Repro Pharm

Question 1

MOA of leuprolide?

Answer 1

GnRH analog with agonist (pulsatile) and antagonist (continuous) properties

Question 2

How does leuprolide work continuously?

Answer 2

Downregulates GnRH receptors in pituitary decreasing FSH/LH

Question 3

Uses of leuprolide?

Answer 3

1) Pulsatile = infertility

2) Continuous = prostate cancer (with flutamide), uterine fibroids, precocious puberty

Question 4

AEs of leuprolide?

Answer 4

Antiandrogen, N/V, hot flashes, mood lability, vaginal dryness (dyspareunia)

Question 5

MOA of testosterone, methyltestosterone?

Answer 5

Agonist at androgen receptors

Question 6

Uses of testosterone?

Answer 6

1) Hypogonadism
2) Promotes secondary sex characteristics
3) Stimulates anabolism for burns or injuries

Question 7

AEs of testosterone?

Answer 7

Masculinization in females, reduces intratesticular testosterone in males causing gonadal atrophy and azoospermia, premature closure of epiphyseal plates

Question 8

What does testosterone do to lipids?

Answer 8

Increases LDL, decreases HDL

Question 9

What are the antiandrogens?

Answer 9

1) Finasteride
2) Flutamide
3) Ketoconazole
4) Spironolactone

Question 10

MOA of finasteride?

Answer 10

5a-reductase inhibitor

Question 11

MOA of flutamide?

Answer 11

Nonsteroidal competitive inhibitor of androgens at testosterone receptors

Question 12

MOA of ketoconazole?

Answer 12

Inhibits steroid synthesis (inhibits 17,20-desmolase)

Question 13

MOA of spironolactone?

Answer 13

Inhibits steroid binding

Question 14

Uses for finasteride?

Answer 14

BPH, male pattern baldness

Question 15

Uses for flutamide?

Answer 15

Prostate cancer

Question 16

Uses for ketoconazole and spironolactone?

Answer 16

Prevent hirsutism in PCOS

Question 17

AEs of antiandrogens?

Answer 17

Gynecomastia galactorrhea, sexual dysfunction

Question 18

Uses for ethinyl estradiol, DES, mestranol?

Answer 18

1) Hypogonadism or ovarian failure
2) Menstrual irregularities
3) HRT in postmenopausal women
4) Androgen-dependent prostate cancer

Question 19

AEs of estrogens?

Answer 19

Endometrial cancer, postmenopausal bleeding, clear cell adeno with DES, thrombosis

Question 20

What are the contraindications of estrogens?

Answer 20

ER+ breast cancer, hx of DVTs

Question 21

MOA of clomiphene?

Answer 21

Partial agonist at ERs in hypothalamus, prevents normal feedback inhibition and increases release of LH/FSH which stimulates ovulation

Question 22

Uses of clomiphene?

Answer 22

Infertility in PCOS

Question 23

AEs of clomiphene?

Answer 23

Hot flashes, ovarian enlargement, multiple simultaneous pregnancies, visual disturbance

Question 24

MOA of tamoxifen?

Answer 24

Antagonist in breast, agonist in endometrium

Question 25

Uses of tamoxifen?

Answer 25

Tx and prevent recurrence of ER+ breast cancer

Question 26

MOA of raloxifene?

Answer 26

Agonist in bone reducing bone resorption–used in osteoporosis

Question 27

Uses for HRT?

Answer 27

1) Relief or prevention of menopausal sxs

2) Osteoporosis

Question 28

AEs of HRT?

Answer 28

Increased risk of endometrial cancer (gotta add progesterone if they have a uterus), possible CV risk

Question 29

Aromatase inhibitors?

Answer 29

Anastrozole, exemstane

Question 30

Uses for aromatase inhibitors?

Answer 30

Postmenopausal women with breast cancer (adjuvant therapy, 2nd line)

Question 31

MOA of progestins?

Answer 31

Reduces growth and increase vascularization of endometrium

Question 32

Uses of progestins?

Answer 32

1) OCPs
2) Endometrial cancer
3) Abnormal uterine bleeding

Question 33

MOA of mifepristone (RU-486)?

Answer 33

Competitive inhibitor of progestins at progesterone receptors

Question 34

Uses of mifepristone?

Answer 34

Termination of pregnancy (with misoprostol)

Question 35

AEs of mifepristone?

Answer 35

Heavy bleeding, GI, abdominal pain

Question 36

MOA of OCPs?

Answer 36

1) Combo inhibits LH/FSH and thus prevents estrogen surge inhibiting ovulation
2) Progestins cause cervical mucus thickening and inhibits endometrial proliferation

Question 37

Contraindications of OCPs?

Answer 37

Smokers >35, hx of TE and stroke, hx of estrogen-dependent tumor, hypertriglyceridiemia, liver dz

Question 38

What do OCPs decrease the risk of?

Answer 38

1) Ovarian tumors

2) Endometrial tumors

Question 39

Terbutaline?

Answer 39

B2-agonist that relaxes uterus to tx premature contractions

Question 40

MOA of tamsuloson?

Answer 40

Alpha-1 blocker to tx BPH and HTN

Question 41

Dinoprostone?

Answer 41

PGE2 agonist that causes cervical softening, dilation, stimulates contractions

Question 42

Misoprostol?

Answer 42

PGE1 agonist that causes cervical softening, stimulates contractions, tx for postpartum hemorrhage or induced abortion

Question 43

MOA of sildenafil and vardenafil?

Answer 43

Inhibits PDE5 causing increase in cGMP, SM relaxation in corpus cavernosum, increasing blood flow

Question 44

AEs of PDE5 inhibitors?

Answer 44

HA, flushing, dyspepsia, impaired blue green vision, risk of life-threatening hypotension with nitrates

Question 45

MOA of danazol?

Answer 45

Synthetic androgen that acts as a partial agonist at androgen receptors, suppresses LF/FSH and ovarian estrogen release (brings about a state of medical menopause)

Question 46

Uses for danazol?

Answer 46

1) Endometriosis

2) Hereditary angioedema

Question 47

AEs of danazol?

Answer 47

Weight gain, edema, acne, hirsutism, masculinization, decreased HDL, hepatotoxicity