Estrogens

Question 1

Estrogen preps

Answer 1

Natural- estradiol
Semisynthetic (steroidal)
Synthetic (non steroidal) - DES

Question 2

Oral but first pass with low bioavailability

Answer 2

Estradiol

Question 3

Fat soluble so stored in adipose with high bioavailability

Answer 3

Ethinylstradiol orally
From mestranol

Question 4

Also effective orally but not a steroid

Answer 4

DES

Question 5

Enhances the coagulability of blood

Answer 5

Estrogen- increasing levels of factors 2 7 9 and 10

Question 6

Added to estrogen to decrease the risk of endometrial cancer

Answer 6

Progesterone

Question 7

Main use of progesterone

Answer 7

Oral contraception alone or with estrogen
Dysmenorrhoea and amenorrhoea

Question 8

Progesterone in amenorrhea

Answer 8

On the 15th to 25th day (take estrogen for 25 days)

Question 9

Progesterone preps

Answer 9

Natural - Hydroxyprogesterone caproate
Synthetic -

Question 10

Rapidly metabolised so given as oily IM injection (or pellets or microcrystal implants)

Answer 10

Hydroxyprogesteron caproate

Question 11

Synthetic progesterone prep

Answer 11

Medroxy progesterone (orally/ IM)- progesterone derivative
Norethindrone and norgestrel (orally/ SC)- nortestosterone derivatives

Question 12

Weal androgenic effect progesterone

Answer 12

Because nortestosterone derivatives some of them

Question 13

Anti estrogen (SERM)

Answer 13

Chlomiphene citrate - ovulation inducing
Tamoxifen
Raloxifene

Question 14

Estrogen synthesis inhibitors

Answer 14

Aromatase inhibitors for extra adrenaline sources of estrogen in breast, liver, fat, skin, muscle :
Steroidal (suicidal) exemestane
Non steroidal (binds reversibly) letrozole

Question 15

Ovulation inducing agents

Answer 15

Chlomiphene citrate - blocks hypothalamic ER so no usual negative feedback increasing FSH and all the estrogen
Human menopausal gonadotropins
Metforming in PCOs 50 percent
Letrozole (NS aromatase inhibitor)

Question 16

Must be followed by HCG with LH activity only

Answer 16

Human Menopausal Gonadotropins

Question 17

Antiprogestrones

Answer 17

Mifepristone
Danazol

Question 18

Used as postcoital contraceptive with prostaglandin analogue misoprostol either orally or intravaginally

Answer 18

Mifrepristone

Question 19

Danazol

Answer 19

Weak androgen, anti estrogen, anti progesterone

Question 20

Used in ttt of endometriosis and fibrocystic breast disease

Answer 20

Danazol

Question 21

Androgen prep

Answer 21

Natural - androsterone and testosterone
Synthetic- test. propionate and methyl test.

Question 22

Doesn’t require active form of test.

Answer 22

Muscle

Question 23

Anti androgens

Answer 23

Finasteride
Flutamide and cyproterone
Spironolactone

Question 24

Androgens themselves not given orally but…

Answer 24

Their anti androgens (eg Fiansteride) can

Question 25

Inhibits co version to DHT

Answer 25

Finasteride through inhibition of 5 alpha reductase

Question 26

Competes with test. receptors

Answer 26

Flutamide and cyproterone

Question 27

Competes with FHT receptors

Answer 27

Spironolactone (also reduces 17 alpha hydroxylase so no test. at all and no more hirsutism in women)

Question 28

Anabolic steroids

Answer 28

Nandrolone Methandrostenolone

Question 29

GnTH analogues to inhibit gonadotropin release because not pulsatile

Answer 29

Leuprolide (IV SC or nasal spray)

Question 30

Somatostatin analogue

Answer 30

Octreotide (longer half life)

Question 31

Somatotropin works through

Answer 31

Production of somatomedins

Question 32

FSH nad LH

Answer 32

HMG

Question 33

LH only

Answer 33

HCG

Question 34

Results in Hyperprolactinemia

Answer 34

Dopamine agonists like metoclopramide

Question 35

Treats Hyperprolactinemia

Answer 35

D2 agonists like Cabergoline and Bromocriptine

Question 36

Vasopressin analogue that's longer acting with minimal activity at V1 receptor

Answer 36

Desmopressin (DI)

Question 37

Oxytocin derivative

Answer 37

Syntocinon

Question 38

If only vaginally atrophy

Answer 38

Add vaginal estrogen

Question 39

Main uses estrogen

Answer 39

Contraception Post menopausal hormone therapy Replacement therapy

Question 40

Advantage of non steroidal over steroidal

Answer 40

No androgenic side effect

Question 41

No conversion of androgen to DHT so no effect on

Answer 41

Prostate Hair follicles

Question 42

Given orally to reduce BPH

Answer 42

Finasteride - no DHT conversion

Question 43

Treats cancer prostate and hirsuitism

Answer 43

Flutamide and cyproterone - competes for testosterone receptors

Question 44

Ttt of nocturnal enuresis

Answer 44

Desmopressin

Question 45

Weirdo syntocinon uses

Answer 45

Induction of labour Control of post partum hemorrhage Impaired milk ejection