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USMLE - Pharmacology > Reproductive > Flashcards

Reproductive Flashcards

1
Q

Danazol: Mechanism

A

Partial agonist of androgen receptor

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2
Q

Danazol: Use (2)

A
  1. Endometriosis

2. Hereditary angioedema

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3
Q

Danazol: Side effect (7)

A 
Masculinization
Hirsutism
Decreased HDL levels
Edema
Weight gain
Acne
Hepatotoxicity
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4
Q

Sildenafil, Vardenafil: Mechanism

A

Inhibits phophodiesterase 5, causing increased cGMP, smooth muscle relaxation in corpus cavernosum, increased blood flow and penile erection

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5
Q

Sildenafil, Vardenafil: Use

A

Erectile dysfunction

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6
Q

Sildenafil, Vardenafil: Side effects (5)

A 
Headache
Flushing
Dyspepsia
Impaired blue-green color vision
Life-threatening hypotension (with nitrates)
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7
Q

Tamsulosin: Mechanism

A

alpha-1 antagonist inhibiting smooth muscle contraction

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8
Q

Why is tamsulosin unique as an alpha-1 antagonist

A

Selective for alpha 1A,D receptors on prostate

Vascular receptors = 1B

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9
Q

Tamsulosin: Use

A

BPH

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10
Q

Terbutaline: Mechanism

A

Beta-2 agonist -> uterine relaxation

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11
Q

Terbutaline: Use

A

Reduce premature uterine contraction

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12
Q

Oral contraception: Estrogen and progestin mechanism

A

Inhibit LH/FSH and prevent estrogen surge (no LH surge = no ovulation)

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13
Q

Oral contraception: Progestin mechanism (2)

A

Thickening of cervical mucus, preventing access of sperm to uterus

Inhibit endometrial proliferation - less suitable for implantation

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14
Q

Who should not take oral contraceptives (3)?

A

Smokers > 35 yo (Increased cardiovascular events)
History of thromboembolism or stroke
History of estrogen-dependent tumor

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15
Q

Mifepristone: Mechanism

A

Competitive progestin receptor antagonist

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16
Q

Mifepristone: Use

A

Termination of pregnancy

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17
Q

What is administered with mifepristone for termination of pregnancy?

A

Misoprostol (PGE1)

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18
Q

Mifepristone: Side effects (2)

A

Heavy bleeding

GI (abdominal pain, nausea, vomiting, anorexia)

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19
Q

Progestins: Use (2)

A

Oral contraceptives

Treatment of endometrial cancer and abnormal uterine bleeding

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20
Q

Anastrozole: Mechanism

A

Aromatase inhibitor

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21
Q

Exemestane: Mechanism

A

Aromatase inhibitor

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22
Q

Aromatase inhibitor: Use

A

Postmenopausal women with breast cancer

23
Q

Hormone replacement therapy: Use (2)

A

Relief or prevention of menopausal symptoms

Osteoporosis

24
Q

Estrogen replacement therapy: Side Effects

A

Risk of endometrial cancer

Possible CV risk

25
Q

Clomiphene: Mechanism

A

SERM
Partial agonist at ER in hypothalamus
Prevents normal feedback inhibition and increases release of LH and FSH from pituitary, stimulating ovulation

26
Q

Clomiphene: Use (2)

A

Infertility

Polycystic ovarian syndrome

27
Q

Clomiphene: Side Effects (4)

A

Hot flashes
Ovarian enlargement
Multiple simultaneous pregnancies
Visual disturbances

28
Q

Tamoxifen: Mechanism

A

SERM

Agonist on breast tissue

29
Q

Tamoxifen: Use

A

Treat and prevent recurrence of ER+ breast cancer

30
Q

Raloxifene: Mechanism

A

SERM

Agonist on bone, reduces resorption ofbone

31
Q

Raloxifene: use

A

Osteoporosis

32
Q

Ethinyl estradiol: Family

33
Q

DES: Family

34
Q

Mestranol: Family

35
Q

Estrogens: Use (4)

A

Hypogonadism or ovarian failure
Menstrual abnormalities
HRT in postmenopausal women
Androgen-dependent PC in men

36
Q

Estrogens: Side effects (3)

A

Endometrial cancer
Bleeding in postmenopausal women
Risk of thrombi

37
Q

Who should not take estrogens? (2)

A

ER+ breast cancer

History of DVTs

38
Q

DES: Side effects

A

Clear cell adenocarcinoma of vagina in females exposed in utero

39
Q

Finasteride: Mechanism

A

5alpha-reductase inhibitor

Decrease conversion of testosterone to DHT

40
Q

Finasteride: Use (2)

A

BPH

Male pattern baldness

41
Q

Flutamide: Mechanism

A

Nonsteroidal competitive androgen antagonist

42
Q

Flutamide: Use

43
Q

Ketoconazole: Mechanism

A

Inhibits steroid synthesis (17, 20-desmolase)

44
Q

Ketoconazole: Use

A

polycystic ovarian syndrome (hirsutism)

45
Q

Ketoconazole: Side effects (2)

A

Gynecomastia

Amenorrhea

46
Q

Spironolactone: Mechanism (Repro)

A

Inhibits steroid binding

47
Q

Spironolactone: Use (Repro)

A

Polycystic ovarian syndrome (hirsutism)

48
Q

Spironolactone: Side effects (2)

A

Gynecomastia

Amenorrhea

49
Q

Testosterone, methyltestosterone: Family

50
Q

Androgens: Use (2)

A

Hypogonadism/2nd sex characteristic development

Anabolism to promote recovery after burn or injury

51
Q

Androgens: Side effects (5)

A 
Masculinization in females
Gonadal atrophy
Premature closure of epiphyseal plates
Increased LDL
Decreased HDL
52
Q

Leuprolide: Mechanism

A

GnRH analog
Pulsatile: agonist
Continuous: antagonist

53
Q

Leuprolide; Use (4)

A

Pulsatile: Infertility
Continuous: PC, uterine fibroids, precocious puberty

54
Q

Leuprolide: Side effects (3)

A

Antiandrogen
Nausea
Vomiting

USMLE - Pharmacology (6 decks)

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