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Exam 4
Chapter 25 Estrogen, Progesterone and Androgens
12
Pharmacology
Undergraduate 4
04/19/2011

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Term
Number 1. analogs of the female natural hormone . They activate steroid receptors to change gene expression to alter cellular activities. Estrogen agonists are used for contraception, primary hypogonadism (underactive ovary), osteoporosis and hormone replacement therapy for severe menopausal symptoms (no longer recommended for menopausal women due to cariovascular complications (clotting deep venous thrombosis) and increased incidence of breast cancer). Estrogens in high doses is no longer used short term for plan B postcoidal or "morning after" contraception due to serious risks. Plan B now uses high dose progesterone.
Definition
Correct Answer: estradiol, mestranol, ethinyl estradiol
Term
Number 2. bisphosphonates. // they inhibit osteclast proton pump activity, and osteoclast formation and increase osteoclast cell death (apoptosis). They are used to treat osteoporosis, paget's disease, and metastatic bone cancers and are more effective than hormone replacement therapies or SERMs. These strengthen bones when plasma calcium concentrations are normal. They should not be used in a hypocalcemic patient. Jaw bone weakening and esophageal ulcers may develop. Dental x-rays should establish a baseline and monitored over time.
Definition
Correct Answer: etridonate, pamidronate, alendronate, risendronate
Term
Number 3. analog of parathyroid hormone that increases osteoblast activity and decreases osteoclast activity when plasma calcium levels are normal. It is used to treat osteoporosis; it is the only drug that stimulates osteoblasts to build bone rather than inhibiting osteoclast demineralization of bone.
Definition
Correct Answer: teriparitide
Term
Number 4. Hormone of the thyroid that increases calcium deposition in bone. It is isolated from fish and patients allergic to fish are more likely to have allergic reactions to this drug. It is administered intranasally. Although it can be used for osteoporosis no matter the cause, if glucocorticoid-induced osteoporosis it gradually loses efficacy because tolerance develops.
Definition
Correct Answer: calcitonin
Term

Number 5. mineral essential for bone development and a steroid Vitamin that regulates calcium absorption from the GI tract and in the kidney nephron. PTH activates Vit D to increase calcium uptake and conservation in the body.


Definition
Correct Answer: Calcium and Vit D
Term
Number 6. selective estrogen receptor modulators (SERM). // estrogen receptor antagonists in the breast but estrogen agonist in the bone and liver (strengthens bone). / palliative (symptomatic) and prophylactic (preventive) treatment of breast cancer. However tamoxifen causes an increased risk of uterine cancer so it should only be used in hysterectomized women. Raloxifene does not cause uterine cancer. // Both tamoxifen and raloxifene can increase the risk of deep venous thrombosis by decreasing clotting times (antithrombin III and other actions to increase activity of the intrinsic and extrinsic clotting pathways).
Definition
Correct Answer: tamoxifen, raloxifene
Term
Number 7. progesterones. // inhibit ovulation, implantation and thickens cervical mucus. 
used for contraception as pills, patches or incorporated into IUD, dysmenorrhea, excessive uterine bleeding, suppression of postpartum lactation, endometrriosis, endometrial cancer.
Definition
Correct Answer: progestins, medroxyprogesterone, hydroxyprogesterone, noerthindrone, norgestrel
Term
Number 8. RU-486 antiprogestin. It inhibits the release of hCG and there prevents growth of the placenta and causes the placenta to detach from the uterine wall. It causes abortion either alone (85% successful) or with misoprostol (PGE1) (99%) successful. It is an abortificant in the USA and a morning after contraceptive in Europe and most of the world. In the USA, mifeprestone is not legally prescribed unless a patient is actually proven pregnant which means it can not be used as a morning after pill = not postcoital contraception.
Definition
Correct Answer: mifepristone
Term
Number 9. androgen agonists // steroid hormone causes changes in gene expression to increase anabolic state and increase growth and muscle hypertrophy // 
used for hypogonadism, or for anabolic effects to reverse osteoporosis, and heal severe burns, surgical wounds and muscle wasting caused by predisnone, low doses for increased bone growth with Growth hormone before bone epiphyseal plates fuse, endometriosis // (unapproved use) body building. // Adverse effects include feedback inhibition of FSH and LH and therefore, shrinkage of the testicles and reduction of spermatogenesis (but not fullproof for contraception)
Definition

Correct Answer: testosterone, danazol


Term
Number 10. androgen receptor antagonists // block the actions of testosterone and DHT =dihydrotestosterone // used for prostate cancer, cyproterone is used for hirsutism (male facial hair) in women. Used before GnRH like leuprolide IM injection to block the first pulse to prevent prostatic growth until leuprolide can cause drug-induce castration.
Definition
Correct Answer: flutamide, bicalutamide, nilutamide, cyproterone,
Term
Number 11. inhibitors of testosterone synthesis, inhibit 5 alpha reductase // lowers plasma dihyrdotestosterone that is most potent stimulator of prostate // treatment of benign prostatic hypertrophy (finasteride = proscar , dutasteride = avodart), precocious puberty in males. Ketoconazole is an antifungal agent observed to cause gynecomastia as side effect. Spironolactone is K-sparing diuretic that antagonizes aldosterone and also inhibits testosterone synthesis
Definition
Correct Answer: finasteride, dutasteride, ketoconazole, spironolactone
Term
Number 12. aromatase inhibitors decrease the conversion of testosterone to estradiol. In the postmenopausal woman, ovary ceases to make estrogen but the adrenal gland can convert testosterone to estradiol which becomes the main source of estrogen after menopause. Aromatase inhibitors decrease estradiol 85% which has proven very effective to stop breast cancer growth in postmenopausal women.
Definition
Correct Answer: anastrazole, letrozole aminoglutethimide
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