Pharm: other drugs

Question 1

Anastrozole/exemestane

Answer 1

Aromatase inhibitors used in postmenopausal women with breast cancer

Question 2

Progestins

Answer 2

Reduces growth and vascularization of endometrium

Use: OCP and endometrial cancer, abnormal uterine bleeding

Question 3

Mifepristone (RU-486)

Answer 3

Competitive inhibitor of progestin at progesteron receptor

Use: termination of preg admin with misoprostol (PGE1)

Toxicity: heavy bleeding, GI effect (nausea, vomiting, anorexia) abd pain

Question 4

OCP (synthetic progestins, estrogen)

Answer 4

Estrogen and progestin inhibit LH/FSH thus
prevent estrogen surge

No estrogen surge -> no LH surge -> no ovulation

1) Progestins cause thickening of cervical mucus; limiting access of sperm to uterus.
2) Progestin also inhibit endmetrial proliferation, making less suitable for implantation

Question 5

OCP contraindications

Answer 5

Smokers >35 yrs of age (due to increased CV risk)
Hx of DVT and stroke
Hx of estrogen dependent tumor

Question 6

Terbutaline

Answer 6

B2 agonist that relaxes smooth muscle;

reduces premature uterine contraction

Question 7

Tamsulosin

Answer 7

A1 antagonist used to treat BPH by inhibiting smooth muscle contraction

Selective for alpha 1A,D receptor (found on prostate) vs. vascular alpha 1b receptor

Question 8

Sildenafil, vardenafil

Answer 8

PDE5 inhibitor, increases cGMP

Smooth muscle relaxation in corpus cavernosum

Question 9

Sildenafil, vardenafil: toxicity

Answer 9

Toxicity: HA, flushing, dyspepsia, impaired blue-green color vision, life-threatening hypotension with nitrate

“Hot and sweat but then headache, heartburn, hypotension”

Question 10

Danazol

Answer 10

Synthetic androgen, partial agonist at androgen receptor

Use: endometriosis and hereditary angiodema

Toxicity: weight gain, edema, acne, hirsuitism, masculinzation, low HDL, hepatotoxicity.