Hormones Pharm part II, Linger

Question 1

best way to Tx mild side effects of birth control pills

Answer 1

change pill formulation

Question 2

best way to Tx moderate side effects of BCP

Answer 2

discontinue Tx

Question 3

what are the moderate side effects BCP

Answer 3

break through bleeding
weight gain
increased skin pigmentation
acne
hirsutism
vaginal ingections
amenorrhea

Question 4

what are the serious side effects to BCPs

Answer 4

vascular disorders: DVT, MI, CVD
GI disorders: cholestatic jaundice, cholestasis, increased hepatic adenomas
depression
Cancer

Question 5

contraindications to E containing BCPs

Answer 5

smokers >35 y.o, HTN, CAD, CVD, DM with end organ damage, migraine HA, vaginal bleeding of unknown cause
adolescent where epiphyseal closure has not yet happened

Question 6

P only BCP contraindicated

Answer 6

unDx vaginal bleeding, benign or malignant liver disease, known or suspected breast CA

Question 7

BCP used with caution in

Answer 7

liver disease, asthma, eczema, migrain, DM, HTN, optic neuritis, retrobulbular neuritis or convulsive disorders

Question 8

what BCP used in woman with fibroids

Answer 8

P only since E increase fibroid growth

Question 9

non contraceptive benefits of E and P BCP

Answer 9

reduced risk epithelial ovarian and endometrial CA
lower incidence ectopic pregnancy and benign breast disease
reduction in dysfunctional uterine bleeding and dysmenorrhea
improvement in premenstrual Sx

Question 10

MOA tamoxifen and toremifene

Answer 10

competitive partial agonist inhibitors of estradiol at E Receptro

Question 11

clinical use of tamoxifen

Answer 11

used to Tx Breast CA and chemoprevention of breast CA in high risk patients

Question 12

agonist effects of tamoxifen

Answer 12

lower chance fracture
reducs in risk atherosclerosis
increase thromboembolic disease
increase risk endometrial CA

Question 13

side effect tamoxifen

Answer 13

hot flashes

Question 14

MOA taloxifene

Answer 14

agonist on lipids and bone, antagonis on endometrium and breast

Question 15

raloxifene is used for prevention of what

Answer 15

postmenopausal osteoporosis and chemoprevention of breast CA in at risk individuals

Question 16

advserse effects raloxifene

Answer 16

hot flashes, DVT, leg cramps

Question 17

MOA fulvestrant

Answer 17

binds E R and inhibit dimerization while increasing degradation

Question 18

what is used once someone has become resistant to tamoxifen

Answer 18

fulvestrant

Question 19

adverse effects fulvestrant

Answer 19

hot flashes, GI Sx, HA, back pain and pharyngitis

Question 20

MOA clomiphene

Answer 20

weak E, acts as competitive partial agonist inhibior of endogenous E

Question 21

clomiphene is used for what

Answer 21

ovulation inducing agent

Question 22

adverse effects clomiphene

Answer 22

ovarian hyperstimulation, increased incidence multiple births, ovarian cysts, hot flashes, blurred vision

Question 23

MOA mifepristone

Answer 23

acts on P R antagonist and antagonizes glucocorticoid R

Question 24

major use of mifepristone

Answer 24

terminate early pregnancies

Question 25

mifepristone is usually combine with what to terminate pregnancy

Answer 25

misoprostol, synthetic PG E1

Question 26

major adverse effects to mifepristone

Answer 26

nausea, vomiting, diarrhea, pelvic or abdominal pain and prolonged vaginal bleeding

Question 27

What is used for Tx endometriosis and fibrocystic disease of breast

Answer 27

danazol

Question 28

danazol is contraindicated in what patients

Answer 28

pregnant ones

Question 29

MOA aromatase inhibitors

Answer 29

inhbiit aromatase which converts androstenedione and testosterone to the E: estron and estradiol

Question 30

aromatase inhibitors are only used in postmenopausal women why

Answer 30

use can lead to profound E deprivation | may reactivate ovarian function in premenopausal women

Question 31

how can aromatase inhibitor increase ovulation

Answer 31

decrease E so increase LH and FSH from removal of negative feedback =ovulation

Question 32

most effective drug at lowering incidence of hot flashes, endometrial CA, DVT

Answer 32

aromatase inhibitors

Question 33

MOA clomiphene

Answer 33

partial agonist E R but binds for longer duration impairing E negative feedback increasing GnRH pulsatile signals to increase FSH and LH for ovulation

Question 34

clincal use clomiphene

Answer 34

stimulate obulation in women with oligomenorrhea and amenorrhea and ovulatory dysfunction

Question 35

adverse effects clomiphene

Answer 35

hot flashes ovarian enlargement increased incidence multiple pregnancies