Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Endocrine > Reproductive pharmacology > Flashcards

Reproductive pharmacology Flashcards

1
Q

What is the mechanism of action of luprolide

A

GnRH agonist- binds GnRH membrane receptor on pituitary gonadotrope cells.
Usually given in long acting form that eliminates pulsatility and thus causes decreased gonadotropin production

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What are indications for GnRH agonists or antagonists?

A
  • testing for precocious or delayed puberty
  • suppressing precocious puberty
  • endometriosis
  • prostate cancer
  • decrease endogenous ovarian function to use exogenous ovulation indcution
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What are side effects of GnRH agonists?

A

signs of hypogondadism- hot flashes, bone loss, low libido, amenorrhea

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What is a difference in the response to GnRH agonists vs antagonists?

A

agonists do cause LH/ FSH flare then inhibition

antagonists cause immediate inhibition with no flare

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What would be an indication for pulsatile administration of GnRH?

A

treatment of hypogonadotropic hypogonadism due to hypothalamic dysfunction, ex Kallman syndrome

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Daily injections of exogenous ______ stimulate ovarian follicle development

A

FSH

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Injection of hCG (or LH) triggers ______

A

LH surge, ovulation, and progesterone production

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

________ are used to treat prolactinomas

A

dopamin agonists like cabergoline, bromocriptine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Describe the cellular location and biochemistry of the estrogen receptor

A

nuclear location
bound to heat shock proteins that dissociate upon estrogen binding
receptor dimerizes then can bind estrogen response element in DNA

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

_______ is a weak estrogen produced by the placenta

A

estriol

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

____ is the principle ovarian estrogen; _____ is an estrogen common in post-menopause

A

estradiol/ estrone

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What is the source of most estrogen in post-menopausal women

A

peripheral aromatization of adrenal androgens

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What is the effect of estrogen at bone?

A

maintains bone mass

stimulates closure of epiphyses

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What is the effect of estrogen in the liver?

A

Stimulates production of SHBG, thyroid hormone binding globulin, and blood clotting factors

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What are therapeutic uses of estrogens?

A
  • tx estrogen deficiency in premature ovarian failure, menopause
  • prevention, treatment of osteoporosis
  • contraception
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

If estrogen is given therapeutically without opposing progesterone, there is increased risk of __________

A

endometrial carcinoma

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What is the mechanism of action of clomiphene citrate?

A

Inhibits estrogen binding in the hypothalamus and anterior pituitary, preventing the normal feedback regulation and causing increased secretion of GnRH and gonadotropins, stimulating ovarian follicle development

technically has weak agonist effects, but clinically acts as a pure antagonist

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

What is the most common use for clomiphene citrate?

A

ovulation induction

19
Q

What is the mechanism of action of tamoxifen?

A

estrogen antagonist in breast tissue.

weak agonist at endometrium and bone.

20
Q

What are indications for tamoxifen?

A

ER+ breast cancer

21
Q

What is a positive side effect of tamoxifen?

A

anti-resorptive action at bone

22
Q

What are negative side effects of tamoxifen?

A

endometrial hyperplasia, carcinoma
thromboembolism
hot flashes

23
Q

What is the mechanism of action of raloxifine?

A

estrogen agonist in bone.
estrogen antagonist in breast tissue.
Does not have action at the endometrium

24
Q

What are indications for raloxifine?

A

treatment of postmenopausal osteoporosis

25
Q

What are positive side effects of raloxifene?

A

decreased risk of ER+ breast cancer

26
Q

What are negative side effects of raloxifine?

A

thromboembolism

hot flashes

27
Q

Inhibition of _____ will result in lower estrogen levels

A

aromatase

28
Q

Differentiate between type 1 and type 2 aromatase inhibitors

A

Type 1 agent, exemestane, is steroidal in structure and acts as irreversible inhibitor of aromatase.

Type 2 agents, anastrozole and letrozole, are nonsteroidal agents and are reversible inhibitors of the enzyme.

29
Q

What are indications for aromatase inhibitors?

A

ER+ breast cancer

ovulation induction- type 2/ reversible only

30
Q

Describe the cellular location and biochemistry of the progesterone receptor

A

cytoplasmic location

bound to heat shock proteins, dissociation when estrogen binds

31
Q

List the physiologic effects of progestins

A
  • Inhibits estrogen-induced proliferation of the endometrium
  • Prepares endometrium for embryo implantation
  • Supports maternal and fetal needs throughout pregnancy
  • Withdrawal from progesterone triggers menses
32
Q

What are therapeutic uses for progestins?

A
  • postmenopausal hormone therapy to avoid effects of unopposed estrogen
  • contraception
  • support of pregnancies in assisted reproduction where there is no CL
  • abortifactants- mifiprisone
33
Q

_______ and ______ act through a single cytoplasmic androgen receptor

A

testosterone and DHT

34
Q

Why can’t testosterone be given orally?

A

first pass metabolism in the liver

35
Q

What are clinical uses of androgens?

A

male testosterone deficiency

36
Q

What is the mechanism of action of finasteride?

A

Inhibitor of the enzyme 5-α reductase, which converts testosterone to DHT

37
Q

What are clinical uses of finasteride?

A

tx of BPH, male pattern baldness

38
Q

What is the mechanism of action of spironolactone

A

weakly blocks androgen receptor
weakly inhibits testosterone synthesis
blocks mineralocorticoid receptor
weak agonist at progesterone receptor

39
Q

What are uses of spironolactone?

A

hirsutism
hypertension, CHF
primary hyperaldosteronism

40
Q

What are adverse effects of spironolactone?

A

hyperkalemia
irregular menses
gynecomastia

41
Q

What is the mechanism of action of flutaminde

A

competitive antagonist of androgen receptor

42
Q

What are clinical uses of flutamide?

A

prostate cancer

hirsutism (rarely used)

43
Q

What is the key adverse effect of flutamide?

A

hepatotoxicity

Endocrine (19 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions