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Flashcards in Pharmacology Deck (7)
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What is the role of estrogen and progesterone in combined OCPs? In which patients are combined OCPs contraindicated?

- E: inhibits FSH secretion to suppress maturation of follicles into Graafian follicles
- P: inhibits LH secretion to prevent ovulation (also increases the viscosity of cervical mucus)
- combined therapy is contraindicated in patients with estrogen receptor positive breast cancer or with cardiovascular disease (estrogen makes both of these worse, so give these patients progesterone only OCP)


What is in the "morning after" pill (emergency contraception)? What does this result in?

- the morning after pill contains high levels of progesterone (Levonogestrel)
- this acts to de-synchronize the menstrual and ovarian cycles by inhibiting ovulation and/or by preventing the fertilized ovum from implanting (implantation requires high P, but this amount is TOO high)


How do we treat endometriosis?

- can treat with OCPs to eliminate menses
- can treat with Danazol (an androgen agonist)


What is Clomiphene? When is it used?

- Clomiphene is a SERM that acts as an antagonist at estrogen receptors on the hypothalamus to prevent normal feedback inhibition, resulting in LH and FSH release from the AP
- used to treat infertility due to anovulation (ex: PCOS)
- may cause multiple simultaneous pregnancies


What is Tamoxifen? When is it used?

- Tamoxifen is a SERM that acts as an antagonist on breast tissue, and as an agonist on uterus and bone tissue
- used to treat estrogen receptor positive breast cancer; good for osteoporosis, too, but because of the increased endometrial carcinoma risk, we use Raloxifene instead
- associated with increased risk of endometrial carcinoma and thromboembolitic events


What is Raloxifene? When is it used?

- Raloxifene is a SERM that acts as an agonist on bone tissue and as an antagonist on uterus
- used to treat osteoporosis
- no risk for endometrial carcinoma, but high risk for thromboembolitic events


What can we give patients with PCOS to help alleviate the hirsutism and virilization?

- treat PCOS with androgen antagonists:
- Ketoconazole (inhibits cholesterol desmolase) and Spironolactone (inhibits steroid binding, 17alpha-hydroxylase, cholesterol desmolase) are used to prevent hirsutism