Mehl. drugs 03-25 (1) Flashcards
M. Decr. conversion of androgens to estrogens. Drug?
Aromatase inhibitors
M. Aromatase inhibitors.
Letrozole - what does?
Used to stimulate ovulation by decr. negative-feedback at hypothalamus / anterior pituitary.
Some students ask about this agent in comparison to clomiphene (discussed below). The literature seems to be split on it, and I haven’t seen NBME give a fuck.
M. Aromatase inhibitors.
Anastrozole and exemestane are used for???
breast cancer in post-menopausal women.
M. BPH meds. 5a reductase inhibitor used for BPH??
Finasteride
Decr. conversion of testosterone to DHT. Since DHT causes prostatic growth, decr. DHT means decr. prostatic growth.
M. BPH meds. a1 blockers that ̄ constriction of internal urethral sphincter of the bladder and help promote urinary outflow.?? 2
Tamsulosin/terazosin
M. BPH meds. Tamsulosin/terazosin group?
a1 blockers
M. BPH meds. Finasteride mechanism?
5a reductase inhibitor
M. Clomiphene. group?
Selective-estrogen receptor modulator (SERM)
M. Clomiphene. used for what?
Used to stimulate ovulation in those with irregular cycles (in particular those PCOS).
M. Clomiphene.
Has partial-agonist effects at the hypothalamus that are weaker than endogenous estrogen, so the hypothalamus interprets this as decr. estrogen is present, so negative- feedback also decr. -> GnRH incr.
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M. Androgen-receptor partial agonist. Drug?
Danazol
M. Danazol. mechanism?
Androgen-receptor partial agonist.
M. Danazol. might be used in repro for what disease?
Theoretically a med that can be used for endometriosis, but USMLE doesn’t assess this use-case.
M. Danazol. in what non-repro case is used?
Used for hereditary angioedema, where it stimulates the liver to synthesize more C1-esterase inhibitor.
M. Danazol. adverse? 2
Can cause hirsutism and pseudotumor cerebri.
M. GnRH receptor agonists. 3 drugs?
Leuprolide, goserelin, and nafarelin
M. Leuprolide, goserelin, and nafarelin - group?
GnRH receptor agonists
M. GnRH receptor agonists. When administered continuously, they cause what on GnRH receptors??
Cause desensitization of the GnRH receptor at the anterior pituitary, leading to decr. LH and FSH secretion (i.e., even though the drugs are pharmacologic agonists, they function clinically as antagonists).
M. HTN meds. HTN emergencies in pregnancy. 1 drug?
Hydralazine
M. HTN meds. 3 drugs for Tx?
Methyldopa (a2 receptor agonist), labetalol, and nifedipine classically used.
M. Magnesium. Used for what pregnancy disease? 2
Used in severe preeclampsia to prevent seizures (eclampsia).
Used to treat seizures in eclampsia.
M. Magnesium. given for what purpose for fetus?
Given to women giving birth <32 weeks’ gestation as a neuroprotective agent for the neonate.
M. Magnesium. Can in theory be used as tocolytic (discussed below).
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!!! M. Methotrexate = WHEN GIVEN?
Given for small, stable ectopic pregnancies – i.e., mother is hemodynamically stable, there is no evidence of tubal rupture / fluid in the peritoneal cavity, the ectopic is <3.5 cm, and b-hCG is <5000 mIU/mL.
M. Minoxidil in what disease?
Arteriolar dilator that promotes hair growth in androgenetic alopecia.
M. Minoxidil. Arteriolar dilator that promotes hair growth in androgenetic alopecia. USMLE wants you to know the latter is polygenic and risk is incr. with anabolic steroids.
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M. abortion: 2 drugs?
Mifepristone (progesterone receptor antagonist) is used up to 10 weeks post-intercourse.
This is followed by misoprostol (PGE1 analogue) 1-2 days later.
M. SERMs. SERMs are agents that have different effects depending on the tissue. Tamoxifen and raloxifene are SERMs used for ?????
estrogen-receptor (+) breast cancer, where they both are antagonistic at breast and agonistic at bone.
M. SERMs. Tamoxifen incr. risk for what?
Tamoxifen causes incr. risk of endometrial cancer due to agonistic effects at endometrium.
M. Tocolytics. what does on uterus?
Suppress labor by decr. uterine contractions;
M. Tocolytics. used when?
Often utilized to delay premature labor to allow for fetal lung maturity while two boluses of corticosteroids are administered.
M. Tocolytics. 3 drugs?
Terbutaline (mixed b1/2 agonist), ritodrine (b2 agonist), and nifedipine are HY ones.
M. Terbutaline (mixed b1/2 agonist), ritodrine (b2 agonist), and nifedipine are HY ones. what group?
tocolytics
M. Tocolytics. Terbutaline moa?
Terbutaline (mixed b1/2 agonist
M. Tocolytics. Ritodrine moa?
b2 agonist
M. Tocolytics. nifedipine moa?
CCB
M. Tocolytics. Indomethacin and magnesium can also technically be used for this reason.
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