Leffler Flashcards Preview

week 53 > Leffler > Flashcards

Flashcards in Leffler Deck (36)
Loading flashcards...
1

Primary causes of Female Infertility

  • Ovulation disorders- 35%
    • affects Ovaries
    • hormone imbalances
    • eating disorders
  • Tubal Obstruction- 35%
    • affects Fallopian Tubues
    • PID
    • chlamydia
    • appendicitis
    • emdometritis
    • Peritonitis
  • Endometriosis-20%
    • affects Uterus
    • Age 
    • Genetics
    • Toxins
  • Idiopathic-10%

2

Gonadotropins

Hormones secrted by gonadotrope cells in pituitary

3

Drugs for ovulation disorders

  1. FSH
  2. LH
  3. Menotropins (AKA Human Menopausal Gonadotropin; HMG)
  4. Human Chorionic Gonadotropin (HCG)
  5. Clomiphene
  6. Gonadotropin Releasing Hormone (GnRH) Agonists & Antagonists

4

What is FSH?

  • Hormone made and released by gonadotropes in pituitary 

5

What does FSH do?

  • Stimulates germ cells in:
    • females-ovarian follicles
    • males-sertoli cells

6

FSH unique features

  • secreted in pulses
  • works synergistically w/LH to regulate reproduction
  • increased in peri/postmenopausal women
  • FSH release regulated by GnRH

7

FSH: Drug preparations

  • Urofollitropin
    • purified from urine of PM women with LH
  • Follitropin alpha & beta
    • recombinant FSh without LH

8

What is LH?

  • hormone
  • made and released by gonadotropes in the pituitary gland

9

What does LH do?

  • LH surge triggers ovulation
  • secreted in pulses

10

LH Unique Features

  • works synergistically w/FSH to regulate reproduction
  • increased in peri/postmenopausal women
  • LH release regulated by GnRH
  • LH levels are measure in "ovulation prediction kits" to help couples conceive

11

LH: Drug preparations

  • Lutropin
    • recombinant LH
    • administed IM

12

What is Menotropin?

  • Human Menopausal Gonadotropin; HMG
  • Gonadotropin mixture of FSH and LH
  • Hormonally active medication to treat infertility

13

What does Menotropin do?

  • stimulates the ovaries to mature ovarian follicles
    • increase fertility

14

Menotropin Unique Features

  • extracted from the urine of postmenopausal women
  • can be given to men to stimulate sperm production

15

Menotropin Drug Preparations

  • Pergonal
  • Repronex
  • Administered IM daily

16

What is hCG

  • hormone
  • made by part of the fertilized egg (syncytiotrophoblast) after conception
  • analog of LH

17

what does hCG do?

  • LH-like activity
    • some FSH-like activity
  • sitmulates ovulation
  • helps uterus to thicken 
  • maintain growing fetus during pregnancy

18

hCG unique features

  • Synthesized by the placenta-->POST contraception hormone
  • major side effects:
    • multiple births

19

hCG drug preparations

  • Pregnyl
    • administered IM or SQ

20

What is Clomiphene?

  • Antagonist
  • binds to estrogen (E2) receptors in the hypothalamus

21

What does Clomiphene do?

  • Increases LH & FSH release by inhibiting estrogen receptors at the hypothalamus

22

Clomiphene unique features

  • major side effects:
    • multiple births
    • hot flashes
    • visual disturbances

23

Clomiphene drug preparations

  • Clomid
    • adminstered: PO

24

What are GnRH Agonists?

  • Synthetic 10 amino acid peptide

25

What does GnRH agonists do?

  • regulates LH & FSH release

26

GnRH agonists unique features

  • Admin:
    • Pulse
      • Increase LH & FSH
    • Continuous
      • Decrease LH & FSH

27

GnRH Agonist Drug Prepartions:

  • Drugs:
    • Leuprolide
    • Gonadorelin
    • Histerelin
    • Triptorelin
    • Nafarelin
    • Goserelin
  • Administered: IM, SQ
  • They are synthetic GnRH agonists, so they. act like natural GnRH 

28

What are GnRH Antagonists?

  • Synthetic 10 amino acid peptide structurally similar to GnRH

29

What does GnRH antagonists do?

  • Decrease LH & FSH release by blocking GnRH receptors

30

GnRH Antagonists:

  • Major side effects:
    • headache
    • injection site reactions
    • hot flashes
    • weight gain
    • fatigue
    • increased hepatic transaminases