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Flashcards in Pharmacology Deck (7)
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1

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)

2

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)

3

How do we treat endometriosis?

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

4

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

5

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

6

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

7

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