Steroids Flashcards
Which steroid is used for Addison’s disease replacement therapy?
Hydrocortisone
Which steroid is used for premature delivery to increase the production of surfactant?
Betamethasone
What is the MOA of mifepristone?
Block progesterone and glucocorticoid receptor
What are E1/2/3/where do you see them/how potent are they?
E1–>estrone (seen in menopause women)—>intermediate potent
E2—>estrodiol (young female)—>most potent
E3—>estriol (pregnancy)—->least potent
What does metyrapone block?
11-OHase
What are estrogen replacement therapy used for?
Female hypogonadism/menopause/contraceptives/dysmenorrhea/uterine bleeding/acne
Side effects of estrogen replacement therapy?
Breast tenderness/endometrial and breast cancer/stroke and blood clot
What consists of chronic estrogen replacement therapy? and why do we combine 2 drugs?
estrogen + progestins
Progestin offset the risk of endometrial cancer caused by estrogen alone
What does aromatase do? and what drugs inhibit it?
Androstenedione–(aromatase)—>estrone—>estradiol
Anastrazole—>blocking formation of estrogen—>treat postmenopausal breast cancer
What drug can you take if you want kids? side effect?
Kids are gross! jk
Clomiphene—>increase FSH and LH release—>increase ovulation
Multiple births
What are the SERMs? side effect?
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
What are some synthetic progesterones? used for?
Medroxyprogesterone/norethindrone/desogestrel—>used for contraception and hormone replacement
What are some synthetic estrogen?
Ethinyl estradiol/mestranol/DES
What combo is used for OCP and what monotherapy can be used as OCP?
OCP—>estrogen + progestin
Monotherapy contraceptive—>medroxyprogesterone IM every 3 month
Side effects of progesterone?
Decrease HDL and increase LDL
Breakthrough bleeding (bleeding between periods)
Androgenic (hirsutism and acne)
Which synthetic progesterone would most likely cause androgenic affect as side effects?
Norethindrone
What is the MOA of mifepristone and what is it used for?
Glucocorticoid and progesterone antagonists
Used for abortion
What are the effect of estrogen and progestin in OCP? and different combo are used?
Estrogen—>prevent ovulation
Progestin—>prevent implantation
Mono/bi/triphasic with varied estrogen and progestin doses
___ with OCP increase the risk of venous thromboembolism?
Smoking
Drug interaction with OCP?
CYP450 inducers would decrease effectiveness of OCP
What are the synthetic androgen that can be abused?
Oxandrolone and nandrolone—>anabolic steroids
Side effects of androgen?
Excessive masculinization/premature closure of epiphysis/cholestatic jaundice/aggression
What is the androgen receptor blockers and what is it used for?
Flutamide—>for prostate cancer
What are the GnRH analogs and what are they used for? and how do you use them as replacement therapy?
Leuprolide and “relins” like Gosrelin—>decrease LH and FSH—>treat prostate cancer
Give pulsatile—>replacement
Give continuous—>desensitization (block)
Why leuprolide and flutamine are used together for prostate cancer?
If use leuprolide alone—>initially would cause increase in testosterone and cause tumor flair
Flutaminde prevent this from happening
What is the MOA of finasteride and what is it used for?
Block 5 alpha reductase—->block the conversion of testosterone to DHT (stronger version)
BPH and male pattern baldness
What are the 2 effects of DHT?
Prostate growth and hair loss
