Flashcards in Session 4 Deck (12):
How are sex hormones transported around the body?
Bound to sex hormone binding globulin (SHBG) and albumin
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)
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)
What are the indications to commence HRT?
Hot flushes/sweats, vaginal dryness, osteoporosis
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)
How does mifepristone induce labour or medically terminate pregnancy?
Partial agonist to progesterone, inhibiting its action
Sensitises the uterus to prostaglandins
What is the mechanism of action and indications for raloxifene?
Selective oestrogen receptor modulator (SERM)
Protects against osteoporosis, prevention of breast cancer
What is the desired level of cholesterol?
What are the main different classes of lipid lowering drugs?
Statins, cholesterol lipase inhibitors, nicotinic acid and fibrates
When should statins be used for primary prevention?
Adults who have a 20% or greater 10-year risk of developing CVD
How do fibrates work and when are they used?
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.