Repro

Question 1

leuprolide

Answer 1

gnRH analog: agonist when pulsed, antag continuous (decreases fsh, lh)

Question 2

leuprolide uses:

Answer 2

pulsed/analog: infertility

continuous: prostate ca (with flutamide), uterine fibroids, precocious puberty

Question 3

leuprolide: tox

Answer 3

antiandrogen, n&V

Question 4

(methyl)testosterone)

Answer 4

agonist @ androgen R, Rx for hypogonadism, promotion of secondary sex characteristics, stimulates anabolism post surgery/burn/injury

Question 5

(methyl)testosterone): tox

Answer 5

masculization in females, intratesticular testos decrease (inhibits LH release) so atrophy, premature closure of epiphyseal plates. increase LDH, decrease HDL

Question 6

finasteride

Answer 6

5-a-reductase inhibitor (less conversion of testos to DHT). for BPH, male pattern baldness, encourages female breasts

Question 7

flutamide

Answer 7

nonsteroid, competitive inhib androgens @ testost R. for prostate CA

Question 8

ketoconazole

Answer 8

inhibits steroid synthesis (inhibits 17,20 desmolase)

Question 9

spironolactone

Answer 9

inhibits steroid binding

Question 10

keto and spiro

Answer 10

PCOS for preventing hirsutism. tox: gynecomastia, amenorrhea

Question 11

estrogens (binds estrogen R)

Answer 11

DES, mestranol, ethinyl estradiol

Question 12

estrogens: uses

Answer 12

hypogonadism, ovarian failure, menstrual abnormalities, HRT (postmenopausal), adrogen-dependent prostate ca

Question 13

estrogens: tox

Answer 13

increased risk of endometrial ca (so add progesterone for HRT) & thrombi, bleeding (postmenopausal chics), cell cell adenoCa vagina (DES in utero)

Question 14

estrogens: contraindic

Answer 14

ER positive breast Ca, Hx of DVTs

Question 15

HRT

Answer 15

relieves hot flashes, vag atrophy, OP (increases estrogen, decreases osteoclasts)

Question 16

HRT

Answer 16

possible increased CV risk

Question 17

anastrozole/exemestane

Answer 17

aromatase inhibitors used in postmenopausal women with breast Ca

Question 18

progestins (binds progest Rs)

Answer 18

reduces growth and increases vasc of endometrium

Question 19

progestins

Answer 19

OCPs, Rx endometrial Ca, abnormal uterine bleeding

Question 20

mifepristone (RU-486)

Answer 20

competitive inhib of progestins (@ R), abortion when given with misopristol (PGE1 inhib)

Question 21

mifepristone (RU-486): tox

Answer 21

heavy bleeding, GI (abdo pain, n&v, anorexia)

Question 22

OCP

Answer 22

inhibits LH/FSH so no estrogen surge so (no LH surge so no ovulation)

Question 23

OCP: contra

Answer 23

smokers, over 35 (cardio risk), VTE/stroke/estrogen dependent tumor

Question 24

terbutaline

Answer 24

b2 agonist relaxes uterus, reduces premature uterine contractions

Question 25

tamsulosin

Answer 25

a1A,D (on prostate, vs vascular a1b Rs) ANtagonist for BPH (inhbits smooth musc contraction)

Question 26

sildenafil, vardenafil:

Answer 26

inhib PDE5, increases cGMP, smooth musc relaxes in corpus cavernosum, increase blood flood, erection

Question 27

sildenafil, vardenafil: tox

Answer 27

impaired blue-grn vision, headache, heartburn/dyspepsia, hypotension (in pts taking nitrates), flushing

Question 28

danazol

Answer 28

synth androgen, partial agonist @ R, for endometriosis, hereditary angioedema

Question 29

danazol tox

Answer 29

weight gain/edema, acne/hirsutism/masculinization, decreased HDL, hepatotox

Question 30

clomiphene: mech

Answer 30

partial agonist estrogen Rs (hypothalamus), increases release of LH, FSH since no normal feedback inhib –> ovulation

Question 31

clomiphene: Rx

Answer 31

infertility, PCOS

Question 32

clomiphene: tox

Answer 32

hot flashes, enlarged ovaries, multiple simultaneous pregs, visual disturbances

Question 33

tamoxifen

Answer 33

estrogen antag on breast tissue, Rx: ER+ breast Ca

Question 34

raloxifene

Answer 34

estrogen agonist bone, reduces resorption of bone. Rx OP