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Reproductive Pharmacology > Contraception > Flashcards

Contraception Flashcards

1
Q

What are the three types of estrogen, in order of potency?

A

Estradiol (ovary)
Estrone (fat?)
Estriole (placenta)

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2
Q

What percent of estrogen is protein bound?

A

70% to SHBG: sex hormone binding globulin

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3
Q

What does estrogen administration do to free androgens? How?

A

Estrogen increases SHBG

More SHBG lowers FREE androgens

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4
Q

What transports progesterone? This also carries what?

A

Transcortin (which also carries cortisol)

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5
Q

How does Estrogen work?

A 
nuclear receptors
ERalpha  (female repro tract, elsewhere(
ERbeta   (prostate and ovary)
HRE 
nucleus
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6
Q

What is the action of Estrogen overview?

A 
HDL up, LDL down
Breast grows
Osteoclast inhibited
Bones grow
Uterus grow
Increase liver action: clotting and bining globulins
Close episeal plates in both seces 
Tumor growth
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7
Q

What is a precursor to adrenal steroids?

A

Progesterone

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8
Q

Where is progesterone made?

A

Ovary, adrenal, testes, placenta

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9
Q

What does progesterone do to breasts?

A

Increase secretory units development

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10
Q

What does progesterone do?

A 
Modulate estrogen actions
Secretory uterus
Thick mucus cervix
Pregnancy maintenance
Increase body temp in luteal phase
Depressant/hypnotic effects possible
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11
Q

What are E/P given for?

A 
Fertility control
Hormone replacement
Uterine bleeding
Luteal phase dysfunction
Ovulation induction
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12
Q

What is given to increase LH/FSH from the hypothalamus? How?

A

Clomiphene
Fulvestrant
by blocking ER receptors in hypothalamus

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13
Q

What are the AEs of Estrogen?

A

Cancer: endometrial, breast, uterus, bone, kidney, testes

Stroke: DVT by increased clotting factors

GI, menstrual disorders, mastalgia, HTN, decreased lactation

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14
Q

What is the AE of DES?

A

Women whose mothers took it while pregnant have higher risk of clear cell carcinoma of vagina

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15
Q

What are the AEs of Progesterone?

A

Breast cancer!
LDL up, HDL down
GI
Menstrual disorder

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16
Q

What are the most effective birth controls? Least effective?

A

Most; IUD and sterilization

Least: barrier and calendar

17
Q

What are the benefits of contraception?

A

No babies
Decrease lifetime risk ovary/endometrial cancer
Decrease free androgens: less acne

18
Q

What causes contraception failure?

A 
Antibiotics! 
Rifampin
Anti-retrovirals
Anticonvulsants
St. John's wort
19
Q

What are estrogen drugs?

A

Ethinyl estradiol

Mestranol

20
Q

What are progesterone drugs?

A

Norgestrel

Levonorgestrel

21
Q

Progestin can lead to what skin problem?

A

acne

22
Q

Estogen does what to breasts?

A

Enlargement

23
Q

What are contraindications to E/P OCP?

A 
Thromboembolic state
CVD
MI
CAD
Hyperlipidemia
Breast cancer
Endometrial cancer
24
Q

How does progestin only pill work?

A

Thickens cervical mucus
Alters endometrium
Only blocks 70% of ovulations

25
Q

What is a good birth control pill for breast feeding or smoking women?

A

Progesterone only! (Norgestrel, levonorgestrel)

26
Q

What is the parch?

A

Combo P/E

27
Q

How long do you take the patch?

A

One new one every week, 3 weeks

One week off

28
Q

What is the patch less effective in?

A

Obesity

29
Q

What is advantageous about the ring?

A

Rapid return to fertility after removal

30
Q

What is injected? How often and how long does it last?

A 
Progesterone only (Medroxyprogesterone)
Every 3 months. 
2 yrs of injections, then another 6-12 months until return to fertlity
31
Q

What is in the implant? how long does it last?

A

Progesterone only.

3 years.

32
Q

What are the two types of IUD? How long do they last?

A

Copper: 15-20 years
Progestin: 5 years

33
Q

How long are spermicides effective?

A

1 hour

34
Q

How long do you leave sponges in vagina?

A

6 hours

35
Q

What are emergency contraceptives, “plan B pills”? What time window is there to take it?

A

Progesterone high dose:
levonorgestrel 2 doses separated by 12 hours

72 hours: sooner the better

36
Q

What drugs are used for termination after 72 hours?

A

Mifeprisone
Onapristone

Within 7 weeks

37
Q

What is the action of mifepristone and onapristone?

A

Progestin receptor antagonists:
Prevent action of progesterone
Inhabitable uterus

Reproductive Pharmacology (11 decks)

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