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