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Pharm > women's health > Flashcards

women's health Flashcards

1
Q

hypothalamus releases _______ onto anterior pituitary. AP releases ______ and ______

A

GnRH; gonadotrophs LH and FSH

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2
Q

what two cells does FSH work on? what does it do in each cell?

A

1) . stimulates development of ovarian follicles (granulosa cells)
2) . regulate spermatogenesis in testes (Sertoli cells)

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3
Q

what three things does LH do?

A

1) . causes ovulation and formation of corpus luteum in the ovary
2) . stimulates production of estrogen and progesterone by the ovary
3) . stimulates testosterone production by the testes

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4
Q

DHEA turns into ______________ by 3beta-hydroxysteroid dehydrogenase

A

androstenedione

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5
Q

androstenedione turns into _____________ (testes) and then that turns into ________ (ovaries)

A

testosterone; 17 beta-estradiol

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6
Q

in the ___________ cell, cholesterol turns into pregnenolone and then ____________

A

granulosa; progesterone

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7
Q

progesterone travels from the ____________ cell to the ________ cell to make ___________

A

granulosa; theca; androgens

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8
Q

androgens in the ________ cell travels to the __________ cell to be converted to ________

A

theca; granulosa; estrogens

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9
Q

what is the enzyme that converts androgens to estrogens?

A

aromatase

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10
Q

what enzyme is lacking during menopause? this causes lack of what hormone?

A

aromatase (bc granulosa cells are lacking); estrogen cant be made, only progesterone

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11
Q

estradiol is secreted by ______ and is ______ potent. this is the _________ estrogen in _____________ women

A

ovary; most potent; primary; pre-menopausal

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12
Q

what are the three types of estrogens?

A

estradiol (17 beta-estradiol), estrone, estriol

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13
Q

estrone is a __________ of estradiol; it has the __/___ potency of estradiol

A

metabolite; 1/3

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14
Q

estriol is a ____________ of estradiol. it is the primary estrogen after __________

A

metabolite; menopause

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15
Q

estrogen increases levels of what four clotting factors? what does this increase for pts?

A

2, 7, 9, 10; increases risk of blood clots

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16
Q

estrogen _________ HDL and _________ LDL

A

increases; decreases

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17
Q

estrogen decreases rate of bone ___________: _________ osteoblast activity (____________ osteocyte survival) and decreases number and activity of ___________. this effect on bone is important for _______________

A

resorption; increases and increases; osteoclast; homeostasis

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18
Q

estrogen is important for closure of what plates in males and females? starts closing upon 2 years of puberty in what sex?

A

epiphyseal; females

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19
Q

estrogen promotes __________ and _____ atherogenesis (in terms of blood vessels)

A

vasodilation; slows

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20
Q

estrogen binds to receptors in the ___________. when receptors are activated, they increase or decrease ____ __________

A

nucleus; gene transcription

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21
Q

what are the two types of estrogen receptors? does it matter which one we are targeting with drugs?

A

alpha and beta; no

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22
Q

where are ER alpha receptors found?

A

female reproductive tract, mammary gland, hypothalamus, endothelial cells, and vascular smooth muscle

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23
Q

where are ER beta receptors found?

A

highly expressed in prostate and ovaries; lower expression in lung, brain, bone, and vasculature

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24
Q

what two hormones share the same MOA?

A

estrogen and progestin

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25
Q

natural estrogens are derived from what two sources?

A

plant: saw palmetto or soybeans
animal: pregnant mares are a major commercial source of estrogen

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26
Q

what is the type of synthetic estrogen used for hormone replacement/contraception? what is different about this compared to estrogen the body normally makes?

A

ethinyl estradiol (prolonged DOA and higher potency)

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27
Q

micronized products have a large surface area for rapid absorption. what does this do for a drug?

A

increases its bioavailability

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28
Q

what does the ethinyl component in estrogen do to metabolism?

A

it inhibits first-pass metabolism (cleared more slowly)

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29
Q

estrogens undergo _______ hepatic metabolism and _____________ recirculation

A

rapid; enterohepatic (liver will see these substances twice)

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30
Q

what are estrogens highly protein bound to?

A

sex hormone binding globulin

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31
Q

what two ways is estrogen excreted? in what form is it excreted?

A

in the urine as estradiol, estrone, and estriol; in breast milk too, decreases the quality/quantity of human milk

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32
Q

estrogen has what impact on blood pressure?

A

increases it, because increases angiotensinogen synthesis and increases angiotensin II

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33
Q

why can estrogen cause thromboembolic disorders and gallbladder disease?

A

thromboembolic- increase hepatic synthesis of clotting factors
GB disease- increase cholesterol excretion in bile leading to gallstones

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34
Q

what are five contraindications to estrogens?

A

1) . estrogen dependent tumor (breast cancer or high risk of it)
2) . undiagnosed vaginal bleeding (could be due to CA)
3) . liver disease
4) . thromboembolic disease (anyone with hx of clots)
5) . heavy smokers (inc risk of blood clots)

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35
Q

clinical use of estrogen (weeds):

A 
Contraception
Dysmenorrhea
Acne 
Primary hypogonadism
Postmenopausal hormonal therapy
Relieves genitourinary atrophy
Relieves vasomotor instability
Osteoporosis
Insomnia and fatigue
Mood changes
Sexual function
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36
Q

what is the natural form of progestogen? what is this produced in response to? what secreted this in both males and females?

A

progesterone; LH

males: secreted by the testes
females: secreted by corpus luteum mostly during second half of menstrual cycle and placenta

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37
Q

what body organ synthesizes a small amount of progesterone in males and females?

A

adrenal cortex

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38
Q

MOA of progestogen?

A

same as all other steroid hormones

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39
Q

what is the main goal of progestogen?

A

promotes development of secretory endometrium to support implantation and embryo development

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40
Q

what does progestogen inhibit?

A

production of gonadotropin, preventing further ovulation

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41
Q

if conception occurs, does progestogen continue to be secreted?

A

yes, it maintains endometrium and reduces uterine contractions

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42
Q

what happens to progesterone production if there’s no conception?

A

corpus luteum progesterone production stops quickly and menstruation starts

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43
Q

what are the 7 progestogens?

A 
Progesterone
Medroxyprogesterone 
Levonorgestrel
Norethindrone
Norgestrel
Norgestimate
Drospirenone
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44
Q

what are the uses of progestogen: (5)

A

1) . contraception- alone or in combo with estrogen
2) . Hormone replacement therapy along with estrogen
3) . vasomotor symptoms- postmenopausal women who can’t use estrogen
4) . dysmenorrhea
5. endometriosis and infertility

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45
Q

ADRs of progestogens

A

HAs, inc appetite, inc weight gain, depression, fatigue, hair loss, acne/oily skin

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46
Q

breast fullness/tenderness is a sign of an ADR from what drug/hormone?

A

estrogen

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47
Q

acne and hirsutism are signs of ADRs for what drug/hormone?

A

progestin

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48
Q

cyclic weight gain and cyclic headache are signs of ADRs for what drug/hormone?

A

estrogen

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49
Q

what are the types of hormonal contraception? (7)

A

1) . minipill (progestin only)
2) . implant
3) . long acting IM injection
4) . combined oral pill
5) . 91-day oral combo
6) . combination patch
7) . contraceptive vaginal ring

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50
Q

what are the types of contraception (in general)? (6)

A

1) . periodic abstinence
2) . mechanical barriers
3) . hormonal contraception
4) . IUD
5) . sterilization (female/male)
6) . emergency contraception

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51
Q

what are the top four BEST contraceptive methods (two reversible/two irreversible)

A

reversible: Nexplanon/implant (0.05%), IUD (0.2-0.8%)
irreversible: vasectomy, female sterilization

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52
Q

what five methods of contraception are the middle tier in terms of effectiveness? what are their percent chance of pregnancy?

A

injectable, pill, patch, ring, diaphragm (6-12%)

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53
Q

what six things are categorized as the least effective contraceptive methods? what are their percent chance of pregnancy?

A

male condom (18%), female condom (21)%, withdrawal (22%), sponge, fertility awareness based methods, spermicide (28%)

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54
Q

what is the pharmacologic effect of hormonal contraception- estrogen and progestin?

A

estrogen/progestin inhibit LH/FSH and prevent estrogen surge (no estrogen surge = no LH surge = no ovulation

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55
Q

factors in selecting contraception (7)

A

1) . personal preference
2) . effect on menstrual pattern/bleeding
3) . childbearing plans
4) . pattern of sexual activity
5) . partner influences/concerns
6) . ability to acquire/use effectively
7) . tolerance for the medication

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56
Q

Nexplanon: rod coated with _________, provides contraception for ___ years. once pts get it removed, they return to ovulation _______ (usually within _______)

A

progestin; 3; return to ovulation quickly; 3 weeks of removal

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57
Q

what is the IM injection for contraception? how many days does it last? what hormone does it use?

A

medroxyprogesterone; 90 day; progestin

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58
Q

ADRs for IM injection (5, one main one)

A

1) . DELAY in return to fertility (6-12 months)
2) . amenorrhea or irregular bleeding
3) . weight gain
4) . HA
5) . acne

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59
Q

boxed warning for IM injection

A

women who have used for at least 5 years have significantly reduced BMD of lumbar spine/femoral neck (particularly after 15 yrs and if started before age 20)

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60
Q

is the boxed warning for IM injection reversible?

A

almost completely reversible, even after 4 or more years of drug

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61
Q

what are the two types of oral progestin?

A

norgestrel or norethindrone

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62
Q

a “missed dose of minipill” means you’re outside a ___ hr window. what do you do after a missed dose?

A

three; must use back up method for 48 hours

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63
Q

what are combo pills made up of?

A

estrogen- ethinyl estradiol
progestin- norgestimate, desogestrol, dienogest, ethyodiol (BEST)
-drospirenone (might have hyperkalemia)
-norgestrel, levonorgestrel, norethindrone (more ADRs)

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64
Q

what is the monophasic pill formulation? what are the two drug names?

A

constant dose every day for 21 days (estrogen/progestin), 7 days of no hormones +/- iron; ortho-cyclen, yasmin

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65
Q

what is the biphasic pill formulation? what are the two drug names?

A

amount of hormone may change 1/3 way through cycle; mircette and orthoNovum

66
Q

what is the triphasic pill formulation? what are the two drug names?

A

amount of hormone changes every week; ortho-novum 7/7/7 or ortho tri-cyclen

67
Q

what is the quadriphasic formulation? what are the two drug names?

A

four varying amounts throughout monthly pack; natazia and quartette

68
Q

Multiphasic pills have a ______ total hormone dose per cycle; no evidence they cause fewer ADRs or improve bleeding patterns compared to __________ pills

A

lower; monophasic

69
Q

91-day oral combo pill: combo of ________ and ___________ for ___ weeks and then ____ week of placebo or estrogen only. how many periods per year?

A

estrogen; progesterone; 12; 1; 4 periods

70
Q

91 day combo pill estrogen kind- _____ spotting and unplanned _________ for 12 weeks while on pill

A

less; bleeding

71
Q

what are the three start methods for oral contraceptives?

A

1) . same day: begin taking active pill the 1st day of menses
2) . sunday start: begin taking active pill the first sunday after menses begins (use BUM for at least a week)
3) . quick start: begin taking active pill day given the prescription (use BUM for at least a week)

72
Q

if you miss one pill for OC, when do you take the next one?

A

take as soon as remembered (no BUM needed)

73
Q

if you miss two OC pills in week 1 or 2 of cycle, how do you correct?

A

take 2 pills for 2 days plus BUM for 7 days

74
Q

if you miss two OC pills in week 3 of cycle, how do you correct?

A

finish the pills in the current pack, omit hormone free week and begin new pack (insurance might not cover this)
**if cant start new pack, use BUM until you can take 7 consecutive days from new pack

75
Q

what impact does estrogen/progestin contraceptives have on fracture risk?

A

decreased postmenopausal hip fracture risk for women using estrogen products in their 40s (use after other agents for osteoporosis)

76
Q

4 non contraceptive benefits of estrogen/progestin contraceptives

A

helps with:

1) . menstrual cycle disorders
2) . hyperandrogenism
3) . gynecologic disorders
4) . cancer risk

77
Q

OC are substrates of the ________ enzyme. what does this mean?

A

CYP450; any drug that increases the CYP450 enzyme will increase the clearance/decrease efficacy of oral contraceptives

78
Q

what are the two types of CYP450 inducers? what contraceptive forms are recommended to use with these drugs instead of OCs?

A

1) . antiepileptic: phenytoin, carbamazepine, topiramate, oxcarbazepine (use 90 day injection)
2) . antibiotics: rifampin- used for TB (other ABX not proven to affect estradiol so BUM isn’t required)

79
Q

how do OC impact lamotrigine?

A

OC’s increase the clearance of it, reducing plasma concentration up to 60%

80
Q

ADRs of OC

A

bleeding irregularities, acne, MI, nausea, weight gain, mood swings, breast tenderness, HA, hirsutism, depression, HTN

81
Q

what does bleeding early vs late mean when someone is taking OC?

A

early- not enough estrogen (inc estrogen)

late (after day 14)- not enough progestin (inc levels)

82
Q

what is acne a sign of when taking OC? what is the fix for it?

A

sign of too much progestin; switch to a higher level pf estrogen and/or select a lower androgenic OC

83
Q

when do you have a higher risk of MI when taking an OC?

A

with estrogen doses > 50 mcg (low risk factor bc most OC only use 30 mcg per day)

84
Q

contraindications to OC (3)

A

1) . breast cancer (or other estrogen/progestin dependent neoplasm)
2) . hepatic tumors or dz
3) . pt at risk for arterial/venous thrombotic disease- estrogen drives the increased clotting factors

85
Q

what are 6 types of people at risk for arterial/venous thrombotic disease?

A

CVD, CAD, DVT/PE, uncontrolled HTN, migraine with aura (progesterone OC is best), and women over 35 yrs old who smoke

86
Q

when breastfeeding, you can used combined OC pills but have to wait __-__ weeks after birth to start

A

6-8

87
Q

what hormone is the preferred one to use in contraceptives when breastfeeding? what are the four suggested contraceptives?

A 
progestin
mini pill (micornor, Nor QD, Ovrette), depo Provera, IUD, Nexplanon
88
Q

what is the combined hormonal transdermal patch?

A

Xulane- ethinyl estrogen and norelgestromin

89
Q

how to use the transdermal patch?

A

place on once a week for 3 weeks and then one week of no patch

90
Q

Missed doses of transdermal patch: what to do if patch is off for less than 24 hrs vs more than 24 hrs

A

less than 24 hrs- reapply, no BUM needed

more than 24 hrs- open a new patch, new day 1, must use BUM for 1 week

91
Q

the transdermal patch is less effective for what pt population?

A

people over 90 kg (198 lbs)

92
Q

NuvaRing: has what type of delivery for systemic effect? how to use? _______ be removed during intercourse

A

topical delivery; inserted by pt and left in for 3 weeks, and removed with one week off; shouldn’t

93
Q

what to do with misses does of NuvaRing: less than or greater than 3 hours

A

less than 3 hrs: reinsert

more than 3 hrs: reinsert and use BUM until ring has been used for a week

94
Q

what are the two main forms of IUD? which one is mostly used?

A 
levonorgestrel coated- mostly used
Copper coated (ParaGard T)
95
Q

how does the levonorgestrel coated IUD prevent pregnancy? (3 things)

A

1) . thickens cervical mucus which inhibits sperm passage/survival
2) . inhibits ovulation dec LH and FSH
3) . thins endometrium, which decreases implantation

96
Q

how does copper IUD prevent pregnancy? (2)

A

1) . inhibits sperm motility preventing fertilization

2) . prevents implantation

97
Q

what is the copper IUD NOT coated with?

A

progesterone

98
Q

indications of use for IUD (3)

A

1) . no hx of PID or ectopic preg
2) . have heavy menses, cramps, anemia, or dysfunctional uterine bleeding
3) . women seeking long term protection (2 yrs or more)

99
Q

what are the three types of levonorgesterel coated IUDs? how long does each last?

A

1) . mirena- lasts 5 yrs
2) . Skyla- 3 yrs (smaller than mirena)
3) . liletta- 4 yrs

100
Q

how long does the copper IUD last? what can it also be used for besides its primary use?

A

10 yrs; emergency contraception

101
Q

once removing an IUD, how long does it take to return to fertility?

A

1-3 months

102
Q

ADRs of IUD

A

PAINS
P: period late; abnormal spotting or bleeding
A: abdominal pain, pain with intercourse
I: infection exposure, abnormal vaginal discharge
N: not feeling well, fever, chills
S: string missing, shorter or longer

103
Q

contraindications of IUDs (6)

A

1) . inc susceptibility to infection (DM, AIDS, valve heart dz)
2) . current pregnancy
3) . pelvic infection, PID in past year
4) . CA/distorted uterine cavity
5) . undiagnosed vaginal bleeding
6) . hx of ectopic preg

104
Q

4 types of EC

A

levonorgestrel, YUZPE, Copper IUD, Ulipristal

105
Q

how do oral EC methods work?

A

primarily by delaying ovulation

106
Q

if patient has already ovulated what is important to remember about EC?

A

it doesn’t stop the implantation

107
Q

what is the only OTC EC? what is the timing of use? what is % efficacy?

A

Plan B- levonorgestrel; 72-120 hrs; 85% efficacy

108
Q

what is the YUZPE EC? how to use? timing of use? % efficacy

A

estrogen plus progesterone, Rx only; 100-120 mcg estrogen AND 500-600 mcg progesterone, give together as two separate doses, 12 hrs apart; timing is up to 120 hrs, 99% efficacy

109
Q

when using the copper IUD for EC, when do you have the insert it? what is % efficacy?

A

inserted within 120 hrs after intercourse; 99%

110
Q

what is the ulipristal/ella timing of use? what is % efficacy? what does this delay?

A

up to 120 hrs, 98% (Rx, single dose); ovulation

111
Q

what is the abortifacient drug?

A

mifepristone/mifeprex

112
Q

what is MOA of mifepristone?

A

binds to intracellular progesterone receptor which blocks effects of progesterone; leads to contraction inducing activity in uterine smooth muscle

113
Q

what is mifepristone given with?

A

misoprostol- stimulates contractions and induces labor

114
Q

abortifacient is used for termination of pregnancy through ___ days of gestation

A

70

115
Q

ADRs of mifepristone (2)

A

vaginal bleeding for 9-16 days, uterine hemorrhage

116
Q

what is the most common reason postmenopausal women seek hormone replacement?

A

vasomotor symptoms (hot flashes)

117
Q

what are two main symptoms related to estrogen deficiency (menopause)?

A

vasomotor (hot flashes) and GU

118
Q

what are some GU problems menopausal women have? (4)

A

1) . Decreased estrogen leads to shrinkage of labia minora and vuvlovaginal atrophy
2) . Loss of lubrication
3) . Vaginal pH becomes more basic – creating favorable environment for bacterial colonization
4) . Thinning of urethra and bladder lining and decreased muscle tone – urinary frequency/urgency & UTI

119
Q

what are the four main menopause tx options?

A

1) . hormone therapy
2) . SSRI’s
3) . prasterone vaginal insert (intrarosa)
4) . Natural products

120
Q

what are the four types of hormone therapy for menopause?

A

1) . estrogen and progesterone (EPT)
2) . estrogen only (ET)
3) . estrogen-receptor agonists or antagonists (SERM)- osphena
4) . estrogen and Bazedoxifene (Duavee)

121
Q

what are the two types of EPT?

A

estrogen plus cyclic progestogen and estrogen plus daily progestogen

122
Q

what are the three types of natural products for menopause tx?

A

1) . soy isoflavones- act similar to estrogen and ADRs
2) . evening primrose oil
3) . black cohosh- some help with hot flashes (but liver toxicity)

123
Q

what is the primary indication of hormone therapy?

A

moderate to severe vasomotor symptoms

124
Q

which population of women should be getting HT?

A

women younger than 60 who are within 10 yrs of menopause onset (not at high risk of CVD or breast CA)

125
Q

what can be used in high risk women where hormone therapy isn’t recommended for vasomotor symptoms?

A

SSRIs- Effexor, Prozac, paxil, zoloft

126
Q

what three drugs can help vasomotor symptoms if the pt cant take estrogen?

A

clonidine, megestrol, and gabapentin

127
Q

when taking hormone therapy, what is important about dose?

A

use lowest effective dose

128
Q

what hormone therapy is recommended for postmenopausal women with moderate-severe vaginal symptoms?

A

local estrogen therapy preferred if no vasomotor symptoms

129
Q

stress incontinence: how does systemic vs local hormone therapy impact it?

A

systemic- may worsen

local- may help

130
Q

hormone therapy is or is not recommended for sole tx of diminished libido?

A

NOT

131
Q

what are the two drugs used for menopausal sexual dysfunction?

A

Osphena and

Intrarosa (vaginal insert)- (both used for moderate to severe dyspareunia)

132
Q

osteoporosis: hormone therapy for __________. estrogen _____ the rate of resorption but ______ restore bone loss

A

prevention; reduces; doesn’t

133
Q

what is a combo product for tx of moderate-severe vasomotor symptoms and osteoporosis prevention?

A

duavee (estrogen and bazedoxifene)

134
Q

therapy duration for hormone replacement

A

check after 3 months- year; try to discontinue if asymptomatic; if symptoms recur try to treat an additional 3 months (optimal tx is for less than 5 years)

135
Q

give only estrogen HRT to pts without a ____________. give _________ _______ for women intolerant of oral products. give _______ ______ in women with no vasomotor symptoms

A

uterus; transdermal patches; topical/vaginal products

136
Q

If pt has a uterus, give low dose _______ AND ________________ to prevent endometrial hyperplasia

A

estrogen and progesterone

137
Q

what is the estrogen plus cyclic progesterone (sequential therapy)?

A

daily estrogen with progesterone added for 10-14 days/month (often bleed at end of cycle)

138
Q

what is the estrogen plus continuous progesterone (continuous therapy)?

A

give both everyday, some bleeding at first but usually tapers off (ie for ppl who don’t want a period)

139
Q

two main risks of estrogen hormone therapy

A

endometrial cancer (10-20 yrs incs risk 8 fold) and breast cancer (risk isnt that large and dec after d/c drug)

140
Q

MOA of danazol

A

weak androgen, suppresses LH and FSH leading to atrophy of endometrial tissue, inhibits LH/FSH surge

141
Q

2 clinical uses for danazol

A

1) . endometriosis

2) . fibrocystic breast disease

142
Q

boxed warnings of danazol

A

thromboembolic events, hepatic effects, androgenic effects on female fetus (be careful in preg/BF)

143
Q

ADRs of danazol (4)

A

weight gain, edema, acne, decreased breast size

144
Q

Unless a pt is having vasomotor symptoms, you aren’t going to use _______ to only treat sexual function or osteoporosis

A

HRT

145
Q

which drug increases the sensitivity of insulin receptors? what menstrual disorder could this help with?

A

metformin; keeps DM in check for pts with POS

146
Q

what diuretic can help with PCOS symptoms? why does this help?

A

spironolactone; it is an ant androgen that can help improve symptoms of hirsutism

147
Q

two potential tx for endometriosis are _________ ________ and ________

A

aromatase inhibitors (affects FSH and LH) amd NSAIDs (anti inflam for pain)

148
Q

SERMS MOA

A

estrogen related compounds that have selective AGONISM or ANTAGONISM for receptors depending on TISSUE TYPE
(used for a variety of things**)

149
Q

what are the 5 SERMS?

A

1) . tamoxifen (nolvadex)
2) . toremifene (fareston)
3) . raloxifene (evista)
4) . osphena
5) . clomiphene (clomid)

150
Q

MOA of tamoxifen/nolvadex

A

binds to estrogen receptors on tumors to inhibit growth (specifically breast tissue)
**negative impact in uterine tissue

151
Q

clinical uses for tamoxifen/nolvadex

A

metastatic breast CA, tx of breast CA after surgery/radiation, prevention of breast CA in high risk pre-menopausal women

152
Q

boxed warning for tamoxifen (nolvadex)

A

increased incidence of uterine and endometrial CAs

153
Q

clinical use of Toremifene/fareston

A

tx of metastatic breast CA in postmenopausal women with estrogen receptor positive tumors

154
Q

boxed warning of toremifene/fareston

A

prolongs QT interval (avoid use with drugs that do/strong CYP3A4 inhibitors)

155
Q

what are the three aromatase inhibitors?

A

anastrazole/arimidex
letrozole/femara
exemestane/aromasin

156
Q

moa of aromatase inhibitors

A

inhibits enzyme which prevents conversion of androgens to estrogen

157
Q

what two things do aromatase inhibitors do to the body?

A

1) . significant;y reduce plasma estrogen levels

2) . increased secretion of FSH from anterior pituitary (induces ovulation with less risk of multiple birth)

158
Q

clinical use of aromatase inhibitors

A

breast cancer in postmenopausal women- not going to feed tumor

159
Q

what is the off label use of letrozole/femara?

A

infertility/ovulation: pulsatile use (used for some days and then removed)

160
Q

MOA for clomiphene/clomid

A

interferes with negative feedback of estrogens on the hypothalamus (causes an increase in GnRH, LH, FSH secretion to stimulate ovulation)

161
Q

two clinical uses of clomiphene/clomid

A

tx of ovulatory dysfunction (for people who want to get pregnant) and PCOS

162
Q

ADRs of clomiphene/clomid (4)

A

multiple pregnancies (10%), reversible skin loss, hot flashes, constipation

Pharm (10 decks)

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