Steroids

Question 1

Which steroid is used for Addison’s disease replacement therapy?

Answer 1

Hydrocortisone

Question 2

Which steroid is used for premature delivery to increase the production of surfactant?

Answer 2

Betamethasone

Question 3

What is the MOA of mifepristone?

Answer 3

Block progesterone and glucocorticoid receptor

Question 4

What are E1/2/3/where do you see them/how potent are they?

Answer 4

E1–>estrone (seen in menopause women)—>intermediate potent
E2—>estrodiol (young female)—>most potent
E3—>estriol (pregnancy)—->least potent

Question 5

What does metyrapone block?

Answer 5

11-OHase

Question 6

What are estrogen replacement therapy used for?

Answer 6

Female hypogonadism/menopause/contraceptives/dysmenorrhea/uterine bleeding/acne

Question 7

Side effects of estrogen replacement therapy?

Answer 7

Breast tenderness/endometrial and breast cancer/stroke and blood clot

Question 8

What consists of chronic estrogen replacement therapy? and why do we combine 2 drugs?

Answer 8

estrogen + progestins

Progestin offset the risk of endometrial cancer caused by estrogen alone

Question 9

What does aromatase do? and what drugs inhibit it?

Answer 9

Androstenedione–(aromatase)—>estrone—>estradiol

Anastrazole—>blocking formation of estrogen—>treat postmenopausal breast cancer

Question 10

What drug can you take if you want kids? side effect?

Answer 10

Kids are gross! jk
Clomiphene—>increase FSH and LH release—>increase ovulation
Multiple births

Question 11

What are the SERMs? side effect?

Answer 11

Tamoxifen—>agonist on bone/antagonist on breast/partial agonist on endometrium—>increase risk of endometrial cancer
Raloxifene—>agonist on bone/antagonist on breast/antagonist on endometrium
They can be used to treat breast cancer
Raloxifene is also used for osteoporosis

Question 12

What are some synthetic progesterones? used for?

Answer 12

Medroxyprogesterone/norethindrone/desogestrel—>used for contraception and hormone replacement

Question 13

What are some synthetic estrogen?

Answer 13

Ethinyl estradiol/mestranol/DES

Question 14

What combo is used for OCP and what monotherapy can be used as OCP?

Answer 14

OCP—>estrogen + progestin

Monotherapy contraceptive—>medroxyprogesterone IM every 3 month

Question 15

Side effects of progesterone?

Answer 15

Decrease HDL and increase LDL
Breakthrough bleeding (bleeding between periods)
Androgenic (hirsutism and acne)

Question 16

Which synthetic progesterone would most likely cause androgenic affect as side effects?

Answer 16

Norethindrone

Question 17

What is the MOA of mifepristone and what is it used for?

Answer 17

Glucocorticoid and progesterone antagonists

Used for abortion

Question 18

What are the effect of estrogen and progestin in OCP? and different combo are used?

Answer 18

Estrogen—>prevent ovulation
Progestin—>prevent implantation
Mono/bi/triphasic with varied estrogen and progestin doses

Question 19

___ with OCP increase the risk of venous thromboembolism?

Answer 19

Smoking

Question 20

Drug interaction with OCP?

Answer 20

CYP450 inducers would decrease effectiveness of OCP

Question 21

What are the synthetic androgen that can be abused?

Answer 21

Oxandrolone and nandrolone—>anabolic steroids

Question 22

Side effects of androgen?

Answer 22

Excessive masculinization/premature closure of epiphysis/cholestatic jaundice/aggression

Question 23

What is the androgen receptor blockers and what is it used for?

Answer 23

Flutamide—>for prostate cancer

Question 24

What are the GnRH analogs and what are they used for? and how do you use them as replacement therapy?

Answer 24

Leuprolide and “relins” like Gosrelin—>decrease LH and FSH—>treat prostate cancer
Give pulsatile—>replacement
Give continuous—>desensitization (block)

Question 25

Why leuprolide and flutamine are used together for prostate cancer?

Answer 25

If use leuprolide alone—>initially would cause increase in testosterone and cause tumor flair
Flutaminde prevent this from happening

Question 26

What is the MOA of finasteride and what is it used for?

Answer 26

Block 5 alpha reductase—->block the conversion of testosterone to DHT (stronger version)
BPH and male pattern baldness

Question 27

What are the 2 effects of DHT?

Answer 27

Prostate growth and hair loss