Steroid Hormones Flashcards
What are the non endocrine uses of steroids?
inflammatory disorders
What is the MOA of mifepristone?
blocks glucocorticoid and progestin receptors
What are some synthesis inhibitors of adrenal steroids?
metyrapone (blocks 11-hydroxylation);
ketoconazole
What is the major natural estrogen?
estradiol
What are some clinical uses for estrogen? (Name 4 things)
- female hypogonadism
- HRT hormone replacement therapy in menopause (but not used as much any longer because of S/E
- contraception
- dysmenorrhea
- uterine bleeding
- acne
S/E of using estrogens?
breast tenderness, endometrial hyperplasia, increase gallbladder disease, cholestasis, migraine, and bloating
Increase risk of blood coagulation via decreased antithrombin III and increase factors II, VII, IX, X (only at high doses)
Inc. risk of endometrial cancer with use of estrogens
What should you add with estrogens to reduce risk of endometrial cancer in a woman?
add progestins
Anastrozole MOA?
aromatase inhibitor > dec estrogen synthesis
What are the indications for anastrozole use?
estrogen-dependent, postmenopausal breast cancer
What is the MOA of clomiphene?
dec. feedback inhibition> inc FSH and LH> inc ovulation > pregnancy
Indication for clomiphene.
fertility drug
Adverse effect of using clomiphene?
mult. births
Name some SERM drugs.
tamoxifen, raloxifene
What does SERMs stand for?
selective estrogen- receptor modulators
Describe the MOA of tamoxifen on the bone, breasts, and endometrium?
E receptor agonist (bone)
E receptor antagonist (breast)
E partial agonist (endometrium)
Risk associated with tamoxifen?
endometrial cancer
Indications for use of tamoxifen?
estrogen-dependent breast cancer and for prophylaxis in high-risk patients
What is the MOA of raloxifene at bone, breasts, uterus?
E receptor agonist (bone)
E receptor antagonist (breast and uterus)
Indications for raloxifene?
prophylaxis of postmenopausal osteoporosis, breast cancer
What is the major natural progestin?
preogesterone
What is found in the name of progestin drugs often?
“nor-“
“-gest”
What are the primary progestin drugs?
medroxyprogesterone, norethindrone, desogestrel
What are the clinical uses for progestins?
contraception (oral with estrogens or depot contraception with medroxyprogesterone IM every 3 months)
HRT
S/E of progestin use?(Name 4)
dec. HDL and inc LDL (antiestrogenic)
glucose intolerance
breakthrough bleeding
androgenic (hirsutism and acne)
weight gain,
depression
Indication for mifepristone.
Used as an abortifacient (with prostaglandins)
What part of the reproductive cycle (ovulation) do oral contraceptives mainly suppress?
mid cycle LH surge
Benefit of using OC’s as a combination drug.
dec risk of endometrial and ovarian cancer
dec. dysmenorrhea
dec. endometriosis
dec PID
dec osteoporosis
Smoking with OCs carries what risk?
can increase risk of CVS side effects
What are some androgen agonist drug names?
oxandrolone, nandrolone
What are the indications for the use of androgens? (Name 3)
- małe hypogonadism and for anabolic actions > inc. muscle mass, ^ RBCs, dec. nitrogen excretion
- illicit use in athletes
What are the S/E of androgen use?
excessive masculinization, premature closure of the epiphysis, cholestatic jaundice, aggression, dependence
Flutamide MOA.
androgen receptor blocker
Indication of flutamide?
used for androgen receptor positive prostate cancer
What is the MOA of leuprolide?
GnRH analog
What is the indication for Leuprolide?
used for androgen receptor positive prostate cancer
What is the MOA of finasteride?
5 alpha reductase inhibitor preventing conversion of testosterone to DHT
Indication for finasteride?
BPH, male pattern baldness
What is an important contraindication you must think of before prescribing one finasteride?
teratogen
