Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Repro Week 2 > Cook > Flashcards

Cook Flashcards

1
Q

What are the therapeutic uses of gonadtropins in fertility?

A

They can be used to treat infertility in anovulatory women or women with hypogonadism.

Women who have not been able to become pregnant with clomiphene (Clomid, Serophene) may be encouraged to try gonadotropins as a next step.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q
A
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What is Menotropin?

A

Menotropin preparations are mixed solutions of FSH and LH isolated from urine that are designed for use in selected women where they stimulate the ovaries to mature follicles, thus making them more fertile. They can also be used in hypogonadal men to stimulate sperm production.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q
A
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

How are menotropins given?

A

They are administered by typically daily injection, intramuscularly or subcutaneously, for about ten days under close supervision to adjust dose and duration of therapy.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Are Menotropins 1:1 in FSH:LH ratios?

A

While earlier menotropin medications contained FSH and LH at a 1:1 ratio, the recognition that it is FSH that is critical for follicle stimulation has led to development of newer preparations that contain a much higher FSH/LH ratio, Fertinex being an example.[4]

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

T or F. Progesterone inhibits uterine contraction

A

T.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What are the pharmacokinetic advantages of synthetic estrogens like ethinyl estradiol and mestranol?

A

These have ethinyl groups (triple bonds) which greatly decrease hepatic metabolism compared to native estrogens which have very poor bioavailability

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q
A
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Why would clomiphene and fulvestrant be useful for infertility in anovulatory women?

A

These are pure antiestrogens, aka they inhibit estrogen action in all tissue so they prevent feedback inhibition of natural estrogens and stimulate release of GnRH which stimulates LH/FSH release leading to ovulation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

The risk for CV events in women taking estrogen is especially high in what population?

A

smokers

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What are the most effective contraceptives?

A

IUDs, progestin implants, and sterilization

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What are the most popular contraceptives?

A

hormonal contraceptives

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What are the least effective contraceptives?

A

Barrier and fertility-based methods (calendar)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Why would combo estrogen/progestin be a good contraceptive?

A

feedback inhibition on the pituitary inhibits gonadotropin release. While there are many different formulations, the estrogen in these pills is typically ethinyl estradiol or mestranol and the progesterone is typically noerthindrone, norgestrel, or levonorgestrel

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

How are most oral contraceptives packaged?

A

21/7 cycle (21 active/7 placebo). Some have less placebo days- these preps may decrease menstrual symptoms (HA, bloating, menstrual pain)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What are some contraindications to combo oral contraceptives?

A

TE disease

cerbral vascular disease

MI or CAD

congenital hyperlipidemia

Known or suspected breast cancer

Endometrial cancer

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What is a ‘minipill’?

A

Low dose of only progestin. Blocks ovulation in only 60-80% of cycles and the presence of progestin impairs pserm transport by thickening the cervical mucus, decreases motility of ova in the fallopian tubes, and impairs the endometrium

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

T or F. Minipills have a slightly higher failure rate than combo pills

A

T.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

What are some non-contraceptive benefits of birth control?

A
  • reduced dysfunctional uterine bleeding and dysmenorrhea
  • Menstrual regularity
  • increased hemoglobin

combo pills raise SHBG and thus decrease free androgens, resultsing in less hirsutism and acne

-Tx of PCOS

20
Q

How are minipills taken?

A

Taken daily and continuous, no placebos. Pills should be taken at the same time each day.

21
Q

Minipills are best for women who are _____

A

breast feeding or 35+ and smoke

Progestin is responsible for the acne and weight gain seen

22
Q

How are transdermal patches given?

A

New patch each week for 3 weeks, then patch-free for one week

Note that transdermal patches deliver both ethinyl estradiol and progestin

23
Q

What are some of the AEs of transdermal patch contraceptives?

A
  • the patch is less effective in women 90+ kg becuase of adipose tissue
  • breakthrough bleeding is more common in the first 2 cycles
  • skin irriation may be a problem
24
Q

How are vaginal contraceptive rings given?

A

Inserted intravaginally by the pt. and left in palce for 3 weeks and take out for 1 week. During those three weeks the ring should not be removed for more than 3 hrs and is not effective until in palce for 7+ days

NOTE: This delivers both ethinyl estradiol and progestin

25
Q

T or F. There is a rapid return to fertility after removal of a vaginal contraceptive ring

A
26
Q

What hormones do injectable contraceptives give?

A

progesterone only- usually medroxyprogesterone. Injected every 3 months

Discontinue after 2 yrs unless no alternative

27
Q

AEs of injectable contraceptives?

A

Amenorrhea common, irregular bleeding can occur

weight gain, HA, and decreased bone density

delayed return to fertility (6-12 months)

28
Q

Implants hormonal contraceptives give what hormone?

A

progesterone only, usually etonogestrel given as a signle rod implanted under the skin in the upper arm

Same AEs as all progestins

29
Q

How long are implanted hormonal contraceptives effective for?

A

3 yrs

30
Q

What are the types of IUD?

A

Copper containing (copper is spermacidal) and progestin releasing (levonorgestrel)

31
Q

T or F. Fertility is quickly restored after using an IUD

A

T. There is a high initial cost, but very low overall cost

32
Q

What are the AEs of an IUD?

A

less blood loss; FDA approved for dysmenorrhea

cooper may cause cramping

progestin may cause irregular bleeding (6-12 mo)

33
Q
A
34
Q

What is the most common spermicide?

A

Nonoxynol-9, a surfactant available in foams, gels, creams, suppositories. NOTE: These are only effective for about 1 hr so reapplication is necessary and they MUST be in contact with the cervix to work

35
Q

What are the potential AEs of spermacides?

A

less effective than others, irriations of vaginal mucosa, toxic shock syndrome

36
Q

What is a ‘sponge’?

A

barrier form of protection containing nonoxynol-9 that is moistned in water and palced over the cervix. This is immediately effective and is effective for up to 24 hrs but must remain in place 6 hrs after intercourse (inferior to diaphragms)

37
Q
A
38
Q
A
39
Q

Emergency contraception is most effective if taken within ____ hrs of intercourse

A

72- Use progetins to delay ovulation

40
Q
A
41
Q

What do PlanB and Preven consist of?

A

two doses of levonorgestrel seperated by 12 hrs (first dose should be within 72 hrs of intercourse)

42
Q

What type of delivery of androgens is most effective/

A

IM

43
Q

What are the AEs of testosterone abuse?

A

lower testosterone levels

decreased libido

decreased spermatogenesis

hepatotoxicity

44
Q

What is Oxandrolone (Oxandrin)?

A

an anabolic steroid that has less conversion to estrogens and less inhibition of testosterone synthesis

45
Q
A
46
Q

What is Cyproterone acetate?

A

Competes with DHT for androgen receptor binding, preventing translocation into the nucleus for tx of acne, baldness, hirsutism, virilizing syndrome, and inhibitng libidio in sexually deviant men

47
Q

Why is nicalutamide better than flutamide?

A

lower hepatic toxicity and once a day administration

48
Q

Notes about Finasteride

A

Should not be touched by pregnant women, absorbed through skin and can cause birth defect in male fetus. Men taking this should not donate blood

Repro Week 2 (14 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions