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Pharmacology > Exam 12: Sex Hormones and Gonadotropins > Flashcards

Exam 12: Sex Hormones and Gonadotropins Flashcards

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1
Q

2 Estrogen Oral Contraceptives

A

Ethynyl Estradiol

Estradiol valerate

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2
Q

5 Progestin Oral Contraceptives

A 
Levonorgestrel
Desogestrel
Norgestimate
Drospirenone
Norethindrone
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3
Q

What type of oral contraception is useful in that it does NOT interfere with lactation?

A

Progestins

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4
Q

Oral contraceptive most associated with weight gain

A

Medroxyprogesterone

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5
Q

Drug in Plan B

A

Levonorgestrel

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6
Q

Problem with Original Oral Contraception

A

Large doses

More side effects

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7
Q

Classic oral contraceptive cycle

A

21 days of Oral contraceptives followed by 7 days of inert pills or ferrous fumurate

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8
Q

Multiphase Combined Oral Contraceptives

A

Mimic normal hormonal events of the menstrual cycle

Allows inhibition of ovulation with decreased overall exposure to the synthetic hormones (lower doses)

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9
Q

Drug used in four-phasic oral contraceptives

A

Estradiol valerate

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10
Q

2 choices for starting date of oral contraceptive

A

First day of menses for more rapid contraception

First Sunday after menses (make sure they use backup contraception for 7 days)

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11
Q

Most prominent estrogen type produced in the ovary

A

Estradiol

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12
Q

Primary synthetic estrogen used in oral contraceptives

A

Ethanyl estradiol

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13
Q

Enterohepatic recirculation of oral contraceptives

A
  1. Conjugated to sulfate or glucuronide in the liver
  2. Secreted into the intestine via biliary tract
  3. Bacteria cleaves conjugate, allowing reabsorption
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14
Q

2 Progestins that are less androgenic than others

A

Norgestimate

Desogestrel

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15
Q

Yaz combo, uses

A

Ethanyl estradiol and Drospirenone

Birth control, also indicated for acne

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16
Q

Most common side effects of combined oral contraceptives

A

Nausea

Take with dinner or at bedtime

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17
Q

Dermatological side effects of combined oral contraceptives

A
  1. Chloasma (brown pigmentation, especially on the face)
    Avoid UV light
  2. Acne
  3. Hirsutism
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18
Q

CV side effects of combined oral contraceptives

A

HTN

MI and stroke, especially in smokers

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19
Q

Serious risk of combined oral contraceptives

A

Thromboembolic disorders

Estrogen is implicated in increased clotting factors and decreased antithrombin III

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20
Q

Desogestrel side effect

A

FDA review indicated that it increased risk of nonfatal venous thrombosis

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21
Q

Hepatobilliary side effects of Combined oral contraceptives

A

Gallstones (not much anymore with lower doses)

Benign hepatocellular adenoma

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22
Q

Metabolic side effects of oral contraceptives

A

decreased glucose tolerance

may increase LDL and triglycerides

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23
Q

GU side effects of oral contraceptives

A

Breakthrough bleeding/spotting

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24
Q

Infection associated with combined oral contraceptives

A

Candida vaginitis

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25
CNS side effects of oral contraceptives
depression | migraines
26
Ocular side effects of combined oral contraceptives
Worsening of myopia/nearsightedness
27
Cancer associated with oral contraceptives
Increased risk of breast cancer and cervical cancer
28
Effect of oral contraceptives on fertility
Infertility may extend for a long time after they stop the birth control
29
Problem with oral contraceptives after giving birth
Avoid use for 3-4 weeks due to risk of blood clots | Estrogen can affect the breast milk, progestins do not
30
Cancer prevented by oral contraceptives
Decreased risk of endometrial cancer and ovarian cancer
31
3 birth controls that also treat acne
Ortho tri-cyclen Estrostep Yaz
32
Antibiotics and oral contraceptives
Decrease gut bacteria, decreasing beconjugation and therefore reabsorption (enterohepatic recirculation)
33
When might you use progestin only contraceptives?
When they're lactating or at risk for HTN or blood clots | If they're over 35 years old
34
Ovulation in progestin only contraception
Dont consistently inhibit ovulation (40% of cycles are still ovulatory) Other mechanisms help prevent pregnancy (inhospitable environment of the ovum)
35
Advantage of Medroxyprogesterone
It's injected once every 3 months, so they don't have to take a pill every day This is the one that really causes weight gain There's also a sub Q preparation
36
Morning after pill adverse side effect
Delay or inhibition of ovulation
37
Premarin
Conjugated equine estrogens
38
Pempro
Conjugated equine estrogens + medroxyprogesterone
39
2 SERMs
Raloxifine | Clomiphene
40
GnRH agonist
Leuprolide
41
2 gonadotropins drugs
Menotropins | Chorionic gonadotropin
42
2 5-alphareductase inhibitors
Finasteride | Dutasteride
43
Difference between estrogen replacement and hormone replacement therapy
HRT is estrogen + progestin
44
Who must have HRT instead of ERT?
Women with intact uterus (they need the progestin) | This prevents estrogen-induced endometrial hyperplasia and endometrial cancer
45
Estrogen effect of cholsterol
Increased HDL, decreased LDL
46
are ERT/HRT indicated in vasomotor symptoms of menopause
yes | this is a major complaint during transition
47
are ERT/HRT indicated in symptoms of vaginal atrophy and dryness
yes
48
are ERT/HRT indicated in helping to prevent osteoporosis?
consider other options (bisphosphonates)
49
are ERT/HRT indicated in prevention of cardiovascular disease
Do not use them for this | trials indicate no overall benefit
50
are ERT/HRT indicated in prevention of alzheimer's?
No | studies show no improvement
51
Adverse effects of HRT/ERT
Increase risk of breast cancer Brease tenderness Nausea THROMBOEMBOLISM (mostly in first couple of years) Gallbladder disease (less with transdermal preps)
52
Contraindications to HRT/ERT
``` Endometrial cancer Breast cancer Undiagnosed vaginal bleeding Thromboembolism Liver disease (maybe try transdermal) ```
53
When might you use a transdermal patch for ERT/HRT?
Hypertriglyceridemia, liver disease, gallbladder disease
54
Raloxifine use, mechanism
Osteoporosis | SERM
55
Clomiphene use, mechanism
Female infertility | Hypothalamus estrogen antagonist, increasing FHS and LH
56
Clomiphene contraindication
Ovarian cysts | Can cause enlargement/formation of ovarian cysts
57
Leuprilide uses
Androgen dependent prostate cancer Endometriosis Precocious puberty Infertility
58
Leuprolide mehcanism
GnRH agonist (cause initial surge and then inhibition of LH and FSH)
59
Leuprolide side effects
Impotence and decreased libido | Also hot flashes and night sweats
60
Menotropins mechanism
LH and FSH isolated from urine of postmenopausal women
61
Menotropin uses
Used with hCG Induce ovulation in infertile anovulatory women Use to stimulate spermatogenesis in men
62
Chorionic gonadotropin uses
Ovulation induction and spermatogenesis
63
Chorionic gonadotropin adverse effects
Ovarian hyperstimulation and multiple pregnancies
64
Finasteride and dutasteride mechanism
5 alpha reductase inhibitors, block conversion of testosterone to more active DHT
65
Finasteride and dutasteride uses
treat BPH | can also treat male pattern baldness
66
Finasteride and dutasteride side effect
may cause impotence
67
Risk associated with testosterone replacement therapy
Increased risk of MI | they stopped the trial early because the pattern was so clear

Pharmacology (34 decks)

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