Pharm 3 - Exam 1 Gonads

Rachel's Quizlet

What Gonadotropin triggers ovulation?

Lutenizing Hormone

In males, 95% of testosterone is produced in what cells found in the testes?

Leydig cells

What are examples of synthetic estrogens?

selective estrogen receptor modulators (SERMs) such as tamoxifen and raloxifene

What is the major secretory product of the ovary?

Estradiol

What two estrogens have an ethinyl group (C⫢ CH) at the C17 position of estradiol, which reduces first-pass metabolism?

Ethinyl estradiol and mestranol

What two estrogens are long-acting esters of estradiol that are slowly absorbed following intramuscular administration?

Estradiol cypionate and estradiol valerate

Combination estrogen-progestin preparations contain which two estrogens?

ethinyl estradiol or mestranol 1

What progrestrone is also used to help patient gain weight?

Megestrol

How are progesterone esters used with estrogens and how are they beneficial?

decrease the incidence of estrogen-induced irregular bleeding and to prevent uterine hyperplasia and endometrial cancer

What two synthetic progestins have improved progestational selectivity and lessened androgenic activity?

Desogestrel and norgestimate

Combined Oral Contraceptives contain a synthetic estrogen which is usually?

Ethinyl estradiol

When using COCs, ovulation inhibition occurs how?

The hormones suppress the release of follicle-stimulating hormone (FSH) and luteinizing hormone (LH) from the pituitary gland

What are the 3 MOA of COCs?

Ovulation inhibition, cervical mucus thickening, endometrial thinning

What are important benefits of OCs?

Lower incidence of ectopic pregnancy, iron deficiency,

and rheumatoid arthritis

More potential benefits of OCs?

May reduce the risk of certain cancers (ovarian, endometrial, colorectal), ovarian cysts

What is the first new estrogen in the US in the past 50 years?

Estetrol

What OC has low impact on liver?

Estetrol

When using a COCs with a low estrogen dose, what may occur?

Irregular bleeding or spotting between periods, may be associated with unpredictable bleeding compared to higher-dose option

Which dose of COC is better for a history of nausea and breast tenderness?

"lower" dose, "Standard" dose COC, have higher incidence of SE

The overall incidence of superficial or deep thromboembolic disease is about three-fold higher in women who take?

low-dose oral contraceptives

At what age is there a higher risk of stroke or heart attack when taking OC?

>35 yo

If a patient has liver problems such as Cholestatic jaundice, do they have a higher or lower risk when using OCP?

Higher risk, they are CI

What 4 drugs will reduce effectiveness of OCP?

Rifampin, phenobarbital, phenytoin, carbamazepine

The estrogen component of combined oral contraceptives _________

TBG levels, leading to a decrease in the availability of free thyroid

hormone, which can _________ hypothyroidism in individuals on

levothyroxine replacement.

Increases; worsen

Research shows that women with hypothyroidism treated with thyroxine may require an _________ dosage when taking estrogen therapy, including oral contraceptives.

Increased

Continuous use of progestins alone does not always

prevent ovulation. True or False

True

What are some ways that account for some of the effectiveness of the progestin only pills?

Thickening of cervical mucus, endometrial atrophy, and

decreased motility of the fallopian tubes

When should one take POC?

Smoker >35 yo

When are POC CI?

Breast cancer

What is an adverse effect of POC?

Breakthrough bleeding

What is an Implant-subdermally just under skin of non-dominant arm?

Etonogestrel

What are some uses for menopausal hormone therapy?

Prevention of osteoporosis, relief of vasomotor symptoms, genital atrophy

What therapy is Used for women who have had a hysterectomy (removal of the uterus)?

Estrogen only therapy, estrogen alone can increase the risk of uterine cancer in women with an intact uterus

What are CV risks of HRT?

Increased risk of heart attack, stroke

When should systemic HRT be used?

Systemic tx should only be used in healthy pts under age 60 or within 10 yrs of last period

Why should we consider a HRT patch, gel or spray for systemic estrogen when treating hot flashes?

to lower thrombosis risk because oral estrogens are associated with a higher risk of venous thromboembolism (VTE)

In female androgen deficiency, what symptoms are important to treat with ART?

particularly for symptoms like reduced libido and muscle loss

When should we consider treatment in a patient with low testosterone?

consider tx for pt with low levels plus sexual dysfunction

How does testersterone affect breast cancer cells?

testosterone competes for estrogen receptors on breast cancer cells so CA cells don't grow

What are side effects of misuse of anabolic steroids?

can reduce sperm count, cause infertility, lead to testicular atrophy, gynecomastia, erectile dysfunction, and increased risk of prostate cancer

What is a critical step to prevent accidental transfer of testosterone to others, particularly women and children?

Wash hands thoroughly with soap and water after applying testosterone gel

What is the MOA of Tamoxifen?

SERM (selective estrogen receptor modulator)

What drug is used to prevent and treat breast CA?

Tamoxifen 1

What drug has a black box warning for endometrial CA and blood

clots?

Tamoxifen

What is the MOA of Raloxifene?

SERM. It is a partial estrogen agonist-antagonist

What drug is used as prevention and treatment of postmenopausal

osteoporosis?

Raloxifene 1

What drug is generally preferred over bisphosphonates for younger postmenopausal women with osteoporosis or low bone mineral density (BMD), particularly those at lower risk of fractures and who may also be concerned about breast cancer risk?

Raloxifene 1

What drug is also an option for women who cannot tolerate bisphosphonates or prefer an alternative treatment?

Raloxifene

What drug is used for Dyspareunia due to vulvar and vaginal atrophy/dryness?

Ospemifene

What drug is used for Induction of ovulation?

Clomiphene

What is the dosage of Clomiphene?

Given in a dose of 50 mg for 5 days beginning on the fifth day of the menstrual cycle

What is an enzyme that converts androgens into estrogens?

Aromatase

What is a pure estrogen receptor antagonist for patients resistant to tamoxifen?

Fulvestrant

What drug competitively blocks progesterone and glucocorticoid receptors?

Mifepristone 1

What drug is used to treat refractory Cushing's disease?

Mifepristone

What drug has weak progestational, androgenic, and glucocorticoid activities?

Danazol

What is an adverse effect of Danazol?

hirsutism

What drug is a 5 alpha reductase inhibitor which blocks the conversion of testosterone to dihydrotestosterone (DHT)?

Finasteride 1

What drug is used to treat male-pattern baldness?

Finasteride