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Phar300 > lect 14 female contraception > Flashcards

lect 14 female contraception Flashcards

(69 cards)

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1
Q

to create contraceptives we manipulate which system for the release of what

A

endocrine system for the release of sperm or oocyte

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2
Q

major components of the endocrine system pertaining to contraception

A

GnRH (hypothalamus)–> LH, FSH (gonadotropic cell in anterior pituitary)–> testis, ovaries (gametogenesis, gonadal hormone production)

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3
Q

effect of LH and FSH on ovary

A

release of estrogen and progesterone, increase steroidogenesis, stimulate maturation of ovarian follicle

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4
Q

estrogen and progesteron stimulate what

A

folliculogenesis and secondary sex characteristics

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5
Q

negative feedback loop of HPO axis

A

negative feedback on hypothalamus and pituitary to reduce GnRH and LH and FSH

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6
Q

what does pulsatile mean for GnRH, LH, FSH

A

shape of the chemical message matters. rhythmic, intermittent propagation

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7
Q

FSH regulates what

A

follicle growth and maturation in the ovaries

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8
Q

primary follicles develop into what

A

oocytes

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9
Q

what happens to mature follicles

A

they get ovulated and become the corpus luteum

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10
Q

cells that surround to development of oocytes, make steroid hormones from interaction

A

granulosa and theca cells

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11
Q

theca cells make what

A

testosterone

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12
Q

granulosa cells make what

A

make estradiol from testosterone via aromatase

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13
Q

testosterone to estradiol process

A

cholesterol side chain cleavage to progesterone. progesterone becomes testosterone. aromatase makes estradiol from testosterone

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14
Q

what induces the production of estradiol in granulosa cells

A

FSH

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15
Q

what hormone acts on theca cells and what does it do

A

LH and it increases steroid synthesis and synthesis of FSH receptor to magnify FSH response

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16
Q

role of progesterone in steroidogenesis

A

cross roads. can be made into glucocorticoids in adrenal glands and also act in testes and ovaries to make testosterone and estrogen

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17
Q

estrogen and progesterone act with what receptors

A

nuclear hormone receptors in the same way that glucocort. do

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18
Q

two isoforms of estrogen receptors

A

alpha and beta

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19
Q

true or false? there are more selective estrogen receptor ligands and modulators that act differentially with ERalpha or ERbeta

A

true

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20
Q

estrogen also acts on receptors where for implantation of fertilized oocyte

A

acts in endometrium so that cells there can proliferate and become more receptive to implantation

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21
Q

possible binding for both estrogen and progesterone to cell membrane receptors may cause what

A

nongenomic changes

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22
Q

oocyte is released where

A

into fallopian tube

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23
Q

how many ovulated oocyte per menstrual cycle

A

one

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24
Q

goal of contraception

A

prevent release or fertilization by sperm of ocyte

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25
contraceptive drugs can also be used for...
for ovulation induction
26
hormone replacement therapy use
decrease in estrogens and progesterones leading to menopause
27
chemical analogs of progesterone and estrogen can also be used for...
cancer chemotherapy
28
most effective contraceptives
implants, IUD, sterilization
29
higher risks of pregnancy are with what contrceptives
male and female condoms, withdrawal
30
what peak triggers follicle rupture and ovulation
LH peak
31
estrogen peaks where
during follicle rupture
32
progesterone peaks when
after ovulation, mature corpus luteum
33
ovulation happens when during cycle
mid cycle
34
what degenerates and produces steroids when woman not pregnant
corpus luteum
35
if woman becomes pregnant what happens to uterine endometrium
hormones prepare the endometrium lining. increases after ovulation. to create a favorable environment for fertilized zygote to implant
36
what creates menstruation
degeneration of endometrium lining
37
positive feedback of HPO axis
increase in estradiol above a certain threshold stimulates GnRH and LH release which stimulates oocyte release
38
negative feedback of HPO axis
constant release of estradiol and progesterone prevents LH and FSH release
39
measuring temperature and detecting ovulation with thermometer method
fertility awareness based method
40
in fertile woman temperature increase because of what
progesterone release after ovulation
41
oral contraceptives contain what
analogs of estrogen and progesterone
42
why use analogs in contraceptive pills
because they have longer half lives
43
contraceptive pills use to be monophasic meaning?
each tablet contained a fixed amount of estrogen and progestin
44
contraceptive pills are now multiphasic meaning?
concentration vary during the cycle to try to mimic natural hormones
45
how is release of oocyte prevented and LH surge prevented and FSH
constant low amounts of estrogen given to prevent cycling. constant negative feedback
46
contraceptive effect on fsh
no fsh stimulation of follicle maturation in ovary
47
contraceptive effect of sperm
less able to swim to oocyte by changing composition of the protein the sperm has to swim. decreased fertilization
48
perfect use failure rate of contraceptive vs typical failure rate
0.3% vs 9%
49
failure of pill contraceptive is related to what
poor compliance like forgetting pill
50
metabolism of analogs
metabolized in the liver and gets conjugated to be released in GI tract. Deconjugated by bacteria so that it can be reabsorbed in liver and released on circulation
51
problems with taking some antibiotics with contraception
antibiotic alters enterohepatic circulation such that they kill bacteria that would help remove congugated compound in drug and allow it to get reabsorbed. But antibiotics makes no reabsorption and drug excreted so no recycling of estrogen and progesterone, lower levels and cause normal cycle to come back
52
advantages of oral contraceptive (6)
1. periods more regular 2. can be used by women over 40 3. may decrease menstrual cramps, acne 4. does not interfere with sexual intercourse 5. reduces risk of ovarian cancer 6. increases bone density
53
disadvantages of oral contraceptives (3)
1. increase risk of blood clots 2. my by related to slight increase in breast cancer 3. cant be used by smokers over the age of 35
54
risk of oral contraceptives relating to others
very low risk compared to others
55
contraceptive patch Evra mechanism
steroids penetrate the skin and into circulation so they cana be delivered to the hypothalamus and other tissues
56
pearl index of patch
0.88 so better than pill. half the rate of pregnancy in women after 6 cycles of taking the pill
57
compounds in patch
150 microg NGMN and 20 microg EE
58
contraceptive implants effectiveness
99%
59
IUD mechanism and types
inserted in uterus. Copper T delivers copper and progstin iud delivers progesterone
60
common analog of progesterone
levonorgestrol
61
emergency contraceptive and mechanism
plan b: levonorgesterol. | temporary block of ovulation
62
when should we take plan b
within 72 hours of unprotected sex
63
effectiveness of plan b
75-97% depending on time after intercourse
64
selective progesterone receptor modulator and is a partial antagonist and agonist
ulipristal acetate
65
ulipristal acetate efficacy and days
similar to that of progestin. effective for up to 5 days after intercourse
66
what drugs interact with contraceptive by inducing p450s and how
barbiturates, phenytoin (anti-epileptics), rifampicin. Contraceptives get metabolized by p450s that have been induced by these drugs
67
why should the pill not be taken for smokers over 35
increased mortality in smokers who take the pill after the age of 35 even more at 45 compared to smokers who are younger
68
patch compliance vs pill compliance
more compliance in patch and is not affected by age | more compliance in pill for older people, less compliance in younger people
69
implants contraceptives most contain what
progesterone analog levonorgestrel

Phar300 (18 decks)

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