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Sex Hormones Flashcards

(50 cards)

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1
Q

Norethindrone, Medroxyprogesterone acetate, and Etonogesterel are:
A. Emergency contraceptives
B. Progesterone only agonists
C. IU Devices

A

B. Progesterone only agonists

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2
Q

Levonorgestrel and Ulipristal are:
A. Emergency contraceptives
B. Progesterone only agonists
C. IU Devices

A

A. Emergency contraceptives

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3
Q

True or False: Medroxyprogesterone has been shown to cause weight gain

A

True

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4
Q

Copper ParaGuard and Levonotgestrel Mirena, Skyla, etc are:
A. Emergency contraceptives
B. Progesterone only agonists
C. IU Devices

A

C. IU Devices

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5
Q

Most effective contraceptive class? Least?

A

Most = Intrauterine
Least = Emergency

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6
Q

Combination Oral Contraceptives contain synthetic __ and ___

A

estrogen (ethinyl estradiol) and progestin

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7
Q

COC’s are usually given for __ days, followed by __ days with no pills

A

21; 7 days

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8
Q

Monophasic vs. Multiphasic COC therapy?

A

Monophasic: fixed estrogen + progestin dose
Multiphasic: mimic normal hormonal events of menstrual cycle
- first half = low prog:E2 (endo proliferation)
- second hald = high prog:E2 (secretory endo)
- allows for overall decreased hormone exposure

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9
Q

In biphasic COC, __ dose remains constant while ___ dose changes twice during the cycle

A

estrogen = constant
progesin = changes twice (increases)

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10
Q

___: dose of one or both steroidal agents are changes three times during cycle
A. Monophasic
B. Triphasic
C. Biphasic

A

B. Triphasic

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11
Q

____ is four-phasic drug that uses estradiol VALERATE

A

Natazia

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12
Q

When are two good ‘start dates’ for COC?

A

1) First Sunday after menses - more rapid

2) First day of menses (use backup contraception for 7 days)

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13
Q

True or False: The predominant and most potent estrogen made by ovary is E2 (17-beta-estradiol)

A

True

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14
Q

____ is the primary synthetic estrogen used in COC’s. How does it prevent first pass metabolism?

A

Ethinyl estradiol
- Ethinyl group at C17 prevents first pass metabolism

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15
Q

Where does sulfate and glucuronide conjugation occur for enterohepatic recirculation?

A

Liver

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16
Q

Where does biliary secretion of conjugates occur in enterohepatic recirculation?

A

Intestine

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17
Q

___ enzymes cleave conjugates, allowing for reabsorption of estrogen in enterohepatic recirculation

A

Bacterial

  • Oral Antibiotics could affect this
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18
Q

True or False: Synthetic progestins vary in the androgenic activity, estrogenic activity, and anti-estrogenic activity

A

True

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19
Q

True or False: Gonane progestines (e.g norgestimate and desogestrel) are reported to be less androgenic (less acne causing) than estranes

A

True

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20
Q

___ is a derivative of spironolactine and is anti-androgen. It is indicated for treatment of moderate acne vulgaris.

A

Drospirenone

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21
Q

Estrogen and Progesterone inhibit the release of ___ and ___. Therefore, no ___

Study These Flashcards
A

LH and FSH; ovulation

22
Q

True or False: One will ovulate while taking COC’s

23
Q

True or False: Women taking COC’s have an LH spike

24
Q

Most common AE associated with COC’s?

25
What are the three dermatological AE's associated with COC's?
1) chloasma (brown pigmentation of skin) 2) acne (due to increased sebum) 3) hirsuitism
26
True or False: HTN is an AE of COC's
True - can start 1-3 s/p therapy - increased risk with duration and age - estrogens increase RAAS
27
What is a life-threatening AE associated with COC's?
Thromboembolitic disorders - cause: estrogen (increased clotting factors, decreased anti-thrombin 3)
28
Newer progestins, such as ___, ___, and ___may be associated w increased risk of blood clot formation
desogestrel; gestodene; drospirenone
29
What are two metabolic effects of COC's?
1) Decreased glucose tolerance 2) Increased LDL's and TG
30
True or False: Breakthrough bleeding is associated with use of COC's
True - most common in first three months - estrogen deficiency is associated with BTB in early part of cycle while prog def is associated with BTB in later part of cycle
31
COC's may increase risk of ____ cancer in general population of women and increased risk of cervical cancer in women who are ___+
breast; HPV+
32
True or False: Infertility can occur after COC use, last longer in 30-34 year old women
True
33
Whey should COC's be avoided until at least 3-4 weeks postpartum?
Estrogen in COC's can decrease quality of quantity of milk
34
What are three beneficial side effect of COC's?
- Reduced risk of endometrial cancer (progestin prevents endo prolif) - Reduced risk of ovarian cancer (decreased stimulation of ovaries by FSH and LH) - Reduced acne (estrogen decreases seb. gland activity and increase SHBG (decrease free testosterone))
35
____ kill normal microbial flora that produces enzymes that cleave sulfate and glucoronide conjugates of ethinyl estradiol - no enterohepatic circulation
Abx
36
Which antibiotics induce CYP3A4, thereby increasing metabolism of COC, leading to greater failure rate?
Rifbutin Rifampin
37
True or False: Anti-convulsants can decrease effectiveness of COC's
True
38
Patient with smoking history, h/o thromboembolism should take which type of BC?
Progestin only preparations
39
True or False: Estrogen only preparations can be used when women are lactating and want contraception
False - Progestin only preparations used!
40
True or False: Progestin only preparations consistently inhibit ovulation
False - they do not consistently inhibit ovulation
41
Which progesterone only preparation is given via IM and can cause osteoporosis because it decreases estrogen
Medroxyprogesterone
42
True or False: Nexplanon (etonogestrel) is a progestin only preparation
True
43
Levonorgestrel is seen in ____ contraception
emergency
44
How does emergency contraception affect ovulation?
Delays or inhibits ovulation
45
Which emergency contraceptive is a progesterone antagonist and partial agonist? A. Levonorgestrel B. Medroxyprogesteron C. Ulipristal acetate
C. Ulipristal acetate
46
True or False: Ethinyl estradiol + Levonorgestrel is more effective and has less side effects than Levonorgestrel alone
True
47
How do intrauterine devices produce a spermicide?
Cause low grade inflammation -> increases prostaglandins
48
Which IUD prevents fertilization, implantation, and interferes w sperm transport and viability? A. Paraguard B. Mirena
A. Paraguard
49
Which IUD causes thick, cervical mucus, decreases sperm transport activity, and prevents ovulation by making endometrium inhospitable? A. Paraguard B. Mirena
B. Mirena
50
AE associated with IUD?
Insertion may introduce bacteria into pelvis, leading to PID

Pharmacology (53 decks)

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