Sex Hormones II Flashcards
Clomiphene belongs to which group?
A. Selective estrogen receptor modulators
B. GnRH agonists
A. Selective estrogen receptor modulators
- acts in CNS
- treats fertility
- increases LH and FSH
True or False: Leuprolide is a GnRH antagonist
False - Leuprolide is a GnRH agonist
Clinical indication for Leuprolide use for men? for women?
Prostate cancer in men
Endometriosis in women
True or False: Long term use of Leuprolide causes LH and FSH to increase to a severe decrease
False - decrease to severe degree
Menotropins and Chorionic Gonadotropin are used primarily to treat which condition?
Infertility
True or False: Androgel and Androderm are androgens/anti-androgens for men
True
Which two drugs are 5a inhibitors?
1) Finasteride
2) Dutasteride
-Inhibits DHT production
What two conditions are 5a inhibitors used to treat?
1) Male pattern baldness
2) BPH
True or False: Estrogen replacement therapy (ERT) is when only estrogen is given, whereas Hormone Replacement Therapy is when estrogen and progestin are given
True
True or False: ERT and HRT can alleviate acute symptoms of menopause, as well as preventing chronic conditions (heart disease, osteoporosis, Alzheimer’s)
True
Why must a women with intact uterus take progestin?
Estrogen alone can cause estrogen-induced hyperplasia and endometrial cancer
Conjugated estrogens, which are commonly used in the US, are ___ preparations
oral
Why is one more likely to develop a blood clot when taking an oral estradiol?
Increased production of clotting factors and HDL, decrease LDL
(first pass metabolism)
True or False: Transdermal and vaginal administration can bypass first pass metabolism
True
Which can be given longer-term: oral ERT/HRT or topical treatments?
Topical treatment
- due to less systemic effects
True or False: ERT/HRT should be used if a female, peri-menopausal patient is experiencing vasomotor symptoms (e.g night sweats or hot flashes)
True
- Estrogen is most effective therapy!
When can ERT/HRT be stopped?
2-3 years
- any longer than this, there will be greater risks of breast cancer, dementia, blood clot formation
What type of ERT/HRT is most beneficial for vaginal dryness and atrophy?
Estrogen creams, tablets, vaginal ring
True or False: Women with intact uterus may require progestin to prevent endometrial proliferation with some vaginal preps
True
True or False: ERT/HRT are first line drugs to treat osteoporosis, CVD, and prevention of Alzheimer’s
False
- Risedronate and Alendronate (osteoporosis)
True or False: ERT/HRT can be used for premature ovarian failure
True
- Patients will require HRT until age when menopause would occur
There is an increased risk of which type of cancer with ERT/HRT use?
Breast cancer
True or False: breast tenderness, nausea, and *thromboembolism are risks of ERT/HRT
True
True or False: ERT/HRT use is associated with increased risk of hepatectomy
False - Cholecystectomy
All drugs that belong to the SERM class (selective estrogen receptor modulators) have either ___ or ____, depending on tissue type
estrogenic effects (agonists); anti-estrogenic activity (antagonists)
___ was first generation SERM
Tamoxifen (breast cancer)
- Antagonist
Which class of drugs does Clomiphene belong to?
A. ERT/HRT
B. 5a Inhibitor
C. SERMS
C. SERMS (selective estrogen receptor modulators)
What is the estrogen receptor antagonist at hypothalamus and AP, Clomiphene, used to treat?
Female infertility
- Increases FSH and LH
AE and CI associated with Clomiphene?
AE: hot flashes, enlarged ovarian cysts and cyst formation
CI: pre-existing cysts
True or False: FSH, LH, and hcG are gonadotropins
True
___ is released from trophoblasts shortly after fertilization acts on LH-R in corpus luteum to maintain steroid production - no endo breakdown
hCG
True or False: GnRH antagonists cause initial SURGE in LH/FSH, followed by inhibition of gonadotropin release
False - GnRH AGONISTS cause initial SURGE in LH/FSH, followed by inhibition of gonadotropin release
With use of GnRH agonists, over time, receptors become ___ and, therefore, LH and FSH go to zero
desensitized
- Therefore: no testosterone made (men); no estrogen made (women)
Leuprolide belongs to which class?
A. GnRH agonist
B. GnRH antagonist
C. 5a Inhibitors
D. HRT/ERT
A. GnRH agonist
True or False: Leuprolide can treat infertility in first week of use
True
Which GnRH agonist is associated with 100% impotence and decreased libido
Leuprolide
____can treat endometriosis in women and androgen-dependent prostate cancer in men
Leuprolide
- chemical castration
____: LH and FSH isolated from urine of post-menopausal women; given IM to prevent hypersensitivity
Menotropins (Pergonal)
What are the clinical uses of Menotropins (Pergonal) in men vs. women?
1) women = induce ovulation in infertile, anovulatory women (+hCG)
2) men = stimulate spermatogenesis (+hCG)
What are the two clinical uses of chorionic gonadotropin?
1) Induce ovulation
2) Induce spermatogenesis
- Given IM
AE associated with chorionic gonadotropin?
1) Ovarian hyperstimulation
2) Multiple pregnancies
5 alpha reductase can convert testosterone to ____
DHT (more potent type of testosterone)
What are the androgen drugs, Androderm and Androgel, commonly used to treat (3)?
1) Male hypogonadism/testosterone deficiency
2) Male senescence/andropause
3) Athletic enhancement
True or False: Androderm and Androgel administration provide more stable testosterone levels
True
AE of androgens (Androderm and Androgel)?
1) Risk of dosing kids or family members
2) Cardiovascular effects
Which class of drugs do Finasteride and Dutasteride belong to?
5a Reductase Inhibitors (Anti-Androgens)
Finasteride can treat ____
male pattern baldness
In general, what are 5a Reductase Inhibitors used to treat?
Decrease prostate size in BPH
True or False: Finasteride and Dutasteride can cause impotence
True
