Reproductive deck 2

Question 1

Progestin antagonists example and use

Answer 1

Mifepristone (Mifeprex)
Mifepristone inhibits the activity of both endogenous and exogenous progesterone; without progesterone to maintain the pregnancy, termination results.

Will act as an ABORTIFACIENT when used in conjunction with misoprostol during the first 7 weeks of pregnancy.

Question 2

Gonadotropin-releasing hormone what is is ant use

Answer 2

A stimulant in pulsatile doses if the patient has a functional pituitary gland and an ovary to produce the luteinizing hormone surge initiating ovulation - Used to initiate ovulation

Also used to treat endometriosis and uterine fibroids and to suppress prostate cancer

Question 3

Human menopausal gonadotropin: follitropin (Fertinex), menotropins (Pergonal, Humegon)
Men:

Answer 3

stimulate spermatogenesis

Question 4

Human menopausal gonadotropin: follitropin (Fertinex), menotropins (Pergonal, Humegon)
women:

Answer 4

stimulate maturation of follicules and ovulation

Question 5

Lacation supression drugs MOI and also works for

Answer 5

Has an inhibitory effect on pituitary gland, which produces prolactin
Also works for hyperprolactinemia
Also used in Parkinson’s disease

Question 6

Bromocriptine begins to work and has

Answer 6

Begins to work within 2 hours

Many drug interactions

Question 7

Erectile dysfunction drugs PDE5 examples

Answer 7

Sildenafil citrate (Viagra), tadalafil (Cialis), vardenafil (Levitra)

Question 8

PDE5 contrindications

Answer 8

In patients using nitrates because of a risk of severe, even fatal hypotension

Alpha blockers have additive hypotension effect

Question 9

PDE5 inhibitors Small studies in women

Answer 9

Small studies in women are inconclusive

Used in neonatal intensive care unit for persistent pulmonary hypertension

Question 10

Addyi is also known as

Answer 10

pink viagra

Question 11

Addyi is used in and what is the black box warning

Answer 11

For women with diagnosed with severe sexual dysfunction (serotonin and dopamine agonist)
Black Box warning for severe hypotension when used with alcohol

Question 12

Addyi does not have a

Answer 12

a same day effect as with PDE5 inhibitors for men; takes about 3 months for full effect, and many do not benefit at all.

Question 13

Estrogen has positive effects on

Answer 13

bone mass, increases serum triglycerides, and improves ratio of high-density lipoprotein to low-density lipoprotein.

Question 14

Estrogen stimulates

Answer 14

coagulation and fibrinolyticpathways.

Question 15

Progesterone increases

Answer 15

body temperature and insulin levels.

Question 16

Progesterone may depress

Answer 16

the central nervous system.

Question 17

Two formulations of estrogen are available in contraceptive preparations

Answer 17

ethinyl estradiol and mestranol.

Question 18

First-generation progesterones

Answer 18

Norethindrone, norethindrone acetate, and ethynodiol diacetate

Question 19

Second-generation progesterones

Answer 19

Norgestrel and levonorgestrel

Question 20

Third-generation progesterones

Answer 20

Desogestrel and norgestimate

Question 21

Fourth-generation progesterones

Answer 21

Spironolactone derivative: drospirenone

19-nortestosterone derivative: dienogest

Question 22

Progestins are primarily responsible for

Answer 22

the contraceptive effect

Question 23

Progestins exhibit a negative

Answer 23

effect in the hypothalamic-pituitary-ovarian axis.

Question 24

Progestins cause atrophy

Answer 24

of the endometrium, preventing implantation.

Question 25

The estrogen component improves

Answer 25

efficacy by suppressing FSH release

Question 26

Estrogen provides

Answer 26

cycle control

Question 27

Contraceptives goal of treatment

Answer 27

Use the safest, best-tolerated, and most effective method that the patient desires. Safety Tolerance Effectiveness

Question 28

Rational Drug Selection Contraceptives three steps

Answer 28

Start with absolute contraindications. Delivery method should be of patient’s choice. Fine tune based on: Menstrual pattern Side-effect profile Consider: Patient’s desire for discretion Timing of subsequent pregnancy

Question 29

All types of oral contraception (OC) have similar

Answer 29

effectiveness

Question 30

Contraceptive cost

Answer 30

Retail cost of OC is $30 to $100 per cycle. Generic OC is available on $4 retail lists. Intrauterine device (IUD) or implant: upfront cost is expensive, but may have lower overall cost.

Question 31

Noncontraceptive Benefits

Answer 31

Decreased dysmenorrhea, menstrual irregularities, and menstrual blood loss Lessening of acne and hirsutism Fewer ovarian cysts Significantly reduced endometrial and ovarian cancer risk Lower incidence of benign breast conditions, such as fibrocystic changes and fibroadenoma Reduced risk of hospitalization for gonorrheal pelvic inflammatory disease Suppression of endometriosis in women who do not currently desire pregnancy

Question 32

Contracepive drug interactions

Answer 32

Tuberculosis drugs, antiepileptic drugs, St. John’s Wort

Question 33

lipid levels affected by

Answer 33

OC

Question 34

Adverse drug reactions for OC

Answer 34

Venous thromboembolism risk increases three to five times with OC use Also: cholestatic jaundice, benign hepatic neoplasms, myocardial infarction, stroke, and neurological migraines

Question 35

OC traditional dosing

Answer 35

21 days active drug + 7 days inactive tablets with withdrawal bleed during inactive tablets

Question 36

Extended cycle OC

Answer 36

84 days of active drug, then 7 days off | Withdrawal bleed once every 3 months

Question 37

Monophasic OC

Answer 37

same dose of estrogen and progestin for full cycle

Question 38

Biphasic and Triphasic dosing for OC

Answer 38

Biphasic: vary the dose of progestin Triphasic: vary the dose of estrogen, progestin, or both

Question 39

Starting method first day

Answer 39

Pills started on first day of menstrual cycle | No back up method needed

Question 40

Starting method sunday start

Answer 40

First pill taken on the Sunday following the start of menses Back up method for first 7 days Menses only occur during the week

Question 41

OC quick start "same day"

Answer 41

Quick or “same-day” start First pill taken on the day of the office visit Back up method for first 7 days (like condom) because not as effective for the first 7 days

Question 42

What to do if doses are missed of OC

Answer 42

follow what is said to them on the handout for the medication

Question 43

50% of women discontinue OC because of

Answer 43

side effects