Pharm-Female Estrogens-Dewitt Flashcards Preview

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Flashcards in Pharm-Female Estrogens-Dewitt Deck (8)
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1

Estrogen Pathway

2

Low Estrogen: Clinical Presentation

  • Adult
    • infertility
    • irregular or no menses; early menopause
    • no armpit or pubic hair
    • no libido or sexual function
  • Adolescents
    • impaired production of gonadal steroids
    • sexual infantilism
      • don't develop secondary sex characteristics at normal time of puberty or menses
    • Delayed puberty
    • associated with ambiguous external genitalia at birth

3

GnRH agonists

  • Drugs:
    • Gonadorelin
    • Leuprolide
  • Diagnose LH responsiveness and determine if 
    • constituiontal delay
      • delays in puberty
    • Hypogonadotropic hypogonadism
      • adults or adolescents

4

Gonadorelin

  • GnRH agonists
  • diagnose LH responsiveness
  • Admin: Pulsatile
    • initiating an LH surge and ovuluation
    • requires portable battery-powred pump and tubing to deliver pulses
    • Tx: Female infertility
      • NOT to induce puberty in patients with delayed puberty

 

5

Gonadotropins

  • LH & FSH
  • Women w/anovolation-induce follicle development and ovulation
    • used only in women who fail to respond to other treatments
    • bc expensive
  • most often used in ART procedures

6

Clomiphenate citrate

  • most common 1st line agent for infertility
    • used in patients who want to become pregnant 
    • before controlled ovarian stimulation in ART
  • partial/weak estrogen agonist
    • overall effect= antagonist; block endogenous feedback signals
  • stimulate ovulation
  • patients who fail to respond are treated with
    • gonadotropins
    • controlled ovarian stimulation

7

Controlled ovarian stimulation

Produces multiple mature oocytes for ART

  • daily injections w/FSH to induce follicle developement OR
  • Hypogonadotropic hypogonadism require LH and FSH
    • GnRH agonists or antagonists added to block endogenous GnRH to prevent premature LH surge 
  • After appropriate follicular maturation, gonadotropins and GnRH agonists or antagonists stopped and hCG administered to indiuce ovulation

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