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Pharm > Reproductive/Endocrine > Flashcards

Reproductive/Endocrine Flashcards

1
Q

GnRH analog with agonist properties when used in pulsatile fashion; antagonist
properties when used in continuous fashion
(downregulates GnRH receptor in pituitary
􀁰that decreases 􀁲 FSH/LH).

A

Leuprolide

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2
Q

What drug causes transient increase in pituitary LH secretion; which leads to a rise in testosterone levesl; continuous use will suppress LH release and leads to a decrease in testosterone levels

A

Leuprolide

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3
Q

Antagonist at estrogen receptors in hypothalamus. Prevents normal feedback inhibition and
increases􀁱 release of LH and FSH from pituitary, which stimulates ovulation

A

clomiphene

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4
Q

Antagonist at breast; agonist at bone, uterus; increased􀁱 risk of thromboembolic events and endometrial
cancer.

A

tamoxifen

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5
Q

Antagonist at breast, uterus; agonist at bone; increased risk of thromboembolic events but no increased risk
of endometrial cancer (

A

raloxifene

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6
Q

Anastrozole, letrozole, exemestane are examples of:

A

aromatase inhibitors

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7
Q

Inhibit peripheral conversion of androgens to estrogen.

A

aromatase inhibitors

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8
Q

Used for relief or prevention of menopausal symptoms (eg, hot flashes, vaginal atrophy),
osteoporosis ( increased estrogen, decreased􀁲 osteoclast activity).

Unopposed estrogen replacement therapy ; increased 􀁱 risk of endometrial cancer, so progesterone is added.

Possible increased cardiovascular risk.

A

hormone replacement therapy

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9
Q

Agonists at androgen receptors

A

testosterone, methyltestosterone

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10
Q

5α-reductase inhibitor (􀁲decreases conversion of
testosterone to DHT).

Used for BPH and malepattern
baldness.

A

Finasteride

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11
Q

Inhibits steroid binding, 17α-hydroxylase, and

17,20-desmolase.

A

Spironolactone

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12
Q

Inhibits steroid synthesis (inhibits

17,20-desmolase).

A

Ketoconazole

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13
Q

Nonsteroidal competitive inhibitor at androgen

receptors. Used for prostate carcinoma.

A

Flutamide

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14
Q

α1-antagonist used to treat BPH by inhibiting smooth muscle contraction. Selective for α1A,D receptors (found on prostate) vs vascular α1B receptors.

A

tamsulosin

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15
Q

Direct arteriolar vasodilator.

A

minoxidil

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16
Q

used to treat androgenic alopecia

A

minoxidil

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17
Q

Sildenafil, vardenafil, tadalafil are examples of:

A

phosphodiesterase type 5 inhibitors

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18
Q

Inhibit PDE-5 which increases􀁱 cGMP and causes􀁰 prolonged
smooth muscle relaxation in response to NO which increases􀁱 blood flow in corpus cavernosum of penis,
and decreases pulmonary vascular resistance.

A

phosphodiesterase type 5 inhibitors

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19
Q

Risk of life threatening hypotension in patients taking nitrates

A

phosphodiesterase type 5 inhibitors

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20
Q

Synthetic androgen that acts as partial agonist at androgen receptors.

A

danazol

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21
Q

MC SE of danazol

A

decreased HDL levels and hepatoxicity

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22
Q

β2-agonists that relax the uterus; used to decrease 􀁲 contraction frequency in women during labor.

A

terbutaline, and ritodrine

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23
Q

Produces local inflammatory reaction toxic to sperm and ova, preventing fertilization and implantation; hormone free.

A

copper IUD

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24
Q

Estrogen and progestins inhibit LH/FSH and thus prevent estrogen surge. No estrogen surge 􀁰 no
LH surge 􀁰 no ovulation.

A

Combined contraception

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25
Q

Competitive inhibitors of progestins at progesterone receptors.

A

Mifepristone, ulipristal

**Termination of pregnancy (mifepristone with misoprostol); emergency contraception (ulipristal)

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26
Q

Bind progesterone receptors, 􀁲 decreased growth and 􀁱 increased vascularization of endometrium, thicken cervical
mucus.

A

progestins (Levonorgestrel, medroxyprogesterone, etonogestrel, norethindrone, megestrol, and many others
when combined with estrogen)

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27
Q

MOA: work by suppressing pituitary LH secretion and subsequently decreasing ovarian androgen production.

A

Oral contraceptives

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28
Q

inhibition of phospholipase A2, and inhibition of

transcription factors such as NF-κB.

A

glucocorticoids

29
Q

Sensitizes Ca2+-sensing receptor (CaSR) in parathyroid gland to circulating Ca2+ which decreases 􀁲 PTH.

A

cinacalcet

30
Q

Synthetic analog of aldosterone with little glucocorticoid effects.

A

fludrocortisone

31
Q

ADH antagonist (member of tetracycline family)

A

democycline

32
Q

Propylthiouracil (PTU), methimazole are examples of

A

Thionamides

33
Q

Inhibit oxidation of iodine to iodine by thyroid peroxidase

A

Thionamides

34
Q

Inhibit iodination of tyrosyl resides (organification) on thyroglobulin to form MIT and DIT

A

Thionamides

35
Q

Inhibiting coupling of MIT and DIT to form T3 and T4

A

Thionamides

36
Q

Inhibit proteolytic release of T3 and T4 from thyroglobulin

A

High doses of iodide

37
Q

inhibit conversion fo T4 to T3 via 5` deiodinase in peripheral tissues

A

Propranolol and Propylthiouracil (PTU)

38
Q

Acromegaly, carcinoid syndrome, gastrinoma, glucagonoma, esophageal varices.

A

Somatostatin analog (octreotide)

39
Q

What is a multifunctional enzyme responsible for catalyzing the oxidation of iodide, the iodination of thyroglobulin and the coupling reaction between 2. iodized tyrosine residues?

A

thyroid peroxidase

40
Q

What removes the iodine groups from MIT and DIT for recycling?

A

iodotyrosine deiodinase

41
Q

uptake of iodide from the blood is an energy dependent process carried out by?

A

the na-iodide symporter ; TSH stimulates this uptake and competitively inhibited by perchlorate and pertechnetate

42
Q

What drug is 40% iodide by weight, thus can cause a number of alterations to thyroid function? IT can cause hypothyroidism due to decreased production of thyroid hormone. or hyperthyroidism by increasing thyroid hormone synthesis or destructive thyroiditis

A

Amiodarone

43
Q

decrease androgen aromatization

A

aromatase inhibitors

44
Q

decrease androgen synthesis

A

ketoconazole

45
Q

decreased follicular cell stimulation

A

continuous GnRH stimulation by long acting GnRH analogs (ex. goserelin) suppresses LH and FSH release;d creating production of estrogens in the ovarian follicle.

46
Q

decrease thyroid hormone synthesis by inhibiting thyroid peroxidase

A

PTU and methimazole

47
Q

The most likely biochemical target of pioglitazone is:

A

intracellular nuclear receptor

48
Q

Which selective estrogen receptor modulator inhibits the effects of estrogen on breast tissue and is effective for prevention and treatment of gynecomastia in patients on ADT?

A

Tamoxifen

49
Q

The glucose lowering effects of TZDs requires __________________and protein synthesis, it takes several days to a few weeks after commencing TZd to observe significant results

A

alteration in gene transcription AKA transcription modulation

50
Q

Glucocorticoids cause an increase in what organ’s protein synthesis ?

A

Liver protein synthesis ; by increasing hepatic glycogenesis and gluconeogenesis

51
Q

An increase in estrogen activity (raises or lowers) circulating ____ levels?

A

raises circulating TBG levels; so there will be an increased total T4 pool.

52
Q

impairs ligand receptor binding?

A

flutamide

53
Q

Decreased leydig cell stimulation by LH

A

leuprolide, goserelin, nafarelin, histrelin

54
Q

Decrease synthesis of testosterone in the leydig cells of the testis

A

ketoconazole

55
Q

Decreased peripheral androgen aromatization occurs with

A

aromatase inhibitors

56
Q

3 parts to Hyperthyroidism treatment

A

Antithyroid drugs, radioactive iodine, surgical thyroidectomy

57
Q

PTU and methimazole are associated with what SE?

A

agranulocytosis (absolute neutrophil count less than 500/mL

58
Q

Check wbc count with differential for what antithyroid drugs?

A

PTU and methimazole * in patient that present with fever

59
Q

Administration of what may prevent thyroid absorption of radioactive iodine isotopes by competitive inhibition?

A

Potassium iodide

60
Q

anion inhibitors (perchlorate and pertechnetate) work by?

A

blocking iodide absorption by the thyroid gland via competitive inhibition

61
Q

Thionamides (methimazole and PTU) work by?

A

decrease the formation of thyroid hormones by inhibiting thyroid peroxidase

62
Q

iodide salts work by?

A

inhibiting synthesis as well as release of thyroid hormones

63
Q

What occurs as a result of increased testosterone secretion or increased conversion of testosterone to DHT?

A

Hirsutism

64
Q

What drug has anti-androgenic properties and is used to treat hirsutism?

A

spironolactone

65
Q

Also, used to rx hirsutism are?

A

flutamide and finasteride

66
Q

What is a GnRH agonist that causes first a transient increase then a decrease in both testosterone and DHT levels?

A

Leuprolide

67
Q

What causes a discordant decease in DHT level?

A

finasteride

68
Q

Mifepristone is an example of a?

A

anti-progestin

Pharm (9 decks)

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