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Urogenital Pharmacology > Female Fertility & Contraception > Flashcards

Female Fertility & Contraception Flashcards

1
Q

Mention uses of ethinyl estradiol

A
  1. OCPs
  2. Replacement therpy:
    a. 1ry hypogonadism
    b. Postmenopausal: dec menophasal symptoms & osteroporosis, cardioprotective
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2
Q

Adverse effects of synthetic estrogen

A

Nausea, breast tenderness, weight gain, endometrial hyperplasia, inc risk of endometrial & bc, HTN & thromboembolism
In male: dec libido, gynecomastia, impotence, feminization

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3
Q

Mention uses of norgesterol

A
  1. Hormonal contrac (main use)
  2. Dysmenorrhea (inhibit ovulation)
  3. Endometriosis (long-lasting ovarian suppression)
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4
Q

Mention adverse effects of progestins

A

Irregular bleeding followed by amenorrhea, weight gain, edema, depression, HTN, low HDL, hirsutism & acne

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5
Q

Mention ovulation-inducing agents

A
  1. Clomiphene
  2. HCG
  3. Human menopausal G: menotropins, urofallitropin
  4. Gonadorelin sc pulses
  5. Bromocriptine in hyperprolactinemia
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6
Q

Describe MOA & routes of ergot alkaloids

A

Mixed partial agonist effects at a-adrenoreceptors & 5HT receptors
Oral, IM, intramyometrial CI IV

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7
Q

Mention uses of ergot alkaloids with respect FGS

A
  1. Prevent/control postpartum Hge
  2. After C-section or instrumental delivery to prevent uterine atony
  3. Sub involuted uterus
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8
Q

Mention adverse effects of ergot alkaloids

A
  1. NVA
  2. Inc BP, seizures
  3. Vasospasm, palpitations (transient chest pains, coronary arterial spasm)
  4. Reduce milk secretion if used for longer period postpartum
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9
Q

Mention CIs of ergot alkaloids

A

During pregnancy, HTN, cardiac patients

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10
Q

Copmpare oral preparations of contraceptives

A

Combined estrogen & progesterone (most effective)
Progesterone only (minipill) less reliable but no risk of thromboembolism

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11
Q

Mention indications of parenteral progesterone preparations

A
  1. Contraception
  2. Regulation of menstrual cycle
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12
Q

Mention adverse effects & CIs of

A

Minor: NV, headache, breast tenderness, edema
Intermediate: bleeding (low dose), amenorrhea (high dose), acne, hirstutism, skin pigmentation
Major: 1. CVS: thromboembolism, pulmonary embolism, HTN, stroke, MI
2. Carcinogenic: breast & endometrial
3. Cholecystitis
4. Depression

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13
Q

Describe drug interaction of hormonal cotracep

A

Enzyme inducers dec efficacy leading to pregnancy

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14
Q

Describe MOA, uses & AEs of clomiphene

A

-Partial agonist estrohen acts centrally, blocks central estrogen receptors in hypo preventing feedback inhibition of estrogen on FSHRH & LHRH, stimulate ovulation & corpus luteum formatio
-Used in female infertility due to ovulation disorders
-AEs hot flushed, multiple pregnancies, overstimulation of ovaries

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15
Q

Describe MOA, uses & AEs of tamoxiphen

A

-SERM partial agonist acting peripherally, inhibit estrogen action on breast (antagonist), preserves bone mineral density & inc endometrial cancer risk (agonist)
-Used in ttt of hormone sensitive bc
AEs: hot flushes, vaginal discharges, menstrual irregularities

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16
Q

Describe MOA, uses & AEs of raloxifene

A

-SERM as estrogen on bone but not on breast or uterus (no risk of cancer)
-ttt of osteoporosis
-AEs: hot flashed, legcramps, sweating, CI : history of venous TE

17
Q

MOA & use of mifepristone

A

-Competitive inhibitor of progesterone & glucocorticoid receptors
-Therapeutic abortion

18
Q

Mention uses and AEs of Leuprolide

A

GnRH analog
-Uses
1. SC pulses to inc gonadotrophins amd stimulate ovulation in infertility
2. Continuous to inhibit gonadotrophins in cancer prostate endometriosis and IVF
-AEs:
1. Headache, hot flushes, depression
2. Vaginal dryness, dec libido, ovarian cyst
3. Osteoporosis

19
Q

Mention uses of genirelix

A

GnRH antagonist
1. Controlled ovarian hyper-stimulation (inhibit LH surge)
2. Advanced prostatic cancer

20
Q

Mention thepeutic uses of hCG

A

Its action is similar to LH:
1. Infertility, IVF
2. Undescended testes
3. 1ry or 2ry amenorrhea due to lack of gonadotrophins

21
Q

List adverse effects of gonadotrophins

A
  1. Hyperstimulation syndrome; enlarged ovary, ascites, hemoperitoneum
  2. Multiple births
  3. Spontaneous abortions
  4. Gymecomastia in males

Urogenital Pharmacology (6 decks)

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