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Endo/Repro: Week 4 > Hellkatz: Female Repro Drugs > Flashcards

Hellkatz: Female Repro Drugs Flashcards

1
Q

How do you tx women with hypothalamic anovulatory function?

A

Give both FSH and LH w/ daily injection

For superovulation in normal ovulatory women (FSH/LH on d 2-3 of menstrual cycle)

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2
Q

How do you treat women with endogenous estrogen activity and normal hypothalamic-pituitary-ovarian function?

A

use clomiphene citrate an estrogen antagonist which induces FSH secretion

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3
Q

What is urine derived human gonadotropins?

A

Menotropins

Urofolitropoin

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4
Q

What is given w/ hCG in sequence for ovulation in anovulatory women and for production of multiple follicles?

A

menotropins

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5
Q

What is given w/ hCG in sequence for induction of ovulation of patients w/ PCOD (w/ FSH/LH and failed Clomiphene citrate)?

A

Urofolitropoin

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6
Q

Estrogen antagonist in the hypothalamus that acts on SERM and BLOCKS ER signaling in the hypothalamus and anterior pituitary and stimulates the release of GnRH and Gonadotropins?

A

Clomiphene citrate

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7
Q

What is used as a fertility drug to induce multiple ovulations?

A

Clomiphene citrate

*multiple fetuses are possible

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8
Q

Hot flashes and ovarian hyperstimulation syndrome are SE of what drug?

A

Clomiphene citrate

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9
Q

What has LH like induction of ovulation?

A

hCG

often used following follicle stimulation by clomiphene or gonadotropins

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10
Q

What are common SE of drugs that stimulate/mimic gonadotropins?

A

Hyperstimulation
Mutiple Fetuses
Ovarian hyperstimulation syndrome (w/shift of vascular fluids to abdominal and thoracic cavities- usually mild symptoms, occasionally severe)

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11
Q

Leupolide

A

Synthetic GnRH agonist

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12
Q

Non-pulsatile administration of this drug suppresses FSH/LH after an initial transient rise

A

Leupolide

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13
Q

What drug is often paired with FSH/LH or Clomiphene to stimulate follicle production?

A

Leuopolide

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14
Q

What drug reduces sxs of uterine fibroids and controls hormone dependent prostate and breast cancers?

A

Leupolide

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15
Q

Competitive antagonist of GnRH> suppresses Gonadotropin release

A

GnRH Antagonists
Ganirelix
Cetrorelix

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16
Q

What drug is used to prevent LH surge while promoting folliculogenesis, is used in breast/prostate cancer to inhibit steroid production and is used in benign uterine diseases?

A

Ganirelix

Cetrorelix

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17
Q

What are the metabolic effects of estrogen?

A

Na and water retention

Increase in HDL, decrease in LDL (yay)

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18
Q

What drugs usually are used in combination w/ progestins and interfere w/ the LH surge and ovulation?

A

Oral contraceptives

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19
Q

What is used to treat dysmenorrhea (painful periods)?

A

Estrogen

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20
Q

What is the hormonal contraceptive estrogen?

A

Estradiol 17B ethinyl estradiol

-readily absorbed in tissues, but is limited in effectiveness by first pass metabolism

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21
Q

What reduces the metabolism of estrogen and makes it orally active?

A

addition at C-17

22
Q

What increases the syntehsis of SHBG?

A

estrogens (estradiol is bound to SHBG when circulating)

23
Q

What drug is an estrogen antagonist in the breast and vasculature and an agonist in the uterus, bone, and lipoproteins?

A

Tamoxifen

24
Q

What drug is used for the treatment and prevention of estrogen positive breast cancer?

A

Tamoxifen

25
Q

Nausea, vomiting, skin rashes
Hot flashes
Thromboembolic events
Endometrial cancer

Are all SE of…

A

Tamoxifen

Clomiphene Citrate

26
Q

What is an estrogen antagonist in some tissues but an agonist in oithers?

A

Clomiphene citrate

27
Q

This drug is used for ovulatory dysfunction in pts who are NOT pregnant, have normal liver function, and may have amenorrhea and PCOD.

A

Clomiphene citrate

28
Q

What drugs is an agonist of bone and lipoproteins and an antagonist in the breast and uterus?

A

Raloxifen

29
Q

DVT and leg cramps are SE of…

A

Raloxifen

30
Q

What drug is an antagonist in the breast and is often used for breast cancer treatment?

A

Toremifene

Also an agonist in the uterus but has NO effect on the bone

31
Q

What are the pros and cons of toremifene?

A

SE: hot flashes

Benefit: lowers LDL, increases HDL

32
Q

What are the four SERMs?

A

Tamoxifen
Raloxifen
Clomiphene citrate
Toremifine

33
Q

What drug is a PURE estrogen antagonist that blocks receptor binding and down regulates ERs in all tissues?

A

Fulverstrant

34
Q

Drug used for ER positive breast cancer treatment that is an IM injection 1x/month

A

Fulverstrant

35
Q

You have a pt who you’re going to start on an ER positive breast cancer treatments. What do you warn her are the SE?

A

Fulverstrant

GI disturbances, hot flashes, thromboembolism

36
Q

Aromatase inhibitors:

Anostrazole vs exemestane?

A

anastrozole= nonsteroidal, reversible

Exemstane= steroidal, non reversible

37
Q

A postmenopausal women comes to your office who is being treated for an ER + cancer, but can’t remember the name of the drug. She is experiencing severe hot flashes.

A

Aromatase inhibitors:

Anostrazole or exemestane

38
Q

Stimulation of these receptors develops and maintains the secretory endometirum, promotes uterine relaxation during pregnancy and prepares the breast for lactation.

A

Progesterone acting on:

PR-A and PR-B

39
Q

Progestin interaction w/ Cortisol binding globulin vs. SHBG?

A

Progesterone= CBG

19-nor progestin= SHBG

40
Q

This natural hormone is synthesized in the corpus luteum during the second half of the menstrual cycle, and by the placenta during the 2nd and third trimester.

A

Progesterone C21 steroid

41
Q

What are the three major categories of synthetic progestins?

A

Medroxyprogesterone actetate
estranes
gonanes

42
Q

What are the advantages of oral contraceptives?

A
  • Reliable contraception, easy to use
  • Decrease risk of endometrial and ovarian cancer
  • Decrease incidence of intrauterine and ectopic pregnancy
  • Menses regulation
  • Reduces acne
43
Q

What contraceptive may increase the risk of breast cancer over time, and may cause depression, weight gain, nausea, HTN and DVT?

A

OCPs

44
Q

Levonogestrel

A

Progesterone agonist used for EC

45
Q

Mifepristone and Ulipristal acetate

A

Progesterone antagonist used for EC

46
Q

What EC is also an abortefacient when used at high doses +/- prostaglandin and in early term (</=49d post coitus)

A

Mifepristone

47
Q

What drug is used as EC in smaller doses (w/in 3-5 d) and to terminate early pregnancy in larger doses?

A

Selective progesterone receptor modulators

48
Q

Commonly used EC that prevents ovulation, CANNOT terminate a pregnancy and may cause N and V.

A

Levonogestrel (plan B)

49
Q

EC that has efficacy up to 5 d after intercourse

A

Ella

50
Q

EC that causes N/V, abd pain and heavy vaginal bleeding

A

Mifepristone

Endo/Repro: Week 4 (14 decks)

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