Pharmacology II: Reproductive and Endocrine Systems

Vocabulary flashcards covering reproductive pharmacology (infertility agents, tocolytics, hormonal contraceptives, HRT, and male health) and endocrine pharmacology (thyroid, pituitary, parathyroid/calcium, and adrenal medications).

GnRH (Female Reproductive Cycle)

Hormone that stimulates the anterior pituitary to release FSH and LH, regulating ovarian hormone activity.

LH Surge

A rise in luteinizing hormone (LH) that directly triggers ovulation (the release of the ovum from its follicle).

GnRH (Male Reproductive Cycle)

Hormone that stimulates the release of FSH (which supports sperm production) and LH (which supports testicular hormone production).

Clomiphene Citrate

An ovulation stimulant identified as the first-choice infertility drug; works by increasing FSH and LH release.

Infertility Medications

Pharmacologic agents used to stimulate ovulation and fertility, including clomiphene citrate, menotropin, follitropins, human chorionic gonadotropin, and leuprolide.

Leuprolide (Fertility Therapy)

A GnRH agonist used in fertility protocols to prevent premature ovulation.

Tocolytics

Medications such as IV magnesium sulfate, nifedipine, terbutaline sulfate, and indomethacin used to inhibit uterine contractions during preterm labor to delay delivery.

IV Magnesium Sulfate

A tocolytic agent that relaxes uterine smooth muscle at high doses to inhibit preterm contractions.

Dinoprostone and Misoprostol

Prostaglandin medications listed for cervical ripening and the induction of labor.

Oxytocin

A hormone used during labor to stimulate or strengthen uterine contractions, and at higher uterotonic doses after delivery to stop postpartum bleeding.

Metoclopramide (Lactation Indication)

A medication that stimulates prolactin secretion, helping to induce or increase lactation.

Progesterone-Only Birth Control (Lactation)

Contraception suitable for breastfeeding mothers; chosen because higher-dose estrogen products may reduce milk production.

SSRIs / SNRIs (PMS/PMDD)

Antidepressant drug classes discussed as first-line pharmacotherapy for premenstrual syndrome (PMS) and premenstrual dysphoric disorder (PMDD).

Alprazolam

A benzodiazepine discussed for managing symptoms of anxiety and insomnia associated with PMS/PMDD.

Endometriosis Therapies

Pharmacologic management options including NSAIDs, hormonal contraceptives (such as an IUD), and GnRH agonists.

Conjugated Estrogen

An estrogen product indicated for low or missing estrogen and to relieve menopausal vasomotor symptoms (severe hot flashes/night sweats) and atrophic vaginitis.

Estrogen Transdermal Patch

A topical route of estrogen administration that carries the therapeutic benefit of avoiding hepatic first-pass metabolism.

Estrogen Black Box Warnings

Starred black-box warnings associated with estrogen therapy covering increased risks of cancer, blood clots (thromboembolic conditions such as DVT, PE, CVA, MI), and dementia.

Medroxyprogesterone Acetate

A progestin medication prescribed alongside estrogen to prevent hyperplasia (overgrowth) of the endometrial lining.

Progestins

Synthetic progestational hormones that prevent pregnancy by suppressing pituitary hormones and ovulation, thickening cervical mucus, thinning the endometrium, and slowing sperm transport.

Combination Contraceptives (Mechanism)

Contraceptives in which estrogen suppresses FSH and LH to inhibit ovulation and stabilize the endometrium, while progestin thickens cervical mucus, suppresses the LH surge, and thins the endometrial lining.

Thrombus Warning Symptoms

Signs of blood clots that oral contraceptive users must report immediately: chest pain, severe headache, vision changes, or leg pain.

Leydig Cells

Testicular cells stimulated by luteinizing hormone (LH) from the anterior pituitary to produce testosterone.

Testosterone Replacement

Androgen therapy prescribed to treat hypogonadism and conditions caused by androgen deficiency; requires careful handwashing after gel application to prevent skin-to-skin transfer to children.

Sildenafil

A PDE5 inhibitor for erectile dysfunction (ED) that vasodilates cavernosal smooth muscle to enhance penile blood flow.

Sildenafil Contraindications

Strictly contraindicated with nitrates (e.g., nitroglycerin) due to severe hypotension risk, and in patients not healthy enough for sexual activity.

Priapism

A persistent erection lasting longer than $4\text{ hours}$; an urologic emergency requiring immediate medical intervention.

Finasteride

A $5\alpha$-reductase inhibitor for BPH that blocks testosterone conversion to DHT to decrease prostatic proliferation; takes $6\text{--}12\text{ months}$ for maximal benefit and must not be handled by pregnant women if tablets are broken.

Tamsulosin

An alpha-1 blocker that relaxes smooth muscle in the prostate and bladder neck to improve urinary flow in BPH; may cause orthostatic hypotension.

T3 and T4

Thyroid hormones regulated by TSH from the anterior pituitary that primarily control systemic metabolic rate.

Hypothyroidism vs. Hyperthyroidism

Hypothyroidism presents with slowed metabolism and bradycardia; hyperthyroidism presents with accelerated metabolism and tachycardia.

Propylthiouracil (PTU)

An antithyroid drug that inhibits thyroid hormone synthesis; carries a black-box warning for liver failure and requires $1\text{--}2\text{ weeks}$ of therapy to begin working.

Lugol’s Solution

An iodine formulation administered prior to thyroidectomy to reduce thyroid gland size and vascularity; administered through a straw to prevent tooth discoloration.

Levothyroxine

Synthetic $T_4$ replacement used for hypothyroidism; must be taken on an empty stomach first thing in the morning, with heart rate assessed prior to administration.

Anterior Pituitary Hormones

The six primary hormones produced by the anterior pituitary: GH, ACTH, FSH, LH, prolactin (PRL), and TSH.

Posterior Pituitary Hormones

The two hormones stored and secreted by the posterior pituitary: antidiuretic hormone (ADH/vasopressin) and oxytocin.

Somatropin

A recombinant growth hormone used to treat growth failure in children; strictly contraindicated once epiphyseal plates (growth plates) are closed.

Desmopressin (DDAVP)

A synthetic ADH analogue used to treat diabetes insipidus by decreasing urine output; carries black-box warnings for severe hyponatremia and rapid fluid volume shifts.

Octreotide

A somatostatin analogue used to suppress excess growth hormone in acromegaly; requires blood glucose monitoring because it alters insulin dynamics and can cause hyperglycemia.

PTH and Calcitonin

Counter-regulatory hormones for calcium homeostasis: Parathyroid hormone (PTH) raises serum calcium, whereas calcitonin acts to lower it.

Hypocalcemia vs. Hypercalcemia Signs

Hypocalcemia causes muscle spasms, Chvostek's sign, and Trousseau's sign; hypercalcemia causes kidney stones, depression, bone problems, muscle weakness, and loss of muscle tone.

Alendronate

A bisphosphonate that inhibits osteoclast-mediated bone resorption; must be taken first thing in the morning with a full glass of water, remaining upright for at least $30\text{ minutes}$ to avoid esophageal erosion.

Adrenal Crisis

Acute, life-threatening adrenal insufficiency occurring under physiological stress; requires immediate emergency parenteral corticosteroid infusion.

Hydrocortisone

A systemic corticosteroid providing glucocorticoid and mineralocorticoid activity for Addison's disease; requires stress-dose increases and must never be discontinued abruptly.

Fludrocortisone

A potent oral mineralocorticoid that promotes sodium and water retention and potassium excretion to raise blood pressure; can cause hypertension, CHF, and hypokalemia.

Ketoconazole (Endocrine Indication)

An antifungal agent used in Cushing’s disease to inhibit adrenal cortisol synthesis; requires monitoring of liver function tests and administration with an acidic beverage (e.g., orange juice or coffee).