Repro Drugs

Question 1

Leuprolide

Answer 1

• GnRH agonist that works on the AP
• Continous leads to inhibition of AP and is used to treat prostate cancer
• Pulsatile stimulates AP and is used to treat infertility

Question 2

Testosteron

Answer 2

• agonist of AR
• used to increase male secondary sex characteristics
• Used in trauma patients to increase anabolism
• S/E: Testicular atrophy and azoospermia. masculination and hepatotoxicity. Premature closure of epiphyseal plates.

Question 3

Finasteride

Answer 3

• 5 alpha reductase inhibitor
• Used to treat BPH and MPB
• S/E: gynecomastia

Question 4

Flutamide

Answer 4

AR blocker

-Used with leuprolide for chemical castration in prostate cancer

Question 5

Ketocolanazole

Answer 5

• blocks desmolase, which is the rate limiting step in steroid synthesis
• Decreases all steroids, can be used for PCOS masculinization
• S/E: skin color changes (elevated ACTH) amenorrhea, gynecomastia

Question 6

Spironolactone

Answer 6

• Nonsteroidal blocker of steroid receptor

- Used mainly as a potatssium sparing diuretic, but can also be used to treat male S/E of PCOS

Question 7

Estrogens

Answer 7

• HRT, hypogonasism, also given to men in androgen dependent prostate cancer
• S/E: Endometrial hyperplasia, increased risk of breast cancer, thromboembolic events.

Question 8

Clomophine

Answer 8

• SERM that works at hypothalamus to inhibit negative feedback leading to increased gonodotrop release from AP
• Used to stimulate fertility
• May cause twinning+, AP enlargment leading to visual changes, ovarian enlargment

Question 9

Tamoxifen

Answer 9

• SERM that inhibits ER on breast tisseu
• Used for ER positive breast cancer
• S/E: Endometrial hyperplasia and cancer

Question 10

Raloxifen

Answer 10

• SERM with minimal effect on endometrial tissue

- Used to treat menopause associated osteoporosis

Question 11

HRT

Answer 11

• Given as estrogens and progestins
• Treat menopausal symptoms including hot flashes and osteoprosis
• Progestins added to prevent endometrial hyperplasia and carcinoma.

Question 12

Anastrazole, emestane

Answer 12

-Aromatase inhibitors used to treat ER positive breast cancer

Question 13

Mifepristone

Answer 13

• Inhibits Progesterone and glucocorticoid receptor
• Used as an abortifactant, must monitor for success of treatment
• S/E: Abnormal bleeding and abdominal pain

Question 14

OC

Answer 14

• Combination of E and Prog to negatively feedback on AP. Leading to no E surge, no LH surge, and no ovulation.
• Combination to reduce negative sideffects of unoposed estrogen
• Also progeterone increases thickness of cervical mucus and inhibits sperm. Also prevents endometrial growth and impairs embryo implantation
• Contraindicated in smokers 35+, ER positive breast cancer, history of DVT.

Question 15

Terbutaline

Answer 15

• Beta 2 agonist that relaxes smooth muscle

- Used to prevent pre-term contractions

Question 16

Tamsulosin

Answer 16

• Specific inhibitor of alpha1a in bladder. No S/E
• Prazosin and Terazosin have alpha 1 antagonist properties and may be used in patients with HTN. There is risk of orthostatic HTN.

Question 17

Sidenafil/Verdalenfil

Answer 17

• Inhibit PDE leading to increased cGMP and leading to vasodilation and erection. Can also be used in pHTN
• S/E: Deadly hypotension if taken with nitrates. Also can cause headache, flushing, dyspepsia, and blue-green color vision changes.

Question 18

Danazol

Answer 18

• Partial androgen agonist,
• Used to treat endometriosis and hereditery angioedema (AD lack of C1 esterase leading to inflamation and release of bradykinin and vasodilators)
• S/E: masculinization

Question 19

Methyldopa

Answer 19

-Prefered treatment for HTN during pregnancy.