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| Drug | Mode of Action | Indication | Side Effects | Notes/Mnemonics |
|---|---|---|---|---|
| Leuprolide, Goserelin | GnRH Analogs. Pulsatile: Agonist. Continuous: Antagonist (Downregulation). | Pulsatile: Infertility. Continuous: Prostate cancer, Fibroids, Endometriosis, Precocious puberty. | Hypogonadism, Hot flashes, N/V. | "Loud" (pulsatile) or "Low" (continuous). Antiandrogen first for prostate CA flare. |
| Drug | Mode of Action | Indication | Side Effects | Notes/Mnemonics |
|---|---|---|---|---|
| Ethinyl estradiol, DES, Mestranol | Estrogens. Bind ER. | Hypogonadism, Ovarian failure, HRT. | Thrombus risk, Endometrial cancer, Clear cell vaginal CA (DES). | Contraindicated: Smoker >35, DVT hx, ER+ breast cancer. |
| Clomiphene | SERM. Antagonist at hypothalamus. Blocks feedback -> Incr LH/FSH. | Infertility (PCOS). | Multiple gestations, Hot flashes, Visual disturbances, Ovarian enlargement. | Tricks pituitary into thinking "no estrogen". |
| Tamoxifen | SERM. Antagonist: Breast. Agonist: Bone, Uterus. | ER+ Breast Cancer. | Endometrial cancer, Thromboembolism, Hot flashes. | Risk of uterine cancer distinguishes from Raloxifene. |
| Raloxifene | SERM. Antagonist: Breast, Uterus. Agonist: Bone. | Osteoporosis. | Thromboembolism, Hot flashes. | "Relax" = No uterine cancer risk. |
| Anastrozole, Letrozole, Exemestane | Aromatase Inhibitors. Block conversion to estrogen. | ER+ Breast Cancer (Post-menopausal). | Osteoporosis, Fracture risk. | Preferred over Tamoxifen for post-menopausal. |
| Drug | Mode of Action | Indication | Side Effects | Notes/Mnemonics |
|---|---|---|---|---|
| Levonorgestrel, Medroxyprogesterone | Progestins. Thicken cervical mucus, inhibit proliferation. | Contraception, Endometrial cancer, AUB. | Weight gain, Acne, Androgenic effects. | Added to HRT to protect endometrium. |
| Mifepristone (RU-486) | Antiprogestin. Competitive inhibitor. | Abortion (with Misoprostol). | Heavy bleeding, Cramping. | Decidua breakdown -> detachment. |
| Ulipristal | SPRM. Inhibits ovulation. | Emergency contraception. | Headache, Abdominal pain. | "Ultimate" backup. |
| Drug | Mode of Action | Indication | Side Effects | Notes/Mnemonics |
|---|---|---|---|---|
| Testosterone | Agonist at AR. | Hypogonadism. | Epiphyseal closure, LDL Incr, Gonadal atrophy. | Exogenous T shrinks testes. |
| Danazol | Partial Agonist. | Endometriosis, Angioedema. | Masculinization, Hirsutism, Edema. | Acts like a "Dan" (man). |
| Finasteride | 5a-reductase inhibitor. | BPH, Alopecia. | Gynecomastia, Sexual dysfunction. | "Finish" hair loss. Blocks DHT. |
| Flutamide | Competitve Inhibitor at AR. | Prostate CA. | Gynecomastia, Hepatotoxicity. | Used with Leuprolide. |
| Ketoconazole | 17,20-desmolase inhibitor. | PCOS, Prostate CA. | Gynecomastia, Amenorrhea. | "Cuts the Two" (Desmolase). |
| Spironolactone | AR Blocker & 17a-hydroxylase inhibitor. | PCOS, Diuretic. | Gynecomastia, Hyperkalemia. | "Spiro" = Spare K+, Receptor Off. |
| Drug | Mode of Action | Indication | Side Effects | Notes/Mnemonics |
|---|---|---|---|---|
| Terbutaline | B2-agonist. Relaxes uterus. | Tocolysis. | Tachycardia, Tremors. | "It's Not My Time". |
| Tamsulosin | a1A-antagonist (Prostate specific). | BPH (Symptoms). | Floppy Iris Syndrome, Retrograde ejaculation. | Less hypotension than non-selective. |
| Sildenafil | PDE-5 Inhibitor. Incr cGMP. | ED, Pulmonary HTN. | Cyanopsia, Hypotension with Nitrates. | "Blue pill = Blue vision". Nitrates contraindicated. |
| Minoxidil | Opens K+ channels -> Vasodilation. | Alopecia, Severe HTN. | Hypertrichosis, Reflex tachycardia. | Rogaine. |