5.2.1 Reproductive Drug Groups

Question 1

What are the different drug groups in reproductive health?

Answer 1

Sex steroid hormones
- Oestrogen
- Progesterone
- Androgens

Inhibitors and antagonists
- Mifepristone
- Finasteride

Mixed agonists/antagonists
- Selective Oestrogen receptor modulators (SERMs)
- Selective progesterone receptor modulators (SPRMs)

Question 2

What are sex steroids derived from?

Answer 2

Cholesterol

Question 3

Where are sex steroids produced?

Answer 3

Ovaries
Testes
Adrenal gland

Question 4

What are some examples of sex steroids?

Answer 4

Oestradiol
Testosterone
Progesterone

Question 5

Where do sex steroids exert their effects?

Answer 5

Nuclear receptors

Lipophilic so can diffuse freely through cell membrane

Causes gene transcription

Question 6

What are the different actions of oestrogen?

Answer 6

Ovarian metaplasia & cancer (side effect)
Endometrial Proliferation
Sodium retention
Thromboembolism (side effect due to increased blood coaguability)
Resorption of bone decreased
Oedema (water retention)
Glucose tolerance impaired
Elevated HDL, lowered LDL
Nausea (side effect)

Ovarian metaplasia and Nausea are side effects not actions

Question 7

What are the side effects of oestrogen?

Answer 7

Nice BOW TIE

Nausea, vomiting

Breast tenderness, hyperplasia & cancer
Ovarian metaplasia & cancer
Water retention

Thromboembolism
Impaired glucose tolerance
Endometrial hyperplasia & cancer

Question 8

What are the actions of progesterone/ progestin?

Answer 8

Pregnancy maintenance
Retention of fluid
BOne mineral density increased
Weight Gain (side effect)
Energy dependent reaction (anabolic)
Secretory endometrium
Temporal (part of brain responsible for mood changes )
Irritatbility (side effect)
Nausea/vomiting (side effect)

GIN are side effects not actions, but close association with actions

Question 9

What are the side effects of progestin?

Answer 9

Weight gain
Fluid retention
Acne
Nausea/vomiting
Irritability Depression, PMS
Lack of concentration

Question 10

What are the actions of testosterone?

Answer 10

Androgenic-male secondary sex characteristics

Anabolic-growth, increased muscle mass etc.

Question 11

What are the side effects of testosterone?

Answer 11

Acne
Voice changes
Increased aggression
Increased body hair/male pattern baldness

Question 12

What are the different types of hormonal contraceptives?

Answer 12

Short acting or long acting reversible contractpion

Question 13

What do hormonal contraceptives do?

Answer 13

Prevent ovulation, fertilisation or implantation

Question 14

What are the different types of hormonal contraceptives?

Answer 14

Combined oestrogen and progestogen- COCP, patch, ring

Progestogen-only Pill (POP)

LARC- Progestogen depot, implant, IUS

Question 15

What are the pharmacokinetics of oestrogen?

Answer 15

• Natural and synthetic oestrogens well absorbed in the GI tract
• Readily absorbed from skin and mucous membranes
• Metabolism – liver
• Excretion – in the urine as glucuronides and sulfate

Question 16

What are the pharmacokinetics of progesterone?

Answer 16

• Injected progesterone is bound to
  albumin with some stored in adipose tissue
• Oral bioavailability low
• Metabolism- liver
• Metabolites excreted in the urine
  conjugated to glucuronic acid