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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
Everolimus BBW
risk of opportunistic infections - neoplasia; lymphoma/SCC
26
Everolimus AE
non-infectious pneumonitis, blood dyscrasias, hyperglycemia, hyperlipidemia, hypertriglyceridemia, elevated creatinine and LFTs
27
Treatment of triple negative Breast Cancer with lymph node positive
adjuvant anthracycline and Taxane-based chemotherapy
28
Standard Adjuvant chemotherapy regimens for breast cancer
cyclophosphamide/doxorubicin +/- taxol, fluorouracil, docetaxel; docetaxel/cyclophosphamide
29
Medroxyprogesterone MOA
used for endometrial cancer; binds to progestin receptors and block GnRH release
30
Medroxyprogesterone AE
amenorrhea, edema, anorexia, weakness
31
Megestrol MOA
used for endometrial cancer or breast cancer; suppresses pituitary LH release and enhances estrogen degradation, promoting differentiation/maintenance of endometrial tissue
32
Megestrol AE
weight gain, hot flashes, malaise, asthenia, lethargy, tumor flare and hypercalcemia in BC pts with bony metastases, thrombophlebitis, thrombo or pulm embolism
33
Increased risk due to HRT
coronary heart disease, invasive breast cancer, stroke, PE. gallbladder disease, dementia, urinary incontinence
34
Decreased risk due to HRT
hip fractures, diabetes, vasomotor symptoms
35
Contra for HRT
abnormal genital bleeding, BC, estrogen dependent neoplasia, clotting disorders, stroke, MI, pregnancy
36
Non-hormonal therapies for menopause
Paroxetine (FDA approved), Fluoxetine, Escitalopram, Venlafaxine, Clonidine, Gabapentin
37
Most effective treatment for vasomotor symptoms and urogenital atrophy
estrogen +/- progestogen
38
Benefit of transdermal estrogen
avoids first pass hepatic metabolism thus deceased the amount of factor IX clotting factor created
39
Bazedoxifene
combination of estrogens and SERM which act as a agonist in some estrogen sensitive tissues and antagonist in the uterus - reduces endometrial overgrowth
40
Drugs used to induce labor
Oxytocin (Pitocin), Dinoprostine (PGE2), Misoprostol (PGE1), Carboprost tromethamine (15methylPGF2)
41
Drugs used to delay labor
Tocolytics - Magnesium Sulfate, Indomethacin; OTC - Caster Oil, Cohosh, Evening Primrose
42
Uses of Oxytocics
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
Uses of tocolytic agents
delay or prevent premature parturition or slow/arrest delivery so that therapeutics such as glucocorticoids to increase fetal surfactant can be given
44
Uses of Gonadtropins
female infertility, male infertility due to hypogonadism, in vitro fertilization
45
Estrogen drugs
ethinyl estradiol, mestranol, estrogen esters
46
Progestin Drugs
Norethindrone, Norgestrel, Levorgestrel
47
Antiestrogens
clomiphene, fulvestrant
48
Antiprogestins
Mifepristone, Onapristone
49
Androgen receptor antagonists
flutamide, bicalutamide
50
Menotropin
used for infertility; from urine of postmenopausal women, contains FSH and LH (IM injection); recominant FSH is also used (SC)
51
Chorionic gonadotropin
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
Actions of progesterones
decreases HDL levels and stimulates LDL production, responsible for body temperature increase at ovulation, depressant and hypnotic effects on the brain
53
Uses of Clomiphene and Fulvestrant
ovulation induction for infertility in anovulatory women
54
MOA of Clomiphene and Fulvestrant
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
Estrogen AE
increased risk of stroke via venous thromboembolism - elevated risk in smokers
56
Most effective contraceptive methods
IUDs, progestin implants, sterilization
57
Combination pill MOA
prevents LH and FSH release by feedback inhibition
58
Contraindications for Combo pill
thromboembolic disease, CVA, MI, CAD, HLD, breast cancer, endometrial cancer
59
Minipill MOA
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
Combo pill benefits
raise SHBG, decrease androgens (less hirsutism and acne), treatment of PCOD
61
General oral contraceptive benefits
deduced dysfunctional uterine bleeding and dysmenorrhea, menstrual regularity, increased hemoglobin
62
Progestin AE
acne and weight gain
63
People who are bad candidates for patch contraceptives
obese women because of adipose tissue decreasing drug systemization
64
Transdermal combo contraceptive AE
skin irritation, break through bleeding in first 2 cycles
65
Injectable contraceptives
progesterone only; injected every 3mo
66
Injectable contraceptives AE
amenorrhea common, irregular bleeding, weight gain, HA, decreased bone density, delayed return to fetility - discontinue after 2yrs unless no alternative
67
Implant contraceptives
Progesterone only, single rod implanted under skin in upper arm; effective for 3 years
68
Copper IUD
copper is spermacidal, effective for 15-20 years; fertility quickly restored after removal; less blood loss, less dysmenorrhea, high initial cost
69
Progestin IUD
release rates decreases with time (FDA limit of 5yrs), fertility restored quickly after removal, less bleeding, less dysmenorrhea, high initial cost
70
Copper IUD AE
cramping
71
Progestin IUD AE
irregular bleeding (6-12mo)
72
Spermicides
most common Nonoxynol-9, a surfactant; effective for 1hr, reapplication necessary; must be in contact with cervix
73
Spermicide AE
less effective, irritation of vaginal mucosa, toxic shock syndrome
74
Sponge contraceptive
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
Emergency contraception
used to prevent or delay ovulation; progestins (leonorgestrel) given 2 doses 12hrs apart; best if taken within 72hrs of intercourse
76
Emergency contraception AE
n/v, HA, breast tenderness, abdominal pain
77
Mifepristone/Onapristone
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
Uses of Adrogens
replacement for adroen deficient men (IM injection most effective)
79
Danazol
Androgen used for treatment of endometriosis and PMS; advantageous because weakly androgenic
80
Oxandrolone
anabolic steroid that has less conversion to estrogens and less inhibition of testosterone synthesis
81
AE of anabolic steroids in atheletes
lower testosterone levels, decreased libido, decreased spermatogenesis, increased hepatotoxicity, development of CHD
82
Cyprotene acetate MOA
competes with DHT for the androgen receptor, prevents translocation into the nuclues
83
Cyprotene acetate uses
acne, baldness, hirsutism, virilizing syndrome, inhibition of libido in deviants
84
Precautions with Finasteride
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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