Reproductive pharm

Question 1

what is the most potent form of endogenous estrogen in women?

Answer 1

estradiol

Question 2

how is estrogen transported in the blood?

Answer 2

bound to albumin and sex binding hormone (they are later broken down by the liver to inactive compounds and excreted in urine)

Question 3

what is the most important therapeutic benefit of HRT?

Answer 3

estrogen decreases resorption of bone and thus blunts the process of osteoporosis.

• it can also assist with sleep quality in post-menopausal women

Question 4

Increased risks with HRT?

Answer 4

Stroke and blood clots

decreased risk of fractures

Question 5

are bio-identical hormones considered synthetic?

Answer 5

yes, they are. They just look similar to the ones produced by the body.

Question 6

What is the hormone ratio of BiEst?

Answer 6

80:20 ratio of estriol (E3) to estradiol (E2)

Question 7

What is the hormone ratio of TriEst?

Answer 7

most commonly found in a ratio of 80: 10: 10, estriol (E3), estradiol (E2) and estrone (E1).

Question 8

What is the source of premarin

Answer 8

obtained from the urine of pregnant mares is a preparation of conjugated estrogens – estrone and equillin.

Question 9

when is premarin indicated?

Answer 9

for prevention and treatment of osteoporosis and of post-menopausal symptoms such as hot flashes, vaginal dryness and itching.

can be used in women who has not undergone hysterectomy. Do not use in pregnant women.

Question 10

MOA of premarin?

Answer 10

Alters gene transcription.

Question 11

Side effects of premarin?

Answer 11

breast pain, increased breast size, palpitations, fever, hives, hoarseness, joint pain, stiffness or swelling, rash, redness of skin, shortness of breath, wheezing, edema and weight gain…..etc.

Question 12

What pregnancy category are conjugated estrogens/Premarin?

Answer 12

Category X

also CI in prior hx of DVT or breast/ovarian/urine cancer

Question 13

what class is Medroxyprogesterone/Provera?

Answer 13

synthetic variant of progesterone (progestin)

Question 14

when is provera indicated?

Answer 14

Contraceptive, hormone replacement therapy, dysfunctional uterine bleeding and treatment of endometriosis.

Question 15

MOA of provera?

Answer 15

alters gene transcription

Question 16

Why is the progestin component added to HRT?

Answer 16

to prevent the development of endometrial hyperplasia and endometrial cancer.

Question 17

What is the Depo form of provera?

Answer 17

I.M.

Question 18

what are the functions of estrogen and progestin in oral contraceptives?

Answer 18

The estrogen component suppresses ovulation while the progestin prevents implantation in the endometrium and helps to make the cervical mucus impenetrable to sperm.

Question 19

what is the most commonly used estrogen? progestin?

Answer 19

ethinyl estradiol, Norgestrel

Question 20

what are the benefits of oral contraceptives?

Answer 20

reduce the risk of colorectal cancer, improves conditions such as PID, dysmenorrhea, PMS, and acne.

May reduce sx of endometriosis, **PCOS, and decrease anemia.
(PCOS- start on insulin, lowing sugar might be what the pts needs!)

Question 21

Risks/side effects with oral contraceptives?

Answer 21

Increased risk for cardiovascular disease, DVT, hypertension and stroke (especially in women who smoke or who are over 35 years of age. Other side effects include acne, depression, headache, edema, nausea and breast fullness.

Question 22

What is the MOA of testosterone

Answer 22

alteration of gene transcription

Question 23

What is the administration route for testosterone

Answer 23

injectable, PO, Sub-lingual, transdermal patches, gels, creams

Question 24

What is the deal with anabolic steroids

Answer 24

They are synthetic derivatives of testosterone that have far stronger anabolic effects than androgenic effects

Question 25

What class is Leuprolide (lupron)

Answer 25

Anti-androgenic hormone and anti estrogenic hormone

Question 26

What are the indications for leuprolide (lupron)

Answer 26

Prostatic cancer, precocious puberty, endometriosis and uterine fibroids, as well as being part of some protocols of I.V.F.

Question 27

What drug class is finasteride

Answer 27

Anti-androgen

Question 28

What is the MOA of finasteride

Answer 28

Limits conversion of T to DHT by inhibiting 5-alpha-reductase II

Question 29

What are warnings that come with using finasteride

Answer 29

crushed or broken tablets not to be handled by women, esp if they are pregnant or may become pregnant

Question 30

What drug classes are used for BPH

Answer 30

5α-reductase inhibitors and alpha blockers