Flashcards in Session 4 Deck (12):
1
How are sex hormones transported around the body?
Bound to sex hormone binding globulin (SHBG) and albumin
2
Why are enzyme inducing drugs (e.g. rifampicin and carbamazepine) contraindicated for the COCP?
Increases activity of cytochrome P450 enzymes which increases the COCP clearance leading to contraceptive failure (used at a minimum does so quite sensitive to changes anyway)
3
Outline the options for emergency contraception
Levonorgestrel up to 72 hours
Up to 120 hours - ulliprisal acetate (progesterone receptor modulator) or Cu2+ IUD (prevents blastocyst attachment to endometrium)
4
What are the indications to commence HRT?
Hot flushes/sweats, vaginal dryness, osteoporosis
5
What are the risks of HRT?
Oestrogen replacement therapy (ERT) - increases endometrial and ovarian cancer risk.
HRT - increases breast cancer risk
Increases risk of VTE and stroke (but beneficial effect on IHD risk)
6
How does mifepristone induce labour or medically terminate pregnancy?
Partial agonist to progesterone, inhibiting its action
Sensitises the uterus to prostaglandins
7
What is the mechanism of action and indications for raloxifene?
Selective oestrogen receptor modulator (SERM)
Protects against osteoporosis, prevention of breast cancer
8
What is the desired level of cholesterol?
<5mmol/L
9
What are the main different classes of lipid lowering drugs?
Statins, cholesterol lipase inhibitors, nicotinic acid and fibrates
10
When should statins be used for primary prevention?
Adults who have a 20% or greater 10-year risk of developing CVD
11
How do fibrates work and when are they used?
E.g.fenofibrate
Decreases serum triglycerides by increasing lipoprotein. Used for those whose serum-TAG concentration is greater than 10 mmol/L or in those who cannot tolerate a statin.
12