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BAHS-504 PHARMACOLOGY EXAM 2 > CONTRACEPTIVES > Flashcards

CONTRACEPTIVES Flashcards

1
Q

describe the control of gonadal hormone release by the CNS

A

hypothalamus releases GnRH (gonadotropin-releasing hormone) onto pituitary

pituitary releases FSH (follicle stimulating hormone) which stimulates maturation of the ovarian follicles, and LH (luteinizing hormone) which triggers ovulation and the development of the corpus luuteum

ovarian follicles secrete estrogen, whereas the corpus luteum secretes progesterone

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2
Q

how do hormones control menstrual cycle?

A
  • GnRH stimulates FSH/LH release
  • FSH stimulates ovarian follicle development and maturation
  • ovarian follicle produces estrogen in the follicular phase
  • estrogen causes a surge of LH accompanied by FSH at midcycle to trigger ovulation
  • corpus luteum secretes progesterone and estrogen in the luteal phase
  • at the end, progesterone and estrogen levels drop, leading to menstration
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3
Q

name the hormone that, as a mechanism of hormonal contraceptive, inhibits the release of FSH, thus suppressing the development of the ovarian follicle

A

estrogen

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4
Q

name the hormone that, as a mechanism of hormonal contraceptive, inhibits the surge of LH and prevents ovulation

A

progestin

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5
Q

name the hormone that, as a mechanism of hormonal contraceptive, causes production of a thick cervical muscous, rendering the endometrium unsuitable for implantation

A

progestin

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6
Q

estradiol, estriol, and estrone are natural steroids formed from what hormone?

A

estrogen

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7
Q

progesterone is a natural steroid formed from what hormone?

A

progestin

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8
Q

where are estrogen steroid hormones synthesized?

A

ovarian granulosa cells

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9
Q

where are progestin steroid hormones synthesized?

A

corpus luteum

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10
Q

what are the common effects of estrogen and progestin?

A
  1. development of secondary sex characteristics
  2. control of ovulation/menstrual cycle
  3. control of pregnancy
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11
Q

reduced bone resorption, metabolic effect, and pro-coagulatory effects are specific to which steroid hormones?

A

estrogens

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12
Q

regulation of basal body temperature and endometrial/cervical secretions are specific effects of which steroid hormones?

A

progestins

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13
Q

why are synthetic analogues of estrogens and progesterone primarily used in the clinical setting?

A

natural hormones undergo extensive first pass metabolism

synthetic analogues have greater half-life/greater oral potency

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14
Q

ethinyl estradiol and mestranol are synthetic analogues of what steroid hormone?

A

estrogen

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15
Q

medroxyprogesterone and 19-nortestosterone are analogues of which steroid hormone?

A

progestin

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16
Q

define norethindrone and norgestimate and levonorgestrel in terms of androgenic effect

A

norethindrone is a moderate androgenic

norgestimate and levonorgestrel are weak androgenics

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17
Q

GI disturbances, weight gain, migraine headaches, fluid retention, breast tenderness, increased blood clots are adverse effects of which steroid hormone?

A

estrogen

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18
Q

breakthrough bleeding, mild depression and weight gain are adverse effects of which steroid hormone?

A

progestins

19
Q

what social behavior increases the risk of blood clots caused by estrogen?

A

smoking, especially over the age of 35

20
Q

how do estrogen and progestin combined function as a contraceptive?

A

prevent ovulation (negative feedback on FSH and LH)

thickened cervical mucus

endometrial changes to prevent implantation

21
Q

what estrogen/progestin combination pill is characterized as a monophasic pill with fixed E/P ratio days 1-84, with period only 4X per year?

A

seasonale

22
Q

what estrogen/progestin combination pill is characterized by continuous estrogen/progestin administration, with no scheduled menstrual bleeding, but has an increased risk of unrecognized pregnancy?

A

lybrel

23
Q

which contraceptive is given by injection every 28-33d, and made up of estradiol cypionate and medroxyprogesterone acetate

A

lunell

24
Q

50% of women given an injection of Lunell experience withdrawal bleeding that begins ___-___ days after injection

A

20-25d

25
Q

name the contraceptive that is composed of ethinyl estradiol and norelgestromin, and administered as a transdermal patch worn continuously for 7d

A

ortho evra

26
Q

ortho evra is less effective in women weighing over ________ lb

A

198 lb

27
Q

why are contraceptive patches 3x more likely to cause blood clots?

A

transdermal patches contain 60% more estrogen than pills

28
Q

how long is a nuvaring supposed to remain in place?

A

3 weeks, and removed for 1 wk

29
Q

what is the synthetic progestin in yasmin/yax/ocella that can elevate the body’s potassium levels, thus increasing the risk for serious and potentially fatal heart problems?

A

drospirenone

30
Q

what are the mechanisms of action for progesterone (only) therapy?

A

prevention of ovulation, thickening of cervical mucus, and endometrial changes

(97-98% effective)

31
Q

what is the progestin therapy prepared as norethindrone acetate, taken orally continuously every day

A

minipill

32
Q

what progestin therapy, given IM every 3mon, is prepared from medroxyprogesterone acetate?

A

Depo-provera

33
Q

what progestin therapy, administed via implanted uterine device and worn for 5yr, has levonorgestrel as its active ingredient?

A

mirena

34
Q

what progestin therapy, implanted under the arm and worn for 3yr, has etonogestrel as its active ingredient

A

implanon

35
Q

which postcoital contraception is a combined estrogen/progestin?

A

Preven EC

36
Q

which postcoital contraceptive is a progestin (only)?

A

Plan B One-Step

37
Q

name the fertility drug that is an estrogen receptor antagonist that inhibits the negative feedback effects of estrogen on the hypothalamus and anterior pituitary, thus inducing ovulation

A

clomiphene (clomid)

38
Q

name the contragestation drug that is a competitive antagonist of progesterone and glucocorticoid receptors, used for medical abortion of early pregnancy

A

mifepristone (RU-486, mifeprex)

39
Q

definition:

mimic the effects of estrogen in some organs but act as antagonists in others

A

selective estrogen receptor modulators (SERMs)

40
Q

name the prototype SERM that is an estrogen antagonist in breast tissue, inhibiting proliferation of breast cancer

A

tamoxifen (nolvadex)

41
Q

name the prototype SERM that is an estrogen antagonist in breast and uterine, but an agonist in bone;

prevents postmenopausal osteoporosis

reduces the risk of invasive breast cancer in postmenopausal women

A

raloxifene (evista)

42
Q

name the anti-cancer therapy that is an aromatase inhibitor that reduces estrogen production

A

femara (letrozole)

*first line tx for breast cancer with or without positive response to estrogen

43
Q
A

BAHS-504 PHARMACOLOGY EXAM 2 (6 decks)

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