replacement therapy

Question 11

Mild, non-cyclical breast pain is treated with

Answer 11

simple analgesics

Question 12

this drug may be useful adjunct in treatment of mastalgia (breast pain) unlicensed especially when symptoms can DEFFO be related to cyclical oestrogen production and it may be given on the days of the cycle when symptoms are predicted

Answer 12

tamoxifen

Question 13

how often should treatment for breast pain be reviews (with tamoxifen, danazol)

and what is recurrence rate

Answer 13

Treatment for breast pain should be reviewed after 6 months and continued if necessary. Symptoms recur in about 50% of women within 2 years of withdrawal of therapy but may be less severe.