Week 8 Pharm

Question 1

What drugs treat benign prostatic hyperplasia and hypertension?

Answer 1

Prazosin, doxazosin, terazosin, *tamsulosin, and silodosin

(Tamsulosin and silodosin may be more selective to prostatic α1 receptors, and are not approved for the treatment of hypertension)

Question 2

What is the MOA of Prazosin, doxazosin, terazosin, tamsulosin, and silodosin?

Answer 2

Competitive antagonism at α1 receptors

Question 3

What are the side effects of Prazosin, doxazosin, terazosin, tamsulosin, and silodosin?

Answer 3

Orthostatic hypotension (especially first dose), but little reflex tachycardia, retrograde ejaculation

Question 4

What drugs treat BPH and is generally used in combination with alpha-blocker medicine? It also promotes hair growth in androgenic alopecia (men only). It is also a prostate cancer chemo prevention

Answer 4

Finasteride and Dutasteride

Question 5

What is the MOA of Finasteride and Dutasteride?

Answer 5

5α-Reductase Inhibitors, block conversion of Testosterone to Dihydrotestosterone (DHT)

Question 6

What are the side effects of Finasteride and Dutasteride?

Answer 6

Impotence (>10% in some studies), decreased libido , gynecomastia. Contraindicated in pregnancy.

Question 7

Which anticholinergic drugs help treat overactive bladder due to neurological or non-neurological conditions?

Answer 7

Oxybutynin, Tolterodine, and Trospium

Question 8

What is the MOA of Oxybutynin, Tolterodine, and Trospium?

Answer 8

Direct antispasmodic action on smooth muscle by blocking muscarinic acetylcholine receptors on bladder

Question 9

What are the side effects of Oxybutynin, Tolterodine, and Trospium?

Answer 9

Dizziness, drowsiness, xerostomia, constipation, nausea

Question 10

What drugs treat Erectile Dysfunction and pulmonary arterial hypertension?

Answer 10

Sildenafil, Tadalafil, and Vardenafil

Question 11

What is the MOA of Sildenafil, Tadalafil, and Vardenafil?

Answer 11

PDE5 inhibitors. Inhibit enzyme that degrades cGMP, which leads to smooth muscle relaxation, increased blood flow, and erection.

Question 12

What are the side effects of Sildenafil, Tadalafil, and Vardenafil?

Answer 12

HA, flushing, hypotension, nasal congestion,
back pain, muscle aches, priapism. Concomitant use with organic nitrates (nitroglycerin, eg) is contraindicated due to risk for severe hypotension.

Question 13

What drug can be used for hormonal suppression in prostate cancer and endometriosis?

Answer 13

Leuprolide

Question 14

What is the MOA of Leuprolide?

Answer 14

GNRH agonist
GNRH signal disruption leads to less testosterone production, which slows prostate cancer growth.

Question 15

What are the side effects of Leuprolide?

Answer 15

Same side effects as those of hypogonadism (gynecomastia, diminished libido, energy and mood changes, muscle loss, hot flashes, Irregular menstruation)

Question 16

What drugs are GnRh agonists and treat Endometriosis?

Answer 16

Leuprolide, Nafarelin, and Goserelin

Leuprolide also used for prostate cancer (hormonal suppression)
Goserelin also used for breast cancer and prostate cancer.

Question 17

What is the MOA of Leuprolide, Nafarelin, and Goserelin?

Answer 17

GnRh agonists–stimulate release of pituitary gonadotropins, FSH and LH, resulting in a temporary increase in gonadal hormone synthesis but with continued dosing eventual suppression of release.

Question 18

What are the side effects of Leuprolide, Nafarelin, and Goserelin?

Answer 18

Acne, hot flashes, vaginal dryness, nausea, vomiting, decrease in bone density

Question 19

What drugs is an androgen agonist that treats Endometriosis?

Answer 19

Danazol

Question 20

What is the MOA of Danazol?

Answer 20

Androgen agonist. Also has some progestin agonsit and anti-estrogen activity. Results in suppression of pituitary-ovarian access. Pseudo menopause.

Question 21

What are the side effects of Danazol?

Answer 21

Masculinizing side effects

Question 22

What drugs can be used to treat endometriosis, breast cancer (primary use), and sometimes used for infertility (off label use)?

Answer 22

Anastrozole and Letrozole

Question 23

What is the MOA of Anastrozole and Letrozole?

Answer 23

Inhibit conversion of androstenedione and testosterone to estrone and estradiol

Question 24

What are the side effects of Anastrozole and Letrozole?

Answer 24

Hot flashes, vaginal dryness, decrease in bone density

Question 25

Which drug is a selective estrogen receptor modulator (SERM) that can treat anovulatory infertility?

Answer 25

Clomiphene

Question 26

What is the MOA of Clomiphene?

Answer 26

Selective estrogen receptor modulator (SERM)-inhibits estradiol's negative feedback on GnRH, FSH and LH-increasing their secretion, leading to ovulation.

Question 27

What are the side effects of Clomiphene?

Answer 27

Hot flashes, headache, twins/triplet pregnancy (10%)

Question 28

What drugs stimulate ovulation to treat infertility?

Answer 28

hCG and choriogonadotropin alfa

Question 29

What is the MOA of hCG and choriogonadotropin alfa?

Answer 29

Stimulates ovulation after use of FSH analogs to stimulate follicular development

Question 30

What are the side effects of hCG and choriogonadotropin alfa?

Answer 30

Injection site reactions, twins/triplet pregnancies

Question 31

What drugs are estrogen receptor agonists that treat Menopausal symptoms (Hot flashes and vaginal dryness)?

Answer 31

Estradiol, Conjugated estrogens, Esterified Estrogens, and Estropipate

Question 32

What is the MOA of Estradiol, Conjugated estrogens, Esterified Estrogens, and Estropipate?

Answer 32

Estrogen receptor agonists. Estradiol is bio-identical.

Question 33

What are the side effects of Estradiol, Conjugated estrogens, Esterified Estrogens, and Estropipate?

Answer 33

Variable cardiovascular and breast cancer risk depending on patient characteristics. Risk of stroke and blood clots for all.

Question 34

Which progesterone receptor agonists are used to reduce the risk of endometrial cancer when estrogen is used for menopausal symptoms in patients with an intact uterus?

Answer 34

Medroxyprogesterine, norethindrone, and micronized progesterone (bio-identical)

Question 35

What is the MOA of Medroxyprogesterine, norethindrone, and micronized progesterone?

Answer 35

Progesterone receptor agonists. Micronized progesterone is bio-identical

Question 36

What are the side effects of Medroxyprogesterine, norethindrone, and micronized progesterone?

Answer 36

Mood symptoms, weight gain

Question 37

Which Selective Estrogen Receptor Modulators (SERM) are used to treat Menopausal symptoms?

Answer 37

Raloxifene and Bazedoxifene Raloxifene-for treatment of postmenopausal osteoporosis. Bazedoxifene-for tx of menopausal symptoms (combo pill with conjugated estrogens).

Question 38

What is the MOA of Raloxifene and Bazedoxifene?

Answer 38

Selective estrogen receptor modulator (SERM): estrogen agonist at vaginal tissues and bone, estrogen antagonist at breast.

Question 39

What are the side effects of Raloxifene and Bazedoxifene?

Answer 39

Raloxifene-hot flashes, leg cramps, blood clots. Bazedoxifene-blood clots

Question 40

What drug improves libido and energy in hypogonadal males?

Answer 40

Testosterone

Question 41

What is the MOA of Testosterone?

Answer 41

Testosterone receptor agonist; "bio-identical"

Question 42

What are the side effects of Testosterone?

Answer 42

Application site reactions, gynecomastia, increased cholesterol (total and LDL), decreased HDL, hepatic dysfunction, jaundice, increased hematocrit, water retention, infertility (reduces sperm count), exacerbation of sleep apnea. Newer studies: increased risk of cardiovascular disease in patients >65, and in patients <65 with underlying cardiovascular disease.

Question 43

What androgen receptor antagonists treat prostate cancer?

Answer 43

Flutamide, Bicalutamide, and Nilutamide

Question 44

What are the side effects of Flutamide, Bicalutamide, and Nilutamide?

Answer 44

Liver injury/death, gynecomastia, diarrhea, hot flashes, loss of libido