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Reproductive Block > Pharm - Female > Flashcards

Pharm - Female Flashcards

1
Q

Aromatase inhibitors for breast cancer

A

Anastrozole, Exemestane, Letrozole

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2
Q

SERDs and SERMs for breast cancer

A

Raloxifene, Tamoxifen, Toremifene, Fulvestrant

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3
Q

GnRH agonist for breast cancer

A

Goserelin

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4
Q

HER-2/neu antibodies for breast cancer

A

Pertuzumab, Trastuzumab, Ado-Trastuzumab, Emtasine

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5
Q

TKI for breast cancer

A

Lapatinib

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6
Q

mTOR inhibitor for breast cancer

A

Everolimus

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7
Q

Intervention strategies for premenopausal women

A

GnRH agonists, GnRH antagonists, surgical ablation, SERM, pure antigestrogen

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8
Q

Intervention strategies for postmenopausal women

A

aromatase inhibitors, SERM, receptor destabilizer

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9
Q

Fulvestrant MOA

A

inhibits receptor dimerization leading to increased turnover and disruption of nuclear localization

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10
Q

Fulvestrant AE

A

nausea, asthenia, pain, vasodilation, and HA

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11
Q

Tamoxifen BBW

A

endometrial hypertrophy, vaginal bleeding, endometrial cancer, thromboembolic disease (DVT or PE), stroke

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12
Q

Raloxifene BBW

A

Thromboembolic disease, stroke

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13
Q

Toremifene BBW

A

prolongs QT interval - avoid in preexisting condition and with 3A4 inhibitors; avoid with Hx of endometrial cancer/hyperplasia, thromboembolic disease

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14
Q

Anastrozole, Letrozole, Exemestane MOA

A

aromatase inhibitors; non-steroidal (reversible inhibition), steroidal (irreversible inhibitor)

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15
Q

Aromatase inhibitor AE

A

hot flashes, nausea, hair thinning; more arthralgia and diarrhea but fewer gynecologic symptoms than tamoxifen.

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16
Q

Pertuzumab AE

A

alopecia, loss of appetite, decreased LVEF, neutropenia, and leukopenia

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17
Q

Trastuzumab AE

A

peripheral edema, rash, weight gain, dizziness, URTIs, pharyngitis, fatigue, cardiomyopathy and HF, renal failure, hepatotoxicity, pneumonia and respiratory failure

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18
Q

Drugs used in combination with Pertuzumab and Trastuzumab

A

Taxanes

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19
Q

BBW for Pertuzumab

A

pregnancy

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20
Q

BBW for Trastuzumab

A

cardiomyopathy, infusion reactions, pregnancy, respiratory distress syndrome, respiratory insufficiency

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21
Q

BBW for Ado-Trastuzumab

A

Heart failure, Heptic disease, pregnancy, ventricular dysfunction

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22
Q

Lapatinib BBW

A

liver disease

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23
Q

Lapatinib AE

A

CYP3E4/5 interactions, GI issues, anemia, thrombocytopenia, hand-foot syndrome, interstitial lung disease/pneumonitis, QT prolongation

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24
Q

Goserelin AE

A

hypo-estrogenic effects; decreased bone density, osteopenia/osteoporosis

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25
Q

Everolimus BBW

A

risk of opportunistic infections - neoplasia; lymphoma/SCC

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26
Q

Everolimus AE

A

non-infectious pneumonitis, blood dyscrasias, hyperglycemia, hyperlipidemia, hypertriglyceridemia, elevated creatinine and LFTs

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27
Q

Treatment of triple negative Breast Cancer with lymph node positive

A

adjuvant anthracycline and Taxane-based chemotherapy

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28
Q

Standard Adjuvant chemotherapy regimens for breast cancer

A

cyclophosphamide/doxorubicin +/- taxol, fluorouracil, docetaxel; docetaxel/cyclophosphamide

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29
Q

Medroxyprogesterone MOA

A

used for endometrial cancer; binds to progestin receptors and block GnRH release

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30
Q

Medroxyprogesterone AE

A

amenorrhea, edema, anorexia, weakness

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31
Q

Megestrol MOA

A

used for endometrial cancer or breast cancer; suppresses pituitary LH release and enhances estrogen degradation, promoting differentiation/maintenance of endometrial tissue

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32
Q

Megestrol AE

A

weight gain, hot flashes, malaise, asthenia, lethargy, tumor flare and hypercalcemia in BC pts with bony metastases, thrombophlebitis, thrombo or pulm embolism

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33
Q

Increased risk due to HRT

A

coronary heart disease, invasive breast cancer, stroke, PE. gallbladder disease, dementia, urinary incontinence

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34
Q

Decreased risk due to HRT

A

hip fractures, diabetes, vasomotor symptoms

35
Q

Contra for HRT

A

abnormal genital bleeding, BC, estrogen dependent neoplasia, clotting disorders, stroke, MI, pregnancy

36
Q

Non-hormonal therapies for menopause

A

Paroxetine (FDA approved), Fluoxetine, Escitalopram, Venlafaxine, Clonidine, Gabapentin

37
Q

Most effective treatment for vasomotor symptoms and urogenital atrophy

A

estrogen +/- progestogen

38
Q

Benefit of transdermal estrogen

A

avoids first pass hepatic metabolism thus deceased the amount of factor IX clotting factor created

39
Q

Bazedoxifene

A

combination of estrogens and SERM which act as a agonist in some estrogen sensitive tissues and antagonist in the uterus - reduces endometrial overgrowth

40
Q

Drugs used to induce labor

A

Oxytocin (Pitocin), Dinoprostine (PGE2), Misoprostol (PGE1), Carboprost tromethamine (15methylPGF2)

41
Q

Drugs used to delay labor

A

Tocolytics - Magnesium Sulfate, Indomethacin; OTC - Caster Oil, Cohosh, Evening Primrose

42
Q

Uses of Oxytocics

A

induction of labor in case of premature rupture of membranes, fetal growth restriction, uteroplacental infusfficiency, pre-eclampsia/eclampsia; control of postpartum hemorrhage, induction of therapeutic abortion

43
Q

Uses of tocolytic agents

A

delay or prevent premature parturition or slow/arrest delivery so that therapeutics such as glucocorticoids to increase fetal surfactant can be given

44
Q

Uses of Gonadtropins

A

female infertility, male infertility due to hypogonadism, in vitro fertilization

45
Q

Estrogen drugs

A

ethinyl estradiol, mestranol, estrogen esters

46
Q

Progestin Drugs

A

Norethindrone, Norgestrel, Levorgestrel

47
Q

Antiestrogens

A

clomiphene, fulvestrant

48
Q

Antiprogestins

A

Mifepristone, Onapristone

49
Q

Androgen receptor antagonists

A

flutamide, bicalutamide

50
Q

Menotropin

A

used for infertility; from urine of postmenopausal women, contains FSH and LH (IM injection); recominant FSH is also used (SC)

51
Q

Chorionic gonadotropin

A

used for infertility; from urine of pregnant women (IM injection); CG secreted by placenta in early stages of pregnancy and binds to LH receptor

52
Q

Actions of progesterones

A

decreases HDL levels and stimulates LDL production, responsible for body temperature increase at ovulation, depressant and hypnotic effects on the brain

53
Q

Uses of Clomiphene and Fulvestrant

A

ovulation induction for infertility in anovulatory women

54
Q

MOA of Clomiphene and Fulvestrant

A

act on Estrogen receptors in the hypothalamus to block feedback inhibition of natural estrogens and stimulate release of GnRH which stimulates pituitary production of LH and FSH causing ovulation

55
Q

Estrogen AE

A

increased risk of stroke via venous thromboembolism - elevated risk in smokers

56
Q

Most effective contraceptive methods

A

IUDs, progestin implants, sterilization

57
Q

Combination pill MOA

A

prevents LH and FSH release by feedback inhibition

58
Q

Contraindications for Combo pill

A

thromboembolic disease, CVA, MI, CAD, HLD, breast cancer, endometrial cancer

59
Q

Minipill MOA

A

low dose progestin which impairs sperm transport by thickening the cervical mucus, decreases motility of ovules in the oviduct and alters endometrum to impair implantation

60
Q

Combo pill benefits

A

raise SHBG, decrease androgens (less hirsutism and acne), treatment of PCOD

61
Q

General oral contraceptive benefits

A

deduced dysfunctional uterine bleeding and dysmenorrhea, menstrual regularity, increased hemoglobin

62
Q

Progestin AE

A

acne and weight gain

63
Q

People who are bad candidates for patch contraceptives

A

obese women because of adipose tissue decreasing drug systemization

64
Q

Transdermal combo contraceptive AE

A

skin irritation, break through bleeding in first 2 cycles

65
Q

Injectable contraceptives

A

progesterone only; injected every 3mo

66
Q

Injectable contraceptives AE

A

amenorrhea common, irregular bleeding, weight gain, HA, decreased bone density, delayed return to fetility - discontinue after 2yrs unless no alternative

67
Q

Implant contraceptives

A

Progesterone only, single rod implanted under skin in upper arm; effective for 3 years

68
Q

Copper IUD

A

copper is spermacidal, effective for 15-20 years; fertility quickly restored after removal; less blood loss, less dysmenorrhea, high initial cost

69
Q

Progestin IUD

A

release rates decreases with time (FDA limit of 5yrs), fertility restored quickly after removal, less bleeding, less dysmenorrhea, high initial cost

70
Q

Copper IUD AE

A

cramping

71
Q

Progestin IUD AE

A

irregular bleeding (6-12mo)

72
Q

Spermicides

A

most common Nonoxynol-9, a surfactant; effective for 1hr, reapplication necessary; must be in contact with cervix

73
Q

Spermicide AE

A

less effective, irritation of vaginal mucosa, toxic shock syndrome

74
Q

Sponge contraceptive

A

barrier containing nonoxynol-9, moisten in water then place over cervix; immediately effective for up to 24hrs, but must remain in place 6hrs after intercourse

75
Q

Emergency contraception

A

used to prevent or delay ovulation; progestins (leonorgestrel) given 2 doses 12hrs apart; best if taken within 72hrs of intercourse

76
Q

Emergency contraception AE

A

n/v, HA, breast tenderness, abdominal pain

77
Q

Mifepristone/Onapristone

A

antiprogestin used to terminate pregnany within 1st 49 days of pregnancy; acts by blocking binding of progesterone to its receptor; onapristone is more pure antagonist

78
Q

Uses of Adrogens

A

replacement for adroen deficient men (IM injection most effective)

79
Q

Danazol

A

Androgen used for treatment of endometriosis and PMS; advantageous because weakly androgenic

80
Q

Oxandrolone

A

anabolic steroid that has less conversion to estrogens and less inhibition of testosterone synthesis

81
Q

AE of anabolic steroids in atheletes

A

lower testosterone levels, decreased libido, decreased spermatogenesis, increased hepatotoxicity, development of CHD

82
Q

Cyprotene acetate MOA

A

competes with DHT for the androgen receptor, prevents translocation into the nuclues

83
Q

Cyprotene acetate uses

A

acne, baldness, hirsutism, virilizing syndrome, inhibition of libido in deviants

84
Q

Precautions with Finasteride

A

should not be touched by pregnant women, absorbed through skin and can cause birth defect in male fetus; men should not donate blood

Reproductive Block (4 decks)

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