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USMLE

Repro Pharm

QuestionAnswer
Which drugs cause gynecomastia as a side effect? Some Drugs Create Awesome Knockers! - Spironolactone, Digitalis, Cimetidine, Alcohol, Ketoconazole
Finasteride use and mechanism used for BPH and male-pattern baldness; blocks 5-alpha-reductase to prevent conversion of T to DHT
Flutamide use and mechanism nonsteroidal competitive inhibitor of androgens. blocks T receptor. Used in prostate carcinoma
Kotoconazole use and mechanism inhibits steroid synthesis; used in treatment of polycystic ovarian syndrome to prevent hirsutism
Spironolactone use and mechanism inhibits steroid binding; used in Polycystic ovarian syndrome to prevent hirsutism
Mechanism of Leuprolide? GnRH analog with agonist properties when used in pulsatile fashion. Antagonist when used continuously.
Uses of Leuprolide? Infertility (pulsatile); prostate cancer (continuous use with flutamide); uterine fibroids
Toxicity of Leuprolide? antiandrogen, nausea, vomiting
Sildenafil, Vardenafil mechanism Inhibits cGMP phosphodiesterase --> increased cGMP --> smooth muscle relaxation in corpus cavernosum --> increased blood flow --> PENILE ERECTION!
Toxicity of Sildenafil and Vardenafil? HA, flushing, dyspepsia, impaired blue-green color vision. DO NOT USE WITH NITRATES!!! causes hypotension
mechanism of Mifepristone (RU-486)? competitive inhibitor of progestins at progesterone receptors
clinical use of mifepristone termination of pregnancy. used with misoprostol (PGE1)
toxicity of mifepristone heavy bleeding, GI effects (nausea, vomiting, anorerxia), abdominal pain
advantages of OCPs? decreased risk of endometrial and ovarian cancer; decreased incidence of ectopic pregnancy, decreased pelvic infections, regulation of menses
disadvantages of OCPs? no protection against STDs, increased triglycerides, depression, weight gain, nausea, hypertension, hypercoagulable state
What is Dinoprostone? PGE2 analog causing cervical dilation and uterine contraction, inducing labor
Ritodrine/Terbutaline are what? B2 agonists that relax the uterus
What is anastrozole? aromatase inhibitor used in postmenopausal women with breast cancer.
What are the toxicities of estrogens (ethinyl estradiol, DES, mestranol) increased risk of endometrial cancer, bleeding in postmenopausal women, clear cell adenocarcinoma of vagina in females exposed to DES in utero, increased risk of thrombi
What is the toxicity of testosterone? masculinization in females; reduces intratesticular testosterone in males by inhibiting Leydig cells; leads to gonadal atrophy. premature closure of epiphyseal plates. increased LDL, decreased HDL
Mechanism of Clomiphene? partial agonist at estrogen receptors in pituitary gland. prevents normal feedback inhibition and increased release of LH and FSH from pituitary, which stimulates ovulation
Uses of Clomiphene? treat infertility and PCOS.
toxicity of clomiphene? hot flashes, ovarian enlargement, multiple pregnancies, visual disturbances
mechanism of Tamoxifen? estrogen antagonist on breast tissue. used to prevent recurrence of ER-positive breast cancer
mechanism and use of Raloxifene? estrogen agonist on bone; reduces reabsorption of bone; used to treat osteoporosis
Created by: Asclepius