Wk 11: Sex hormones

Question 1

Outline the effects of testosterone in males

Answer 1

• Maintain spermatogenesis
• Dec GnRH secretion via hypothalamus
• Inhibit LH secretion
• Stimulates protein anabolism + bone growth
• Stimulates erythropoietin secretion of kidney

Question 2

Outline the effects of progesterone

Answer 2

• Induces sticky cervical mucus
• Dec contraction of fallopian tubes + myometrium
• Dec proliferation of vaginal epithelial cells
• Stim breast growth
• Inc body temp

Question 3

Outline the menstrual cycle

Answer 3

• Hypothalamus secretes GnRH
• Anterior pituitary release FSH + LH
• Ovaries prod oestrogen + progesterone
• Uterine lining thickens

Question 4

How does combined oral contraceptives work?

Answer 4

• Oestrogen inhibit FSH secretion via negative feedback
• Suppresses ovarian follicle development by blocking gonadotropin surge
• Progesterone inhibit LH secretion + prevents ovulation + thickens mucus

Question 5

Ulipristal mechanism of action

Answer 5

• High affinity binding to progesterone receptor

- Inhibits/delays ovulation via suppression of LH surge

Question 6

In menopause, people with breast cancer use what?

Answer 6

Clonidine

Question 7

Tibolone - HRT

Answer 7

• Endometrium: Activates progesterone + androgen receptor

- Not for w/in 12 months of last period

Question 8

Raloxifene- HRT

Answer 8

• Selective oestrogen receptor modulator
• Binds to ERa + ERb
• Oestrogenic activity on bone + lipid, Anti-oestrogenic on breast + uterine receptor
• Inc bone mineral density - for vertebral fragility fracture

Question 9

Side effects of HRT

Answer 9

• Breast tenderness
• Leg cramps
• Nausea

Question 10

Outline drugs used to modify pregnant uterus + cervix

Answer 10

• Oxytocin IV induce labour

- IM: prevent postpartum haemorrhage

Question 11

Give examples of tocolytics

Answer 11

• Salbutamol + terbutaline sulfate
• Nifedipine
• Indometacin

Question 12

Salbutamol + terbutaline sulfate MOA

Answer 12

• Bind to B2 receptor on myometrial cell membrane -
• Activates adenylate cyclase
• Inc cAMP
• Dec intracellular calcium - relaxation of uterus

Question 13

Nifedepine

Answer 13

• CCB

- Dec contractile activity of uterus

Question 14

Indometacin

Answer 14

• Cyclooxygenase inhibitor

- Red prostaglandin prod + dec uterine contractions

Question 15

Benign prostatic hyperplasia treatment

Answer 15

• Dutasteride: 5 areductase inhibitors

- 5a reductase converts testosterone to dihydrotestosterone which activate androgen receptor

Question 16

Overactive bladder: anticholinergic

Answer 16

• Oxybutynin: anticholinergic, blocks muscarinic acetylcholine receptor
• Mirabegron: b3 adrenoceptor agonist

Question 17

Prostate cancer

Answer 17

Cyproterone acetate

• Binds to androgen receptor + suppress gene expression
• Suppress LH dependent prod of androgens in pituitary
• S/e: breast tenderness, liver toxicity + depression

Question 18

MOA PDE-5 inhibitors

Answer 18

Sildenafil, tadalafil + vardenafil

• Inhibit phosphodiesterase 5 (which break down cGMP)
• cGMP: relax smooth muscle + inc blood flow to corpus cavernosum