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Boards > Repro Pharm > Flashcards

Repro Pharm Flashcards

1
Q

Which drugs cause gynecomastia?

A 
Some Drugs Cause Awkward Knockers:
Spironolactone 
Digoxin
Cimetidine
Alcohol 
Ketoconazole
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2
Q

What is leuprolide?

A

GnRH analog with agonist properties when used in pulsatile
fashion
Antagonist when given continuously

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3
Q

What is leuprolide used for?

A 
Infertility (pulsatile)
Prostate cancer (continuous - use with flutamide)
Uterine fibroids (continue)
Precocious puberty (continuous)
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4
Q

What are the side effects of leuprolide?

A

Antiandrogen
Nausea
Vom

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5
Q

What is testosterone used for?

A

Hypogonadism
Promotion of secondary sex characteristics
Stimulation of anabolism after burns or injury

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6
Q

What are the side effects of testosterone?

A 
Masculinization in females
Inhibits LH in males so gonadal atrophy
Premature closure of epiphyseal plates 
Increases LDL
Decreases HDL
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7
Q

What is finasteride?

A

A five alpha reductase inhibitor

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8
Q

What is finasteride used for?

A

Male pattern baldness

benign prostatic hypertrophy

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9
Q

What is flutamide?

A

A nonsteroidal competitive inhibitor of androgens at the testosterone receptor

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10
Q

What is flutamide used for?

A

Prostate cancer

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11
Q

What are the side effects of finasteride?

A

ED

Hirsutism

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12
Q

What is the drawback of finasteride?

A

It takes 6 months for the full effect

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13
Q

What is saw palmetto?

A

A 5 alpha reductase inhibitor and androgen receptor blocker

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14
Q

What is the MOA of ketoconazole?

A

Inhibits steroid synthesis (17,20 desmolase - present in theca cells)

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15
Q

What is ketoconazole used for?

A

PCOS

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16
Q

What are the side effects of spironolactone and ketoconazole?

A

Gynecomastia

Amenorrhea

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17
Q

What is the MOA of spironolactone?

A

Inhibits steroid binding

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18
Q

What are estrogens used for?

A 
Hypogonadism 
Ovarian failure
Menstrual abnormalities
HRT in post meno women
And prostrate cancer
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19
Q

What are the side effects of estrogen therapies?

A

Increased risk of endometrial cancer
Bleeding in post meno
Clear cell adenocarcinoma of vagina in women exposed to DES
Increased risk of thrombi

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20
Q

What are the contraindications to using estrogen?

A

Hx of DVT

ER positive breast cancer

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21
Q

What are the selective estrogen receptor modulators?

A

Clomiphene
Tamoxifen
Raloxifene

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22
Q

What is clomiphene?

A

Partial agonist at estrogen receptors in hypothalamus
Prevents normal feedback inhibition
Increases LH and FSH from pituitary to stimulate ovulation.

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23
Q

What is clomiphene used for?

A

Infertility

PCOS

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24
Q

What are the side effects of clomiphene?

A

Hot flashes
Ovarian enlargement
Multiple simultaneous pregnancies
Visual disturbances

25
Q

What is tamoxifen?

A

Antagonist of estrogen receptors at breast tissue and partial agonist at endometrium
Used to treat ER positive breast cancer

26
Q

What is raloxifene?

A

Agonist of estrogen receptors on bone –> decreases resorption of bone

27
Q

What is HRT?

A

For relief and prevention of meno sx and osteoporosis (increase estrogen and decrease osteoclasts activity)

28
Q

What is the risk of unopposed estrogen therapy?

A

Increased risk of endometrial cancer and CV risk

29
Q

What is anastrozole/exemesrane?

A

Aromatase inhibitors used in post meno women with breast cancer

30
Q

What are progestins used for?

A

OC
Tx of endometrial cancer and abnormal uterine bleeding
Causes reduced growth and vascularization of endometrium

31
Q

What is mifepristone?

A

An abortifacient - competitive inhibitor of progesterone receptors.
The anti-progestin effects cause release of endogenous prostaglandins and sensitize the myometrium to the effects of the hormone

32
Q

What is the side effect of mifepristone?

A

Heavy bleeding
N/V
Anorexia
Ab pain

33
Q

What is misoprostol?

A

PGE1

34
Q

How do OCs work?

A

Inhibit LH/FSH surge via negative feedback so there is no ovulation.
Progestins cause thickening of cervical mucus so limits sperm access, inhibit endometrial proliferation so it is less accepting of implantation

35
Q

What are the contraindications for OCs?

A

Smoking over age 35
Hx of thromboembolism or stroke
Hx of estrogen dependent tumor

36
Q

What is terbutaline?

A

B2-agonist that relaxes uterus - tocolysis

37
Q

What is tamsulosin?

A

Alpha-1 antagonist used for BPH

Selective for 1AD receptors in the prostate

38
Q

What are the normal side effects of alpha blockers?

A

Reflex tachycardia
Syncope
Ortho static hypotension
Asthenia

39
Q

What are the side effects of tamsulosin?

A

Ejaculation problems
Nasal stuffiness
Asthenia
Does not cause orthostatic hypotension

40
Q

What is the MOA of sildenafil?

A

Inhibit phosphodiesterase 5 causing an increase in cGMP, smooth muscle relaxation in corpus cavernosum

41
Q

What are the side effects of sildenafil?

A

Headache
Flushing
Dyspepsia
Impaired blue-green color vision

42
Q

What are the contraindications for afils?

A

Patients with angina on nitrates

Alpha blockers for BPH

43
Q

What is danazol?

A

Synthetic androgen that acts as a partial agonist

44
Q

What is danazol used for?

A

Endometriosis

Hereditary angioedema

45
Q

What are the side effects of danazol?

A 
Weight gain
Edema
Acne
Hirsutism
Masculinization 
Decrease HDL
Hepatotoxicity
46
Q

Exogenous testosterone effects?

A

inhibits HPG axis = dec intratesticular testosterone = dec testicular size = azoospermia

47
Q

How do you treat 5-alpha-reductase deficiency?

A

DHT

48
Q

How do you treat hydatidiform mole?

A

Methotrexate

D&C

49
Q

How do you treat Preeclampsia & Eclapsia?

A

IV magnesium sulfate
(both prevent & treat seizures)
bed rest, monitor, dec Na intake, tx HTN (methyldopa)
deliver fetus as soon as viable

50
Q

How do you treat endometritis?

A

gentamycin + clindamycin

may add ampicillin

51
Q

How do you treat endometriosis?

A

Oral contraceptives
Leuprolide
Danazol
NSAIDs

52
Q

How do you treat Adenomyosis?

A

Hysterectomy

53
Q

What are the treatment strategies for PCOS?

A

Medroxyprogesterone (dec LH & androgenesis) or low dose-OCPs
Spironolactone (tx acne & hirsutism)
Clomiphene (stimulates ovulation – if want to get pregnant)
Metformin (+DM or metabolic syndrome)
weight reduction

54
Q

What is the treatment for BPH?

A

alpha1- antagonists = terazosin & tamulosin
(cause relaxation of smooth muscle)
finasteride (inhibits production of DHT from Testosterone)

55
Q

What are the effects of leuprolide in the use of prostate cancer?

A

It decreases circulating levels of testosterone by decreases LH release from the pituitary.
Less LH influence on the Leydig cells results in less testosterone production

56
Q

What are the side effects of terbutaline?

A

Neonatal intraventricular hemorrhage
Hypoglycemia
Hypocalcemia
Ileus

57
Q

What may cause blindness and retinal neovascularizatiom in a neonate?

A

Positive end expiratory pressure used for ARDS

58
Q

What are the complications of surfactant treatment?

A

Transient hypoxia and hypotension
Blockage of endotracheal tube
Pulmonary hemorrhage

59
Q

What is the clinical use of mifepristone?

A

Used for abortions up to 49 days after conception.

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