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Year2 Repro exam I > Hormones Pharm part II, Linger > Flashcards

Hormones Pharm part II, Linger Flashcards

1
Q

best way to Tx mild side effects of birth control pills

A

change pill formulation

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2
Q

best way to Tx moderate side effects of BCP

A

discontinue Tx

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3
Q

what are the moderate side effects BCP

A 
break through bleeding
weight gain
increased skin pigmentation
acne
hirsutism
vaginal ingections
amenorrhea
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4
Q

what are the serious side effects to BCPs

A

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

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5
Q

contraindications to E containing BCPs

A

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

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6
Q

P only BCP contraindicated

A

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

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7
Q

BCP used with caution in

A

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

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8
Q

what BCP used in woman with fibroids

A

P only since E increase fibroid growth

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9
Q

non contraceptive benefits of E and P BCP

A

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

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10
Q

MOA tamoxifen and toremifene

A

competitive partial agonist inhibitors of estradiol at E Receptro

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11
Q

clinical use of tamoxifen

A

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

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12
Q

agonist effects of tamoxifen

A

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

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13
Q

side effect tamoxifen

A

hot flashes

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14
Q

MOA taloxifene

A

agonist on lipids and bone, antagonis on endometrium and breast

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15
Q

raloxifene is used for prevention of what

A

postmenopausal osteoporosis and chemoprevention of breast CA in at risk individuals

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16
Q

advserse effects raloxifene

A

hot flashes, DVT, leg cramps

17
Q

MOA fulvestrant

A

binds E R and inhibit dimerization while increasing degradation

18
Q

what is used once someone has become resistant to tamoxifen

A

fulvestrant

19
Q

adverse effects fulvestrant

A

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

20
Q

MOA clomiphene

A

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

21
Q

clomiphene is used for what

A

ovulation inducing agent

22
Q

adverse effects clomiphene

A

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

23
Q

MOA mifepristone

A

acts on P R antagonist and antagonizes glucocorticoid R

24
Q

major use of mifepristone

A

terminate early pregnancies

25
Q

mifepristone is usually combine with what to terminate pregnancy

A

misoprostol, synthetic PG E1

26
Q

major adverse effects to mifepristone

A

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

27
Q

What is used for Tx endometriosis and fibrocystic disease of breast

A

danazol

28
Q

danazol is contraindicated in what patients

A

pregnant ones

29
Q

MOA aromatase inhibitors

A

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

30
Q

aromatase inhibitors are only used in postmenopausal women why

A

use can lead to profound E deprivation

may reactivate ovarian function in premenopausal women

31
Q

how can aromatase inhibitor increase ovulation

A

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

32
Q

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

A

aromatase inhibitors

33
Q

MOA clomiphene

A

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

34
Q

clincal use clomiphene

A

stimulate obulation in women with oligomenorrhea and amenorrhea and ovulatory dysfunction

35
Q

adverse effects clomiphene

A

hot flashes
ovarian enlargement
increased incidence multiple pregnancies

Year2 Repro exam I (19 decks)

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