Pharm

Question 1

Leuprolide:

• MOA?
• Pulsatile uses? Constant uses? (3)
• Toxicity? (3)

Answer 1

• GnRH analogue (agonist when pulsatile and antagonist in continuous). Downregulates GnRH receptor in pituitary. Decreases FSH and LH.
• Infertility; prostate cancer/uterine fibroids/precocious puberty
• Anti-androgen, nausea/vomiting

Question 2

Ethinyl estradiol

• MOA?
• Use (4)
• Toxicity?

Answer 2

• Binds estrogen receptor
• Hypgonadism, menstrual abnormalities, HRT, prostate cancer
• Increased risk of endometrial cancer/thrombi

Question 3

DES

• MOA?
• Use (4)
• Toxicity?

Answer 3

• Binds estrogen receptor
• Hypgonadism, menstrual abnormalities, HRT, prostate cancer
• Increased risk of endometrial cancer/thrombi/ clear cell adenocarcinoma of vagina

Question 4

Mestranol

• MOA?
• Use (4)
• Toxicity?

Answer 4

• Binds estrogen receptor
• Hypgonadism, menstrual abnormalities, HRT, prostate cancer
• Increased risk of endometrial cancer/thrombi

Question 5

Clomaphene

• MOA?
• Use
• Toxicity? (4)

Answer 5

• SERM; Estrogen receptor antagonist in hypothalamus; increases release of LH/FSH to stimulate ovulation
• Infertility from PCOS
• Hot flashes, ovarian enlargement, multiple pregnancies, visual distrubances

Question 6

Tamoxifen

• MOA?
• Use
• Side effects (2)

Answer 6

• SERM; antagonist on breast tissue, agonist on uterus and bone.
• Breast cancer
• Endometrial cancer/thromboembolic events

Question 7

Raloxifene

• MOA?
• Use
• Side effects (1)

Answer 7

• SERM; agonist on bone, antagonist at uterus
• Osteoporosis
• Thromboembolic events

Question 8

Anastrozole

- MOA?

Answer 8

• Aromatase inhibitor; used in post-menopausal women with breast cancer

Question 9

Exemestane

- MOA?

Answer 9

• Aromatase inhibitor; used in post-menopausal women with breast cancer

Question 10

Mifepristone

• MOA?
• Use
• Used with
• Side effects (3)

Answer 10

• Progesterone inhibtor
• Abortion
• Administered with misoprostol
• Heavy bleeding, GI effects, abdominal pain

Question 11

Terbutaline

• MOA?
• Use?

Answer 11

• Beta 2 agonist to relax uterus

- Decrease contraction frequency during labor

Question 12

Danazol

• MOA?
• Use (2)
• Toxicity? (4)

Answer 12

• Synthetic androgen
• Endometriosis and hereditary angioedema
• Hersutism, edema, low HDL, hepatotoxicity

Question 13

Methyltestosterone

• MOA?
• Use (3)
• Side effects (4)

Answer 13

• Androgen agonist
• Hypogonadism, promotes secondary sex characteristics, stimulates anabolism
• Inhibits LH release, gonadal atrophy, premature closure of epiphyseal plates, lowers LDL

Question 14

Finasteride

• MOA
• Uses (2)

Answer 14

• 5-alpha reductase inhibitor

- BPH and male pattern baldness

Question 15

Flutamide? Cyperotorone?

• MOA
• Use

Answer 15

• Testosterone receptor inhibitor

- Prostate carcinoma

Question 16

Tamsulosin

- MOA

Answer 16

• Alpha 1 antagonist for BPH

Question 17

Sildenafil

• MOA
• Use
• Toxicity (3)

Answer 17

• PDE5 inhibitor; increase CGMP smooth muscle relaxation
• Erectile dysfunction
• Headache, heart burn, hypotension

Question 18

Vardenafil

• MOA
• Use
• Toxicity (3)

Answer 18

• PDE5 inhibitor; increase CGMP smooth muscle relaxation
• Erectile dysfunction
• Headache, heart burn, hypotension

Question 19

Progestin only OC

• MOA (3)
• Implant

Answer 19

• Inhibits ovulation, atrophy of endometrium, thickens cervical mucus
• Decreased tubal motility

Question 20

Progestin + estrogen OC

- MOA (3)

Answer 20

• Inhibits ovulation, thickens mucus, decreases tubal motility

Question 21

Levonorgestrel

• MOA
• Method of use

Answer 21

• Inhibits ovulation, atrophy of endometrium, thickens cervical mucus
• IUD

Question 22

Estrogen Pharm:

• E/P rapidly degraded where? Esterification does what? Ethinyl does what?
• Effect of estrogen? (5)
• Risks? (2)

Answer 22

• Liver; increase solubility; decrease hepatic degradation
• Decrease risk of ovarian/endometrial/colon cancer; less acne; stabalize uterine lining; added FSH supression
• Increase clotting facotrs; higher venous clots