Female Repro Pharm

Question 1

Estrogens

Answer 1

estradiol, ethinyl estradiol, mestranol

Question 2

Estrogen receptor antagonists

Answer 2

clomiphene

Question 3

aromatase inhibitors

Answer 3

letrozole

Question 4

progestins

Answer 4

progesterone, medroxyprogesterone acetate, norethindrone, levonorgestrel, norgestimate, drospirenon. . . . Please Make A mNuemonic for Lazy National Doctors

Question 5

Progesterone receptor antagonists

Answer 5

mifepristone, ulipristal

Question 6

GnRH receptor agonists

Answer 6

leuprolide

Question 7

Gonadotropins

Answer 7

LH, FSH, hMG, hCG, commonly used for ovulation induction in women with PCOS/hypogonadatropic hypogonadism

Question 8

Estrogen uses

Answer 8

Hormone replacement in menopausal women/ovarian failure/hypogonadism, and contraception. Unless hysterectomy, estrogen should be given with progestin in women with intact uterus to reduce risk of endometrial cancer

Question 9

Estrgoen adverse effects

Answer 9

endometrial CA, breast cancer, postmenopausal uterine bleeding, migraine headaches, cholestasis and gall bladder disease, HTN, thromboembolism, nausea, breast tenderness, peripheral edema

Question 10

Estrogen contraindications

Answer 10

high estrogen neoplams risk, hx of thromboembolic disorder, heavy smokers especially over 35

Question 11

Medroxyprogesterone

Answer 11

androgen receptor agonist, 1 injection provides 3 month contraception

Question 12

norethindrone

Answer 12

androgen receptor agonist, structural similar to test, can cause acne and hirsutism

Question 13

levonorgestrel

Answer 13

androgen receptor agonist, structural similar to test, can cause acne and hirsutism

Question 14

norgestimate

Answer 14

less androgenic progestin, good for pt with PCOS (polycystic ovarian syndrome)

Question 15

drospirenone

Answer 15

antiandrogenic, good for pt with PCOS, may raise serum potassium (derived from spiralactone - aldosterone receptor antagonist)

Question 16

Progestin uses

Answer 16

prevention of endometrial hyperplasia, contraception, amenorrhea due to hormonal deficiency and abnormal uterine bleeding due to hormonal imbalance

Question 17

Hormonal contraceptives

Answer 17

combined estrogen (patch, intravaginal ring, combination oral contraceptives) and progestin or progestin only (“mini-pill”, injection/IM/SubQ, intrauterine device/IUD, subdermal implant)f

Question 18

Combined hormonal contraceptive MOA

Answer 18

inhibit ovulation by suppression of GnRH which supresses LH/FSH, Estrogen also supresses FSH and stabilizes endometrium which brevents bleeding, Progestin suppresses LH and creates thick cervical mucus which restricts sperm passage

Question 19

Progestin only contraceptive MOA

Answer 19

thicken scervical mucus and makes endometrium less favorable for implantation, pt should take pill same time everyday

Question 20

Emergency contraception

Answer 20

Plan B - progestin levonorgestrel, ulipristal (ma inhibit or delay ovulation), Mifepristone (antagonize progesterone receptor, not approved by FDA

Question 21

Clomiphene

Answer 21

antagonist at estrogen receptor to increase secretion of GnRH and estrogens, stimulate ovulation in women with oligomenorrhea and amenorrhea, tx of ovulatory dysfunction in women that want to become pregnany

Question 22

Letrozole

Answer 22

Inhibits aromatase to decrease negative feedback on hypothalamus which increases LH and FSH levels which increases follicle development and ovulation, used with infertility from PCOS and women with breast cancer

Question 23

Leuprolide

Answer 23

GnRH agonist, pulsatile or continuous, acts on anterior pituitary to increase LH/FSH unless continuous then has opposite effect