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2nd U1 Pharm > Reproduction > Flashcards

Flashcards in Reproduction Deck (54):
1

Name the 4 Estradiol esters...

Estradiol
Estrone sulfate
Equilin sulfate
Quinestrol

2

How does Estradiol, Estrone sulfate, Equilin sulfate and Quinestrol enter through the body?

Absorbed through:
Skin
Mucus membranes
GI tract

3

How is Estradiol, Estrone sulfate, Equilin sulfate and Quinestrol distributed throughout the body after absorption?

Sex hormone binding globulin

4

Estradiol esters--Estradiol, estrone sulfate, equilin sulfate and Quinestrol are all used for the treatment of what disorders?

Contraception
Primary hypogonadism
Psotmenopausal hormone therapy
Osteoporosis

5

What are the side effects of the estradiol esters--estradiol, Estrone sulfate, Equilin sulfate and Quinestrol?

Weight gain
HTN
Less commonly:
-breast cancer
Nausea
Breast tension/pain
Vaginal bleeding
headache

6

Patients who are put on an estradiol ester therapy are at an increased risk of developing what disorders?

Heart attack
Stoke
DVT
Cervical and endometrial cancer

7

Estradiol esters---Estradiol, Estrone sulfate, Equilin sulfate and Quinestrol are strongly contraindicated in?

Breast or endometrial cancers
Endometriosis
Undiagnosed vaginal bleeds

8

Estradiol esters---Estradiol, Estrone sulfate, Equilin sulfate and Quinestrol are relatively contraindicated in?

pregnancy
Thromboembolic Dz
HTN
hepatic dz
FHx of breast or uterine cancer

9

Name the 2 Alkyl estrogens...

Ethinyl estradiol
Mestranol

10

How are the alkyl estrogens, Ethinyl estradiol and Mestranol, absorbed into the body?

Skin
Mucus membranes
GI tract

11

How are the alkyl estrogens, Ethinyl estradiol and Mestranol, distributed throughout the body?

Sex hormone binding globulin

12

What are the primary uses of Ethinyl estradiol an Alkyl estrogen?

contraception
Primary hypogonadism
Postmenopausal hormone therapy
Osteoporosis

13

What are the primary uses of Mestranol an Alkyl estrogen?

Contraception
Primary hypogonadism
Postmenopausal hormone therapy

14

What are the side effects of Ethinyl estradiol and Mestranol?

Weight gain
HTN
Less commonly:
-breast cancer

15

Patients on ethinyl estradiol or mestranol therapy are at an increased risk of developing what disorders?

Heart attack
Stroke
DVT
cervical and endometrial cancer

16

What is Diethylstilbestrol?

A non-steroidal synthetic estrogen

17

What reproductive drug therapy has an increased risk of developing clear cell adenocarcinoma of the vagina and cervix?

Diethylstilbestrol

18

What is the reproductive drug therapy that is a non-steroidal anti-estrogen and selective estrogen receptor modifier---used for the treatment of ER + breast cancer?

Tamoxifen citrate

19

What is the mechanism of action of tamoxifen citrate?

Blocks estrogen from binding ER and causing growth in ER+ breast cancer

20

What are the side effects of Tamoxifen citrate?

Proestrogenic effect on uterine epithelium--increased risk of endometrial cancer

Partial estrogen agonist in bone and endometrium

21

What class of drug is Clomiphene citrate?

Non-steroidal anti-estrogen

22

What is the mechanism of action for Clomiphene citrate and what does it stimulate?

Blocks estrogen binding to hypothalamic receptors--increased secretion of gonadotropins and LH---> ovulation

23

What is Clomiphene citrate used for?

Stimulate ovulation in patients who want to get pregnant

24

What are the side effects of Clomiphene citrate?

Hot flashes
Multiple pregnancy
Stomach pain
Headache
Vomit

25

What is a Cis-isomer (zuclomiphene)?

Weak estrogen agonist

26

What is trans-isomer (enclomiphene)?

potent estrogen antagonist

27

Name the 2 Natural progesterone drugs...

Micronized progesterone
Transvaginal progesterone

28

What are the natural progesterone drugs, micronized and transvaginal progesterone, used for?

Contraception
Hormone replacement therapy

29

What are the side effects of the natural progesterone drugs--micronized and transvaginal progesterone?

Fatigue
Drowsiness

30

Natural progesterone drugs are contraindicated in?

Thromboembolic disorders
Patients with a Hx of:
-liver dz
-undiagnosed vaginal bleeding
-Pregnancy---atrophy of endometrium reading to birth defects

31

Name the 4 synthetic progesterone drugs?

Medroxyprogesterone
Norethindrone
Norgestrel
Megestrol

32

What are the synthetic progesterone drugs used for?

Contraception
Hormone replacement

33

What are the side effects of synthetic progesterone therapy with Medroxyprogesterone, Norethindrone, Norgestrel, Megestrol and patients are at an increased risk of developing what with this therapy?

Edema
Abdominal bloating
Less commonly:
-strong androgenic effects--hirsutism, acne

Anxiety
Irritability
Depression
Muscular pain

Increased risk of thrombus and PE

34

Synthetic progesterone drugs are contraindicated in?

Thromboembolic disorders
Patients with a Hx of:
-liver dz
-undiagnosed vaginal bleeding
-Pregnancy---atrophy of endometrium reading to birth defects

35

name the 3 combination pills used for contraception...

Monophasic ortho-Novum
Biphasic Ortho-Novum
Triphasic Ortho-Novum

36

What is the mechanism of action of the combination pills used for contraception?

Constant level of estrogen suppresses FSH, LH surge
Progesterone suppresses LH surge, thickens cervical mucus, leads to endometrial atrophy, counters estrogenic effect on endometrium

37

Patients who are on a combination pill for contraception are at a decreased risk for the development of______.

Endometrial cancer

38

Monophasic Ortho-Novum estrogen and progesterone doses are?

Consistent--pill taken for 21 days

39

Biphasic Ortho-Novum estrogen and progesterone doses are?

Fixed estrogen
Progestin increased for days 11-21

40

Triphasic Ortho-Novum estrogen and progesterone doses are?

Fixed or variable estrogen
Progestin increases in 3 phases
-1-7
-8-14
-15-21

41

What is mini-pill and when is it used?

A progestin only pill--less effective that combination pill for contraception

Used when patients have estrogen contraindication

Good for use in lactating women--estrogen reduces milk production

42

What are the side effects of mini-pill?

More likely to produce irregular menstrual cycle

43

Mini-pill suppresses?

Endometrial cancer

44

What is Levonorgestrel, a synthetic progestogen, used for?

Plan-B
Used to prevent implantation

45

What is the time window for taking Levonorgestrel?

within 72 hours of coitus

46

Mifepristone is in what class of drug?

Anti-progestin; glucocorticoid receptor antagonist

47

What is the mechanism of action for Mifepristone?

Competitively binds to progesterone receptor--leading to detachment of fetus

48

What is the use of Mifepristone, an anti-progestin glucocorticoid receptor antagonist?

Abortion
Cushing's syndrome

49

What is the time window for taking Mifepristone?

Must be taken early in pregnancy--by day 49
PO administration

50

Name the 3 PDE5 inhibitors?

Sildenafil citrate
Vardenafil HCl
Tadalafil

51

What is the mechanism of action for the PDE5 inhibitors, Sildenafil citrate, Vardenafil HCl, Tadalafil?

Bind catalytic site of PDE5--inhibiting PDE5 breakdown of cGMP---> decreased Ca++ ---> smooth muscle relaxation---> erection

52

What is the used of PDE5 inhibitors?

Erectile dysfunction--does not trigger an automatic erection, but improved response to sexual stimulation

53

What are the side effects of PDE5 inhibitors?

Headache
Dizziness
Change in vision

Flushing
Upset stomach
Stuffy or runny nose
UTI
Diarrhea

54

PDE5 inhibitors are contraindicated in patients who...

are on nitrates or a-blockers-- due to the possibility of unsafe drop in BP..