OB/GYN drugs (online) 1/3

Question 1

name the homos that have an alpha- protein in common

Answer 1

FSH, LH, TSH, hCG

Question 2

What homo does each rpoduce:
Corpus luteum
follicle
stroma

Answer 2

Corpus lutem: progesterone

folicle: estrogen (estradiol)
stroma: androgens (androstendione, T)

Question 3

FSH 2 functions

Answer 3

follicle development

ovum maturation

Question 4

LH 2 functions

Answer 4

supports corpus luteum

midcycle surge leads to ovulation

Question 5

3 effects of estrogen that lead to fertilizaiton

Answer 5

b. Proliferation of endometrium
c. Increase uterine and tubal motility (propels sprem and ovum together)
Watery cervical secretions (“ferning”)

Question 6

3 side effects of estrogen

Answer 6

a. Na+ and Water retention (increased BP, bloating)
b. Increase in clotting factors (especially if p.o.)
Lipid alterations- lowers LDL, increased HDL, decreased cholesterol

Question 7

When under the dominant control of the estrogens (early to midcycle), conditions in the female reproductive tract are optimized for?

Answer 7

fertilization.

Question 8

When under the dominant control of the progesterone (midcycle to menses), conditions in the female reproductive tract are optimized for?

Answer 8

implantation and maintenance of pregnancy.

Question 9

5 effects of progestins

Answer 9

1. Development of “secretory”endometrium
2. viscous, low volume cervical secretions*
3. decreased uterine motility (“quieting” effect)*
4. thermogenic effect (~ 1° F)
   maintenance of pregnancy

Question 10

Variability in the menstrual cycle occurs during what phase?

Answer 10

the follicular phase

Question 11

What happens to prevent maintenace of corpus luteum? (suicide)

Answer 11

LH maintains corpus luteum. Corpus luteum secretes laods of progesterone which fb inhibits LH production. That’s what leads to the degeneration of the corpus luteum = suicide

Question 12

If pregnancy occurs, what maintains the corpus luteum?

Answer 12

BhCG

Question 13

What does a rise in body temp signify

Answer 13

Progesterone is being released and ovulation has occured- good time to smash if you wan tto get pregnant

Question 14

predominant hormone postmenopause

Answer 14

ALL ESTRADIOL

Question 15

list the small peptide drugs (1) and the PK consequence

Answer 15

GnRH and analogs = useless p.o. (digested!)

Question 16

list the Large Glycoproteins (3) and the PK consequence

Answer 16

FSH, LH, hCG

(Gonadotropins)–> not used p.o.

Question 17

list the Steroids (2) and the PK consequence

Answer 17

Est, PG, analogs-->
• Lipophilic-->	highly protein bound-->
Dampens variation in free homo concentrations
• Absorbed by mucous mbs 
• GI tract
• Percutaneous
Subject to extensive 1st-pass mtb

Question 18

name the 4 natural estrogens

Answer 18

a. Estradiol
b. Esters
c. Estrone
Conjugated Estrogens

Question 19

name the synthetic estrogen and why it isn’t used

Answer 19

DES - teratogenic

Question 20

name the 2 semi-synthetic estrogens and why they are used

Answer 20

17-ethinylestradiol
Mestranol
Used as OCP- can use orally dt blunted 1st pass effect from modification at 17

Question 21

What type of estrogen is Genistein- and its use?

Answer 21

post menopause sx tx

Phytoestrogens (soy flavones)

Question 22

*****What are the three major ways to inhibit estrogenic action:

Answer 22

[1] interfere with gonadotropin release and
subsequent ovarian estrogen production
[2] inhibit synthesis (aromatase inhibitors)
[3] block the estrogen receptor

Question 23

Clomiphene- MOA and use

Answer 23

Estrogen Receptor Antagonists

anovulatory infertility tx

Question 24

Tamoxifen-MOA and use

Answer 24

Est- dependent cancer tx

Question 25

name the SERM

Answer 25

raloxifene

Question 26

Raloxifene use-

Answer 26

maintains bone mass post-menopause without extreme stimulation of breast or uterine tissue

Question 27

Anastrole, Exemestane, Letrozole MOA

Answer 27

Aromatase Inhibitors that prevent endogenous estradiol production

Question 28

name the Progesterone Receptor Agonists: (1 each) Natural; semi-synthetic synthetic

Answer 28

``` Natural = Progesterone semi-synthetic = Medroxyprogesterone synthetic = 19-nortestosterones ```

Question 29

What quality do increasing generations of progesterones have

Answer 29

less androgenic effects

Question 30

what are progesterones used for

Answer 30

contraception

Question 31

Mifepristone (RU486) MOA and use

Answer 31

Progesteron Receptor Antagonists: counteracts Progesterone's inhibition of uterine contractions--> increased uterine activity used for abortion

Question 32

Explain why postmenopausal women are a good source of gonadotropins

Answer 32

post-menopausal steroid hormones are decreased, decreasing negative feedback on Hypothalamus--> increased GnRH--> increased LH, FSH

Question 33

Danazol-MOA

Answer 33

Anti-gonadotropin: exerts negative fb on pituitary wiothout estrogenic effects

Question 34

What are GnRH analogs used for with intermittent versus continuous administration.

Answer 34

interittent: delayed puberty kick-start continuous: prostate CA, endometriosis, precocious puberty

Question 35

name 4 GnRH analogs

Answer 35

Gonadorelin, Leuprolide, nafarelin, goserelin

Question 36

What is used to prevent sx of menopause

Answer 36

estrogen HRT

Question 37

3 benefits of estrogen HRT in menopause

Answer 37

bone density increase cognitive function improvment CV imporvement

Question 38

uses of anti-estrogens

Answer 38

hormone-responsive tumors

Question 39

uses of progestins (3)

Answer 39

1. Dysfuntional uterine bleeding 2. Contraception Threatened or habitual abortion (luteal-phase defect = not enough progesterone produced)