Leffler Flashcards
(36 cards)
1
Q
Primary causes of Female Infertility
A
- 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
Q
Gonadotropins
A
Hormones secrted by gonadotrope cells in pituitary
3
Q
Drugs for ovulation disorders
A
- FSH
- LH
- Menotropins (AKA Human Menopausal Gonadotropin; HMG)
- Human Chorionic Gonadotropin (HCG)
- Clomiphene
- Gonadotropin Releasing Hormone (GnRH) Agonists & Antagonists
4
Q
What is FSH?
A
- Hormone made and released by gonadotropes in pituitary
5
Q
What does FSH do?
A
- Stimulates germ cells in:
- females-ovarian follicles
- males-sertoli cells
6
Q
FSH unique features
A
- secreted in pulses
- works synergistically w/LH to regulate reproduction
- increased in peri/postmenopausal women
- FSH release regulated by GnRH
7
Q
FSH: Drug preparations
A
- Urofollitropin
- purified from urine of PM women with LH
- Follitropin alpha & beta
- recombinant FSh without LH
8
Q
What is LH?
A
- hormone
- made and released by gonadotropes in the pituitary gland
9
Q
What does LH do?
A
- LH surge triggers ovulation
- secreted in pulses
10
Q
LH Unique Features
A
- 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
Q
LH: Drug preparations
A
- Lutropin
- recombinant LH
- administed IM
12
Q
What is Menotropin?
A
- Human Menopausal Gonadotropin; HMG
- Gonadotropin mixture of FSH and LH
- Hormonally active medication to treat infertility
13
Q
What does Menotropin do?
A
- stimulates the ovaries to mature ovarian follicles
- increase fertility
14
Q
Menotropin Unique Features
A
- extracted from the urine of postmenopausal women
- can be given to men to stimulate sperm production
15
Q
Menotropin Drug Preparations
A
- Pergonal
- Repronex
- Administered IM daily
16
Q
What is hCG
A
- hormone
- made by part of the fertilized egg (syncytiotrophoblast) after conception
- analog of LH
17
Q
what does hCG do?
A
- LH-like activity
- some FSH-like activity
- sitmulates ovulation
- helps uterus to thicken
- maintain growing fetus during pregnancy
18
Q
hCG unique features
A
- Synthesized by the placenta–>POST contraception hormone
- major side effects:
- multiple births
19
Q
hCG drug preparations
A
- Pregnyl
- administered IM or SQ
20
Q
What is Clomiphene?
A
- Antagonist
- binds to estrogen (E2) receptors in the hypothalamus
21
Q
What does Clomiphene do?
A
- Increases LH & FSH release by inhibiting estrogen receptors at the hypothalamus
22
Q
Clomiphene unique features
A
- major side effects:
- multiple births
- hot flashes
- visual disturbances
23
Q
Clomiphene drug preparations
A
- Clomid
- adminstered: PO
24
Q
What are GnRH Agonists?
A
- 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
31
GnRH Antagonist Drug Preparations:
* Drugs: -relix
* Cetrorelix
* Ganirelix
* Degarelix
* Administered SQ
32
Drugs for Endometriosis
1. GnRH Agonists
2. GnRH Antagonists
3. Danazol
33
What is Danazol
* synethetic steroid w/weak androgen activity
34
What does Danazol do?
* Suppresses ovarian function by inhibiting LH & FSH surge
35
Danazol unique features
* therapy initiated during menstruation
* must be continued for 3-6 months without interuption
* major side effects:
* elevated liver enzymes
* jaundic
* masculinizaiton
36
Danazol Drug preparations
* Danocrine
* Administered: PO
