Sex hormones Flashcards
Leuprolide drug class?
Long acting GnRH agonist
Cetrorelix drug class?
GnRH antagonist
Menotropin/ Humegon drug class?
FSH
Pregnyl drug class?
LH
What are the endogenous estrogens? (3)
Estradiol, estrone, estriol
Ethinyl estradiol drug class?
Estrogens
Premarin drug class?
Estrogens
Estradiol drug class?
Estrogens
Tamoxifen drug class?
Antiestrogens
Raloxifene drug class?
Antiestrogens
Clomiphene drug class?
Antiestrogens
Anastrozole drug class?
Aromatase inhibitors
Medroxyprogesterone (Provera) drug class?
Progestins (progesterone derivative)
Levonorgestrel drug class?
Progestins (19-nortestosterone, has both progestin and androgenic activity)
Mifepristone drug class?
Antiprogestins
Drospirenone/ ethinyl estradiol drug/ drug class?
Yasmin/ Yaz, combined oral contraceptive
Testoderm transdermal drug class?
Androgens
Flutamide drug class?
Anti-androgens
Spironolactone drug class?
Anti-androgens
Finasteride drug class?
5alpha-reductase inhibitors
What hormone drives follicular development during the follicular/ proliferative phase?
FSH
During ovulation, there is high/ sustained levels of what hormone which leads to positive feedback on LH release and the LH surge?
Estrogen
What follows the LH surge? (2)
Ovulation and luteinization
What hormone maintains the corpus luteum (CL) during the luteal/ secretory phase?
LH
What hormones maintains the endothelium during the luteal/ secretory phase?
Progesterone/ estrogen
What progression of hormone loss leads to menstruation?
Loss of LH = loss of CL = loss of P+E
What is the term for sudden ovarian enlargement with increased vascular permeability leading to a rapid accumulation of fluid in the peritoneal, pleural and pericardial cavities?
Ovarian hyperstimulation syndrome
What symptoms/ complications can accompany ovarian hyperstimulation syndrome? (5)
Thromboembolisms, hypovolemia, fever, +/- shock, death
What is defined as a reduced ovarian response to gonadotropins (including decreased ovarian steroids and decreased gonadotropins)?
Menopause
HA, palpitations, night sweats, insomnia, and hot flashes are examples of what type of problems seen with menopause?
Vasomotor
What are the targets for HRT in menopause? (3)
Genito-urinary problems (loss of trophic effect of estrogen), osteoporosis, heart disease
What are the uses of HRT in females? (3)
Menopause (E + P), girls with no ovarian development or removal of ovaries prior to menopausal age (E+P), hysterectomies (E only)
What guidelines should be followed for HRT in the treatment of hot flashes/ night sweats in menopause?
Lowest dose for shortest duration
Although Raloxifene is still an option for HRT, why is it not first line?
Prevents osteoporosis and breast cancer BUT does NOT affected CHD/ hot flashes
What administration route of HRT is the best for osteoporosis and hot flashes?
Transdermal therapy
What type of HRT is the best to decrease vaginal thinning and irritation?
Estrogen cream
What are the adverse effects of HRT in females? (4)
Breast cancer (E+P), endometrial cancer (E only) CV, gallbladder disease
(only a small risk for breast cancer but reason for bad rep)
When has HRT been shown to have the most beneficial effects and lowest risk of causing breast cancer?
E only and < 10 years after onset of menopause
(typically ~50-59 yo, healthy women in first few years of menopause who need HRT to relieve sxs should have no fears about use and benefits outweigh risks)
What is the MOA for Leuprolide?
Suppresses release of LH and FSH ~3 weeks, after initial surge
What is the DOC for endometriosis and precocious puberty?
Leuprolide
Aside from endometriosis and precocious puberty (DOC), what drug can be used for IVF, sex-dependent CA, and gender affirmation (stops puberty until child decides gender)?
Leuprolide
What are the side effects of Leuprolide and Cetrorelix? (2)
Menopausal sxs, testicular atrophy (shuts down HPG axis)
What are the contraindications to use of Leuprolide and Cetrorelix? (2)
Pregnancy, breast feeding
If Leuprolide is used in the treatment of metastatic prostate cancer, what else must be done?
Treat with antiandrogen at start of treatment (due to initial tumor flare)
What is the MOA for Cetrorelix?
Suppresses release of LH at low doses and FSH at higher doses ~4-5 days, no initial surge
What is the primary drug used for the treatment of IVF, but can also be used for endometriosis, precocious puberty, sex-dependent cancers, and gender affitmation?
Cetrorelix
What is the MOA of menotropins/ Humegon?
HRT
What drug is used for the treatment of pituitary or hypothalamic hypogonadism with infertility?
Menotropins/ Humegon
Menotropins/ Humegon induces spermatogenesis in hypogonadotropic hypogonadal men after how long?
Months
Menotropins/ Humegon stimulates the ovaries and estrogen production after how long?
9-12 days
In what order to you give FSH and LH for infertility treatment in women?
Give FSH then LH to induce ovulation
*F for FSH, Females, First
In what order to you give FSH and LH for infertility treatment in men?
Give LH then FSH to induce spermatogenesis
What are the side effects of menotropins/ Humegon (FSH) and Pregnyl (LH)? (3)
Ovarian hyperstimulation syndrome, multiple births, gynecomastia in men
What is the contraindication to treatment with Menotropins/ Humegon (FSH) and Pregnyl (LH)?
Sex-steroid dependent CA