Ch 34 Fertility and Reproduction Flashcards
1
Q
estradiol
A
- natural estrogen
- uses: primary hypogonadism, postmenopausal hormone replacement therapy, oral contraceptives, acne, dysmenorrhea
- AE: breast tenderness, headache, N/V, anorexia, libido changes, HTN
- CI: pregnancy, hepatic disease, hypercalcemia, endometriosis
2
Q
conjugated estrogens (premarin)
A
- natural estrogen
- uses: primary hypogonadism, postmenopausal hormone replacement therapy, oral contraceptives, acne, dysmenorrhea
- AE: breast tenderness, headache, N/V, anorexia, libido changes, HTN
- CI: pregnancy, hepatic disease, hypercalcemia, endometriosis
3
Q
medroxyprogesterone acetate (provera)
A
- ester of progesterone
- use: suppress ovarian function in dysmenorrhea, endometriosis, or uterine bleeding; part of HRT to reduce irregular bleeding and prevent uterine hyperplasia/endometrial cancer
4
Q
norethindrone
A
- progestin only contraceptive
- blunts mid cycle LH surge
- thickens/decreases cervical mucus
- creates thin, atrophic endometrium
- best suited for smokers, older women, and women contraindicated for estrogen
- higher rate spotting, amenorrhea, ectopic pregnancy
- higher failure rates than combination OCP
5
Q
megestrol acetate (megace)
A
- ester of progesterone
- use: suppress ovarian function in dysmenorrhea, endometriosis, or uterine bleeding; part of HRT to reduce irregular bleeding and prevent uterine hyperplasia/endometrial cancer
6
Q
hydroxyprogesterone caproate (makena)
A
- ester of progesterone
- use: suppress ovarian function in dysmenorrhea, endometriosis, or uterine bleeding; part of HRT to reduce irregular bleeding and prevent uterine hyperplasia/endometrial cancer
- long acting weekly IM formulation to decrease risk of preterm delivery
7
Q
progesterone
A
- extensive first pass breakdown and short plasma half life
- use: suppress ovarian function in dysmenorrhea, endometriosis, or uterine bleeding; part of HRT to reduce irregular bleeding and prevent uterine hyperplasia/endometrial cancer
8
Q
clomiphene
A
- treat anovulatory infertility including associate with polycystic ovary disease
- best candidates have had anovulatory disease since puberty and a functional HPO axis
- only 15% successful
- AE: multiple births with risk reduced by lower initial dose
9
Q
raloxifene (evista)
A
- reduce risk of breast cancer in postmenopausal
- prevention of osteoporosis
- antagonizes estrogen on both breast and uterine tissue
- AE: CVA, PE, DVT
10
Q
tamoxifen (nolvadex)
A
- prevent or treat breast CA that have estrogen receptor positive tumors
- estrogen receptor antagonist in breast tissue
- palliative treatment of advanced metastatic disease
- AE: N/V, hot flashes, vaginal bleeding, menstrual irregularity, increase risk endometrial cancer
11
Q
anastrozole (arimidex)
A
- aromatase inhibitor
- reduce circulating estrogen levels
- first line for locally advanced or metastatic breast CA in postmenopausal
- may halt progression of estrogen sensitive breast CA
- AE: hot flash, nausea, headache, vaginal bleeding, back pain
12
Q
letrozole (femara)
A
- aromatase inhibitor
- reduce circulating estrogen levels
- first line for locally advanced or metastatic breast CA in postmenopausal
- may halt progression of estrogen sensitive breast CA
- AE: hot flash, nausea, headache, vaginal bleeding, back pain
13
Q
mifepristone (mifeprex)
A
- progesterone receptor agonist in the presence of progesterone
- used for medical termination of pregnancy through 49 days
- AE: N/V, anorexia, abd pain, fatigue
14
Q
danazol (danocrine)
A
- synthetic steroid that causes decreased estrogen secretion
- uses: heavy menstrual bleeding, endometriosis, fibrocystic breast disease, hereditary angioedema
- AE: hirsutism, acne, clots, hepatotoxicity, menstrual irregularity
- teratogenic
15
Q
testosterone
A
combined with estrogen for HRT if estrogen alone produces endometrial bleeding
