| Term 
 
        | Mixed agonists with estrogenic effects are called... |  | Definition 
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        | Term 
 
        | What does 5a-reducatase do? Which drug inhibits it? |  | Definition 
 
        | convert testosterone to DHT, finasteride |  | 
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        | Term 
 
        | What is finasteride used to treat? |  | Definition 
 
        | BPH and male-pattern hair loss |  | 
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        | Term 
 
        | Estrogen _____ triglyceride levels and ______ LDL cholesterol. |  | Definition 
 | 
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        | Term 
 
        | Estrogen use by post-menopausal women is associated with a small increase in the risk of... |  | Definition 
 
        | breast cancer and CV events |  | 
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        | Term 
 
        | Dose dependent toxicity of estrogen includes... |  | Definition 
 
        | nausea, breast tenderness, increased risk of migraines, thromboembolic events, GB disease, hypertriglyceridemia, hypertension |  | 
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        | Term 
 
        | DES is associated with... |  | Definition 
 
        | infertility, ectopic pregnancy and vaginal adenocarcinoma in the daughters of women who took it |  | 
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        | Term 
 
        | older drugs like L-norgestrel and norethindrone are more _____ than the newer drugs (norgestimate, desogestrel) |  | Definition 
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        | Term 
 | Definition 
 
        | a full estrogen receptor antagonist |  | 
        |  | 
        
        | Term 
 | Definition 
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        | Term 
 | Definition 
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        | Term 
 | Definition 
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        | Term 
 | Definition 
 
        | an androgen receptor antagonist |  | 
        |  | 
        
        | Term 
 | Definition 
 
        | an androgen synthesis inhibitor |  | 
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        | Term 
 
        | Ketoconazole and danazole have inhibitory effects on... |  | Definition 
 | 
        |  | 
        
        | Term 
 
        | What effect do progestins have on metabolism? |  | Definition 
 
        | they affect carbohydrate metabolism and stimulate deposition of fat |  | 
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        | Term 
 | Definition 
 
        | may increase BP, decrease HDLs, reversible decrease in bone density, delayed resumption of ovulation after termination of therapy |  | 
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        | Term 
 
        | What do hormonal contraceptives contain? |  | Definition 
 
        | either a progestin or a progestin plus an estrogen |  | 
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        | Term 
 
        | What's in postcoital contraceptives? Which variety causes fewer side-effects? |  | Definition 
 
        | progestin alone, estrogen alone, or a combo - progestin-only has fewer side-effects |  | 
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        | Term 
 
        | Progestin-only contraceptives do not always... |  | Definition 
 
        | inhibit ovulation, instead working through effects on cervical mucus glands, uterine tubes and endometrium |  | 
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        | Term 
 
        | Users of combo hormonal contraceptives have decreased risks of... |  | Definition 
 
        | ovarian cysts, ovarian cancer, endometrial cancer, benign breast disease, PID, ectopic pregnancy, iron-deficiency anemia, rheumatoid arthritis |  | 
        |  | 
        
        | Term 
 
        | The major toxic effects of combined hormonal contraceptives relates to the action of the estrogenic component on... |  | Definition 
 | 
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        | Term 
 
        | Is the life-time risk of breast cancer different for users of hormonal contraceptives? |  | Definition 
 
        | no, but there may be an earlier onset |  | 
        |  | 
        
        | Term 
 
        | what are the toxicities of hormonal contraceptives? |  | Definition 
 
        | breakthrough bleeding, nausea, breast tenderness, headache, skin pigmentation, depression. Older, more androgenic progestins can cause weight gain, acne, hirsutism |  | 
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        | Term 
 
        | A high dose of estrogen is post-coital contraceptives is associated with... |  | Definition 
 | 
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        | Term 
 
        | Tamoxifen is effective in the treatment of what? What is its action at that site? |  | Definition 
 
        | hormone-responsive breast cancer, antagonist |  | 
        |  | 
        
        | Term 
 
        | What is the action of Tamoxifen at endometrial receptors? What is the effect of this? |  | Definition 
 
        | agonist, promotes endometrial hyperplasia and increases the risk of endometrial cancer |  | 
        |  | 
        
        | Term 
 
        | What are some side effects of Tamoxifen? |  | Definition 
 
        | hot flashes (antagonist effect), increases the risk of venous thrombosis (agonist effect), prevents osteoporosis (due to more agonist than antagonist effect) |  | 
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        | Term 
 
        | Which drug is structurally related to Tamoxifen and has similar properties? |  | Definition 
 | 
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        | Term 
 
        | How is raloxifene like tamoxifen? How is it different? |  | Definition 
 
        | partial agonist effect on bone, antagonist effects in breast tissue and reduces the incidence of breast cancer for high-risk women.  Adverse effects - hot flashes and DVT. Unlike - no estrogenic effects on endometrial tissue. |  | 
        |  | 
        
        | Term 
 
        | What is clomiphene? What does it do? |  | Definition 
 
        | a nonsteroidal compound with tissue-selective actions, induces ovulation in anovulatory women who want to get preg, selectively blocks estrogen receptors in pituitary and reduces negative feedback thereby increasing FSH and LH |  | 
        |  | 
        
        | Term 
 
        | What is used for treatment of breast cancer that has developed resistance to tamoxifen? |  | Definition 
 | 
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        | Term 
 
        | Anastrozole and related compounds (letrozole) are... |  | Definition 
 
        | nonsteroidal competitive inhibitors of aromatase |  | 
        |  | 
        
        | Term 
 
        | Which drug is an irreversible aromatase inhibitor? |  | Definition 
 | 
        |  | 
        
        | Term 
 
        | Anastrozole, letrozole, and exemestane are used in the treatment of... |  | Definition 
 | 
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        | Term 
 
        | Which drug inhibits several p450 enzymes involved in gonadal steroid synthesis, and is a weak partial agonist of progestin, androgen and glucocortcoid receptors? What is it used for? |  | Definition 
 
        | Danazol, sometimes used for endometriosis and fibrocystic disease of the breast |  | 
        |  | 
        
        | Term 
 
        | Continuous administration of _______ suppresses gonadotropin secretion and thereby inhibits ovarian production of estrogens and progesterone |  | Definition 
 
        | GnRH agonists - i.e. leuprolide |  | 
        |  | 
        
        | Term 
 
        | GnRH agonists are used in combo with other agents in which clinical situations? What can happen if they are used in premenopausal women for more than 6 mo? |  | Definition 
 
        | controlled ovarian hyperstimulation, precocious puberty, short term treatment of endometriosis and uterine fibroids. Decreased bone density |  | 
        |  | 
        
        | Term 
 
        | What is RU486? It is often combined with which other drug? What does that drug do? |  | Definition 
 
        | Mifepristone (RU486) is an orally active steroid antagonist of progesterone and glucocorticoids, used as abortifacient in early preg.  Combo with misoprostol,  a PGE analogue |  | 
        |  | 
        
        | Term 
 
        | Side effects of mifeprostone + misoprostol are primary due to _____ and include... |  | Definition 
 
        | misoprostol, N/V/D, vaginal cramping, bleeding |  | 
        |  | 
        
        | Term 
 
        | Testosterone is synthesized from... |  | Definition 
 | 
        |  | 
        
        | Term 
 
        | Testosterone is converted in several organs to ____, which is the active hormone in those tissues |  | Definition 
 | 
        |  | 
        
        | Term 
 
        | What are two drugs that have an increased ratio of anabolic to androgenic action in laboratory tests? |  | Definition 
 | 
        |  | 
        
        | Term 
 
        | All of the anabolic steroids have full ______ effects when used in humans |  | Definition 
 | 
        |  | 
        
        | Term 
 
        | In both sexes, high doses of anabolic steroids can cause... |  | Definition 
 
        | cholestatic jaundice, elevation of LFTs, possibly hepatocellular carcinoma |  | 
        |  | 
        
        | Term 
 
        | Flutamide and related drugs are... |  | Definition 
 
        | nonsteroidal competitive antagonists of androgen recepts |  | 
        |  | 
        
        | Term 
 
        | Spironolactone inhibits _____ receptors and is used in the treatment of _____ in women. |  | Definition 
 | 
        |  | 
        
        | Term 
 
        | Which class of drugs is less likely than other antiandrogens to cause impotence, infertility and loss of libido? |  | Definition 
 
        | 5a-reductase inhibitors like finasteride |  | 
        |  | 
        
        | Term 
 
        | During the first week of therapy with leuprolide, an androgen receptor antagonist (like _____) is used to prevent the _____ that can result from the surge in testosterone synthesis caused by the initial agonist action. |  | Definition 
 | 
        |  | 
        
        | Term 
 
        | How do combined hormonal contraceptives help women with hirsutism? |  | Definition 
 
        | the estrogen acts on the liver to increase production of SHBG, which reduces the concentration of free androgen in the blood |  | 
        |  | 
        
        | Term 
 
        | Which drug is an antifungal that also inhibits gonadal and adrenal steroid synthesis? |  | Definition 
 | 
        |  | 
        
        | Term 
 
        | ethynl estradiol, estrone, estriol and mestranol are all... |  | Definition 
 | 
        |  | 
        
        | Term 
 
        | norgestrel, medroxyprogesterone, progesterone, norgestimate and norethindrone are all... |  | Definition 
 | 
        |  | 
        
        | Term 
 
        | Tamoxifen, raloxifene and clomiphene are... |  | Definition 
 | 
        |  | 
        
        | Term 
 
        | Anastrozole and letrozole are... |  | Definition 
 | 
        |  | 
        
        | Term 
 | Definition 
 | 
        |  | 
        
        | Term 
 | Definition 
 | 
        |  | 
        
        | Term 
 | Definition 
 | 
        |  | 
        
        | Term 
 
        | Oxandrolone and stanozolol are... |  | Definition 
 | 
        |  | 
        
        | Term 
 
        | methyltestosterone and fluoxymesterone are... |  | Definition 
 | 
        |  | 
        
        | Term 
 | Definition 
 
        | androgen receptor antagonist |  | 
        |  |