Steroid Hormones

Question 1

What are the non endocrine uses of steroids?

Answer 1

inflammatory disorders

Question 2

What is the MOA of mifepristone?

Answer 2

blocks glucocorticoid and progestin receptors

Question 3

What are some synthesis inhibitors of adrenal steroids?

Answer 3

metyrapone (blocks 11-hydroxylation);

ketoconazole

Question 4

What is the major natural estrogen?

Answer 4

estradiol

Question 5

What are some clinical uses for estrogen? (Name 4 things)

Answer 5

• female hypogonadism
• HRT hormone replacement therapy in menopause (but not used as much any longer because of S/E
• contraception
• dysmenorrhea
• uterine bleeding
• acne

Question 6

S/E of using estrogens?

Answer 6

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

Question 7

What should you add with estrogens to reduce risk of endometrial cancer in a woman?

Answer 7

add progestins

Question 8

Anastrozole MOA?

Answer 8

aromatase inhibitor > dec estrogen synthesis

Question 9

What are the indications for anastrozole use?

Answer 9

estrogen-dependent, postmenopausal breast cancer

Question 10

What is the MOA of clomiphene?

Answer 10

dec. feedback inhibition> inc FSH and LH> inc ovulation > pregnancy

Question 11

Indication for clomiphene.

Answer 11

fertility drug

Question 12

Adverse effect of using clomiphene?

Answer 12

mult. births

Question 13

Name some SERM drugs.

Answer 13

tamoxifen, raloxifene

Question 14

What does SERMs stand for?

Answer 14

selective estrogen- receptor modulators

Question 15

Describe the MOA of tamoxifen on the bone, breasts, and endometrium?

Answer 15

E receptor agonist (bone)
E receptor antagonist (breast)
E partial agonist (endometrium)

Question 16

Risk associated with tamoxifen?

Answer 16

endometrial cancer

Question 17

Indications for use of tamoxifen?

Answer 17

estrogen-dependent breast cancer and for prophylaxis in high-risk patients

Question 18

What is the MOA of raloxifene at bone, breasts, uterus?

Answer 18

E receptor agonist (bone)
E receptor antagonist (breast and uterus)

Question 19

Indications for raloxifene?

Answer 19

prophylaxis of postmenopausal osteoporosis, breast cancer

Question 20

What is the major natural progestin?

Answer 20

preogesterone

Question 21

What is found in the name of progestin drugs often?

Answer 21

“nor-“
“-gest”

Question 22

What are the primary progestin drugs?

Answer 22

medroxyprogesterone, norethindrone, desogestrel

Question 23

What are the clinical uses for progestins?

Answer 23

contraception (oral with estrogens or depot contraception with medroxyprogesterone IM every 3 months)

HRT

Question 24

S/E of progestin use?(Name 4)

Answer 24

dec. HDL and inc LDL (antiestrogenic)
glucose intolerance
breakthrough bleeding
androgenic (hirsutism and acne)
weight gain,
depression

Question 25

Indication for mifepristone.

Answer 25

Used as an abortifacient (with prostaglandins)

Question 26

What part of the reproductive cycle (ovulation) do oral contraceptives mainly suppress?

Answer 26

mid cycle LH surge

Question 27

Benefit of using OC’s as a combination drug.

Answer 27

dec risk of endometrial and ovarian cancer
dec. dysmenorrhea
dec. endometriosis
dec PID
dec osteoporosis

Question 28

Smoking with OCs carries what risk?

Answer 28

can increase risk of CVS side effects

Question 29

What are some androgen agonist drug names?

Answer 29

oxandrolone, nandrolone

Question 30

What are the indications for the use of androgens? (Name 3)

Answer 30

• małe hypogonadism and for anabolic actions > inc. muscle mass, ^ RBCs, dec. nitrogen excretion
• illicit use in athletes

Question 31

What are the S/E of androgen use?

Answer 31

excessive masculinization, premature closure of the epiphysis, cholestatic jaundice, aggression, dependence

Question 32

Flutamide MOA.

Answer 32

androgen receptor blocker

Question 33

Indication of flutamide?

Answer 33

used for androgen receptor positive prostate cancer

Question 34

What is the MOA of leuprolide?

Answer 34

GnRH analog

Question 35

What is the indication for Leuprolide?

Answer 35

used for androgen receptor positive prostate cancer

Question 36

What is the MOA of finasteride?

Answer 36

5 alpha reductase inhibitor preventing conversion of testosterone to DHT

Question 37

Indication for finasteride?

Answer 37

BPH, male pattern baldness

Question 38

What is an important contraindication you must think of before prescribing one finasteride?

Answer 38

teratogen