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

Hellkatz: Female Repro Drugs Flashcards

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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?

Study These Flashcards
A

addition at C-17

22
Q

What increases the syntehsis of SHBG?

Study These Flashcards
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?

24
Q

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

25
Nausea, vomiting, skin rashes Hot flashes Thromboembolic events Endometrial cancer Are all SE of...
Tamoxifen | Clomiphene Citrate
26
What is an estrogen antagonist in some tissues but an agonist in oithers?
Clomiphene citrate
27
This drug is used for ovulatory dysfunction in pts who are NOT pregnant, have normal liver function, and may have amenorrhea and PCOD.
Clomiphene citrate
28
What drugs is an agonist of bone and lipoproteins and an antagonist in the breast and uterus?
Raloxifen
29
DVT and leg cramps are SE of...
Raloxifen
30
What drug is an antagonist in the breast and is often used for breast cancer treatment?
Toremifene Also an agonist in the uterus but has NO effect on the bone
31
What are the pros and cons of toremifene?
SE: hot flashes Benefit: lowers LDL, increases HDL
32
What are the four SERMs?
Tamoxifen Raloxifen Clomiphene citrate Toremifine
33
What drug is a PURE estrogen antagonist that blocks receptor binding and down regulates ERs in all tissues?
Fulverstrant
34
Drug used for ER positive breast cancer treatment that is an IM injection 1x/month
Fulverstrant
35
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?
Fulverstrant GI disturbances, hot flashes, thromboembolism
36
Aromatase inhibitors: | Anostrazole vs exemestane?
anastrozole= nonsteroidal, reversible Exemstane= steroidal, non reversible
37
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.
Aromatase inhibitors: | Anostrazole or exemestane
38
Stimulation of these receptors develops and maintains the secretory endometirum, promotes uterine relaxation during pregnancy and prepares the breast for lactation.
Progesterone acting on: | PR-A and PR-B
39
Progestin interaction w/ Cortisol binding globulin vs. SHBG?
Progesterone= CBG | 19-nor progestin= SHBG
40
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.
Progesterone C21 steroid
41
What are the three major categories of synthetic progestins?
Medroxyprogesterone actetate estranes gonanes
42
What are the advantages of oral contraceptives?
* Reliable contraception, easy to use * Decrease risk of endometrial and ovarian cancer * Decrease incidence of intrauterine and ectopic pregnancy * Menses regulation * Reduces acne
43
What contraceptive may increase the risk of breast cancer over time, and may cause depression, weight gain, nausea, HTN and DVT?
OCPs
44
Levonogestrel
Progesterone agonist used for EC
45
Mifepristone and Ulipristal acetate
Progesterone antagonist used for EC
46
What EC is also an abortefacient when used at high doses +/- prostaglandin and in early term (
Mifepristone
47
What drug is used as EC in smaller doses (w/in 3-5 d) and to terminate early pregnancy in larger doses?
Selective progesterone receptor modulators
48
Commonly used EC that prevents ovulation, CANNOT terminate a pregnancy and may cause N and V.
Levonogestrel (plan B)
49
EC that has efficacy up to 5 d after intercourse
Ella
50
EC that causes N/V, abd pain and heavy vaginal bleeding
Mifepristone

Endo/Repro: Week 4 (14 decks)

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