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pharm II, exam 3 > sex hormones II > Flashcards

sex hormones II Flashcards

1
Q

Progesterone is produced by

A

corpus luteum

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2
Q

MOA of progesterone

A

Progesterone acts on nuclear protein receptors, which interact with DNA.

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3
Q

function of progesterone in the uterus

A
  • converts endometrium to a secretory state
    • maintains pregnancy
    • suppresses contractility during pregnancy
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4
Q

Progestins come in what two types

A
  • 19-nortestosterones
  • progesterone derivatives
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5
Q

Uses of progestins

A
  • contraception
  • prevent endometrial hyperplasia in HRT
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6
Q

List the Antiprogestins

A
  • Mifepristone
  • Danazol
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7
Q

MOA of Mifepristone

A
  • progesterone/glucocorticoid receptor antagonist
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8
Q

uses of Mifepristone

A

terminate pregnancy

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9
Q

use for Danazol

A

endometriosis

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10
Q

What is the combination pills: estrogen and progestin that you should know

A

Drospirenone/ethinyl estradiol (Yasmin, Yaz)

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11
Q

use of combination oral contraceptives

A
  • inhibit ovulation
    • no LH surge
  • Cause changes in cervical mucosa and endometrium that decreases implantation.
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12
Q

what part of the combination oral contraceptives initiates bleeding at the end of the cycle with its withdrawal

A

progestin

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13
Q

estrogen: progestin ratio is important. E:P ratio, estrogen stays the same and progestin increases content at each stage. List the three stages

A
  • 1 stage: monophasic
  • 2 stages: biphasic
  • 3 stages: triphasic
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14
Q

estrogen given in off period of seasonique due to

A
  • estrogen decreases uterine bleeding
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15
Q

Yaz is a comibination of ethinyl estradiol and drospirenone . MOA of drospirenone

A

a mineralcorticoid antagonist

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16
Q

advantages of ethinyl estradiol and drospirenone

A
  • less water retention (bloating): FDA approved for PMDD
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17
Q

MOA of Natazia

A

bioidentical E2

18
Q

Use for Progestin-only mini pills

A
  • 87-98% effective for birth control
    • used for adolescents and breast feeding mothers
      • ​(prevents estrogen effects on bone growth)
19
Q

progestin-only long term therapy causes

A

early breakthrough bleeding, later amenorrhea

20
Q

adverse effects of combination oral contraceptives

A
  • common
    • weight gain
    • nausea
    • edema
    • depression
  • breakthrough bleeding
    • progestin alone or too little estrogen
  • cardiovascular
    • clotting
      • women over 35 or smoker
    • mild HTN
    • migrain
    • MI/stroke
  • Teratogenesis
  • Fertility suppressed
21
Q

combination oral contraceptive benefits

A
  • effective contraceptives
  • ovarian and endometrial CA
22
Q

contraindications of combination oral contraceptive

A
  • absolute:
    • thromboembolic phenomena
    • estrogen-dependent neoplasms
  • relative:
    • liver disease
23
Q

drug interactions with combination oral contraceptive

A
  • P450 inducers will reduce effectiveness
  • antibiotics can reduce effectiveness
    • stop enterohepatic circulation
24
Q

ovarian steroids and gonadotropin levels in menopause

A
  • reduced ovarian response to gonadotropins
  • decreased ovarian steroids: estrogen and progesterone
  • increased gonadotropins: FSH, LH
25
Q

list the major menopausal symptoms

A
  1. vasomotor problems: hot flashes
  2. Genito-urinary problems: vaginal dryness, atrophy, pain
  3. osteoporosis
  4. heart disease
26
Q

Hormone replacement therapy for women with h/o hysterectomies

A

estrogen only

27
Q

adverse effects of Hormone replacement therapy

A
  • breast cancer (1.25 fold)
  • cardiovascular
  • gallbladder disease (2.5 fold)
28
Q

general guidelines for giving Hormone replacement therapy

A
  • < 10 years after menopause = HRT has more benefits vs risks
  • > 10 years after menopause = HRT not so great
  • **before prescribing, know risks of HRT, inform patient and choose appropriate tx individually
29
Q

actions of androgens

A
  1. virilizing
    1. spermatogenesis
    2. sexual development
  2. anabolic
    1. increase in bone density
    2. increase amino acid incorporation into muscle
  3. puberty: development of secondary sexual characteristics in male
30
Q

androgen use in men

A

testicular deficiency

31
Q

androgen use in women

A

female hypopituitarism (estrogens and androgens)

32
Q

andogen use in both sexes

A
  • hypoproteinemia of nephrosis
    • proteins lost in urine, helpful because it increase anabolic activity of liver to make more proteins
33
Q

adverse effects of exogenous androgens in men

A

decreased spermatogenesis

  • in testes, need high level of testosterone, if you bring in testosterone, will get negative feedback and loss of LH
34
Q

adverse effects of exogenous androgens in women

A
  • masculinization
  • pseudohermaphroditism of fetus in pregnant women
35
Q

adverse effects of exogenous androgens in both sexes

A
  • oily skin, acne
  • decreased HDL
  • psychological changes
36
Q

list the Androgen Receptor Antagonists

A
  • Flutamide
  • spironolactone
37
Q

use for Androgen Receptor Antagonist: Flutamide

A
  • used in prostate CA with long-acting GnRH agonist
    • Used to suppress ‘tumor flare’ when beginning long-acting GnRH therapy.
38
Q

Use for spironolactone: high dose

A
  • high dose antiandrogen
  • use
    • hirsutism in women
    • precocious puberty
39
Q

List the 5 alpha reductase inhibitors

A
  • Finasteride
  • Dutasteride
  • MOA: no Dihydrotestosterone
40
Q

uses of 5 alpha reductase inhibitors

A
  • benign prostatic hyperplasia
  • male pattern baldness
41
Q

adverse effects of 5 alpha reductase inhibitors

A
  • impotence
  • teratogenic

pharm II, exam 3 (8 decks)

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