Exam 2: Endocrine Pharmacology pt. 3 Flashcards
Name the preparation types of oral contraceptives
- Combination
- Sequential
- Single Entity type
- Long-Acting progestins
Describe specifically the combination type of oral contraceptives
- contain both estrogen and progestin
- 99% effective
- taken on days 5-25 of menstrual cycle
Describe specifically the Sequential type of oral contraceptives
Contain different amounts of progestin with same amount of estrogen
Describe specifically the Single Entity type of oral contraceptives
- Progestin only (minimills)
- Estrogen alone (morning after)
- DES for rape or incest cases
Describe the Long-actin progestin type of oral contraceptives
IM (DepoProvera)
- abolishes menstrual cycle as long as it is given leading to ovarian and endometrial atrophy
What is the DepoProvera shot?
It is a hormone injection that lasts for 3 months to prevent pregnancy. Contains progesterone but no estrogen. Stops ovaries from releasing eggs.
Describe the mechanisms of action for oral contraceptives
- inhibition of ovulation
- estrogen inhibits FSH secretion and ovulatory stimulation is inhibitied
- Progesterone inhibits release of LH thus follicular growth is inhibited
- Progesterone alters endometrium development
Dental considerations for oral contraceptives
- Mimic effects of pregnancy on the gingiva
- Mild inflammation, hyperemia, spontaneous gingival bleeding
- Loss of tissue bone
- Tenderness and ulceration
- May decrease defense to plaque bacteria resulting in irritation or progression of periodontal disease
Describe the drug interactions between OC and antibiotics
- antibiotics alter normal bacterial flora
- OC are inactive; when drug enters the small intestine, normal flora activate the drug
- May be not enough normal flora in small intestine to “activate” the hormones.
What is the ADA recommendation for the OC and antibiotic drug interaction
- recommend an alternative form of birth control until the start of her next cycle
Which antimicrobials do not affect OC steroid levels in women taking combination OC?
- tetracycline
- doxycycline
- ampicillin
- metronidazole
- fluconazole
- fluoroquinolones
Name the Bone Drug types
- SERMS (selective estrogen receptor modulators)
2. Bisphosphonates
What is the action of SERMS
- Activates estrogen receptors in bone
- Used for prevention of osteoporosis in postmenopausal women
What is the specific brand name of the SERMS drug
raloxifene (Evista)
What is the summary of effects for Evista?
- Anti-resorptive action on bone
- Absence of vaginal bleeding
- Absence of endometrial and breast stimulation
Describe the action of bisphosphonates
- Increases bone mineral density
- Inhibits osteoclastic activity
- Inhibits formation, growth and dissolution of bone hydroxyapatite crystals
bisphosphonates are indicated in what type of patients?
treats osteoporosis in postmenopausal women
Name the oral bisophosphonates (prevention and treatment of osteoporosis)
- Fosamax
- Actonel
- Boniva
Name the IV bisphosphonates that are used for treatment of bone pathologies
- Didronel
- Aredia
- Zometa
- Skelid
Name the IV bisphosphonates used for osteoporosis prevention
Reclast
Common side effects of bisphosphonates
Erosive esophagitis
Headache
GI distress
Osteonecrosis of the Jaw
Most cases of jaw osteonecrosis are in what patients?
Patients undergoing chemotherapy with IV Bisphosphonates used to treat bone pathologies (Aredia, Zometa, and Skelid)
4 therapeutic uses for hormones
Replace
Diagnose
Stimulate
Inhibit
Which hypothalamic releasing hormone is used as a drug?
Gonadotropin - releasing hormone (GnRH)
What is GnRH used for as a drug?
Used for ovulation induction in women with primary hypothalamic amenorrhea
Action of GnRH
- Stimulates the release of pituitary luteinizing hormone and folic stimulating hormone
- Action is at end organs (testes, ovaries) to induce gametognsis and gonadal hormone production
What is ACTH used for?
Used as a diagnostic tool
- to diagnose apparent adrenal dysfunction
What hormone is the most abundant hormone in anterior pituitary?
Growth Hormone
Growth hormone is used to treat what?
Pituitary dwarfism.
- May halt aging process??
TSH is used as what?
A diagostic tool to differentiate between pituitary and primary hypothyroidism
FSH and LH iare only effective when administered how?
IM
What is the action of Human menopausal gonadotropin (HMG)?
induces ovulation in 90% of women
What is the use of HCG?
Detected in pregnancy test (diagnostic use)
This is secreted by fetal placenta as early as day 7
Which two posterior pituitary hormones are similar to each other
Vasopressin and oxytosin
- Oxytosin has slight antidiuretc function.
- High levels of vasopressin can trigger uterine contractions like oxytosin
PTH hormone does what?
Increases plasma calcium
- calcium mobilization from bone to plasma
- calcium reabosrption in renal tubules
What hormone is used in medicine to treat hypercalcemia?
Thyrocalcitonin (calcitonin)
- reverses action of parathyroid hormone
What is the primary action of Vitamin D-3?
promote gut absorption of calcium
- In bone, stimulates osteoclast proliferation and bone resorption
Preparation of Vitamin D?
ergocalciferol (Vitamin D2; calciferol)
